A new perspective of blood routine test for the prediction and diagnosis of hyperglycemia.

Abstract

Background and aims: The presence of hyperglycemia induces alterations in the blood cell microenvironment. However, further investigations are warranted to comprehend the regulation of physiological parameter changes within the hyperglycemic cohort and validate their correlation. This study aims to investigate the correlation between hyperglycemia and peripheral blood physiological parameters, providing valuable insights for the screening and treatment of hyperglycemia.

Methods: A retrospective study was conducted to analyze the demographic characteristics and blood routine test (blood RT) results of both the normal population and individuals with hyperglycemia. The distribution of abnormal blood RT results was compared between the hyperglycemic groups and the normal group. Univariate and multivariate logistic regression analyses were employed to investigate the correlation between blood RT results and levels of hyperglycemia. In addition, the stored red blood cells (RBCs) were placed in high glucose concentration and low glucose concentration environment, and the changes of physiological parameters of RBCs were observed after 35 days of storage.

Results: The study included a total of 413 participants, with 202 individuals representing the normal population. Among these, there were 95 males (47.03%) and 107 females (52.97%). The hyperglycemia group consisted of individuals with impaired glucose tolerance (IGT) and diabetes mellitus (DM). Out of the total sample, 61 participants with IGT, consisting of 45 males (73.77%) and 16 females (26.23%). Additionally, there were 150 participants with DM, including 107 males (71.33%) and 43 females (28.67%). The prevalence of hyperglycemia showed a significant increase among males aged over 45 years (p < 0.05). The levels of white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) in the hyperglycemia group were significantly higher than those in the normal group (p < 0.05). The distribution of abnormal blood RT results revealed that the DM group had the highest proportion of abnormal WBC, while the IGT group exhibited the highest proportions of abnormal RBC, HGB, and HCT (p < 0.05). Univariate logistic regression analysis showed that WBC (odds ratio [OR], 1.422; 95% CI, 1.249-1.631), RBC (OR, 2.163; 95% CI, 1.449-3.270), HGB (OR, 1.033; 95% CI, 1.020-1.047), HCT (OR, 4.549; 95% CI, 0.569-8.591), MCH (OR, 1.175; 95% CI, 1.057-1.319), MCHC (OR, 1.071; 95% CI, 1.047-1.098) were the predictor indices for hyperglycemia (p < 0.05). Multivariate logistic regression analysis showed that WBC (OR, 1.434; 95% CI, 1.193-1.742) and MCHC (OR, 4.448; 95% CI, 0.084-237.9) were predictor indices for hyperglycemia (p < 0.05). The results of in vitro experiments demonstrated that the high glucose concentration significantly decreased MCV, while concurrently increasing MCHC and coefficient variation of the distribution width of the red blood cell (RDW-CV) (p < 0.05).

Conclusion: The present study revealed significant correlations between hyperglycemia and gender, age, as well as certain peripheral blood physiological parameters. Moreover, in vitro experiments provided further support for these associations. Consequently, peripheral blood physiological parameters can serve as valuable predictor indices for DM and IGT prevention, offering essential insights to enhance preventive strategies.