Role of hematological parameters in pathogenesis of diabetes mellitus: A review of the literature

Table 1 Summary of role of hematological parameters in diabetes mellitus

Ref.	Hematological parameter	Main finding of hematological parameters in diabetes
Alamri et al[8], 2019	RBC count	Hyperglycemia had a significant impact on RBC count and physiological function, which could be efficiently restored with adequate glycemic control
Rashed et al[9], 2020	RBC count	RBC characteristic was an appropriate tool for assessing diabetes patients
Vilahur et al[10], 2018	RBC count	RBCs in T2DM patients need to be monitored
Wang et al[11], 2021	RBC count	Erythrocyte-related indicators could offer more clinical data and could be used to track the development of diabetes and associated complications
Sonmez et al[14], 2010	Hemoglobin	Hemoglobin may restrict the endothelium-mediated vaso-regulation in diabetes
Lee et al[15], 2018	Hemoglobin	High hemoglobin levels were strongly associated with a lower risk of developing diabetic retinopathy
Rossing et al [16], 2004	Hemoglobin	Diabetes increases a person's vulnerability to low hemoglobin levels through diabetic nephropathy and diabetic retinopathy
Ranil et al[17], 2010	Hemoglobin	Diabetes increases a person's vulnerability to low hemoglobin levels through diabetic nephropathy and diabetic retinopathy
Yang et al[18], 2017	Hemoglobin	Lower hemoglobin levels were linked to higher vibratory sensory thresholds and an increase in the prevalence of diabetic peripheral neuropathy
Kwon et al[19], 2012	Hemoglobin	Correlation between low hemoglobin concentration and diabetes profiles
Chen et al[20], 2018	Hemoglobin	Glucose effectiveness, first- and second-phase insulin secretion, and insulin resistance were linked to hemoglobin
Tamariz et al[22], 2008	Hematocrit	Increased blood viscosity and hematocrit as new risk factors for insulin resistance and T2DM
Capoglu et al[23], 2002	Hematocrit	Impaired glucose tolerance and T2DM may both be independent risk factors for high hematocrit levels
Dillon et al[24], 1965	Hematocrit	Individuals with chronic diseases and anemia need to be understood in the context of declining hematocrit
Feng et al[25], 2020	Hematocrit	The hematocrit index had a strong correlation with insulin resistance and inflammation under impaired fasting blood glucose
Natali et al[26], 2005	Hematocrit	Direct adverse influence on nitric oxide availability might also contribute to the association between high hematocrit and cardiovascular disease in addition to blood rheology
Teodorczyk et al[29], 2012	Hematocrit	The blood glucose monitoring system offered precise blood glucose values that were insensitive to hematocrit values between 20% and 60%
Tripathy et al[27], 2022	Hematocrit	HbA1c and hematocrit markers during the first trimester of pregnancy were found to be a more sensitive and specific early screening method for gestational diabetes mellitus
Wu et al[28], 2018	Hematocrit	HbA1c and hematocrit combined for gestational diabetes mellitus screening might be a valuable method to predict gestational diabetes mellitus
Aberle et al[30], 2020	Hematocrit	SGLT2 inhibition with dapagliflozin causes a continued increase in hematocrit concentration
Evan et al[31], 1983	MCV	Elevated MCV and its underlying relationship with clearly elevated plasma osmolarity in patients with diabetic ketoacidosis
Davidson et al[34], 1981	MCV	No correlation exists between the MCV level and the type of diabetes, treatment, or management
Muntoni et al[32], 1986	MCV	The connection between fasting plasma glucose and MCV
Kwenda et al[33], 2019	MCV	MCV was a suitable marker for the diagnosis of diabetic nephropathy in patients with T2DM
Xiong et al[35], 2017	RDW	Higher risk and a less favorable prognosis for diabetic nephropathy were indicated by high levels of RDW in T2DM patients
Renuka et al[40], 2020	MCV, MCH, MCHC, RDW	HbA1c showed a negative connection with MCV, MCH, and MCHC, and a favorable link with RDW
Alamri et al[8], 2019	MCV, MCH, MCHC, RDW	Higher blood sugar levels elevated the number of red blood cells, MCV, MCH, and MCHC. Poor glycemic management had a negative correlation with red blood cell distribution width
Kannan et al[41], 2019	MCV, MCH, MCHC, RDW	Red-cell turnover indices had a major impact on an HbA1c below 7%, and clinicians must conduct additional testing utilizing plasma glucose levels to determine whether a patient had diabetes or pre-diabetes
Jaman et al[39], 2018	MCHC, RDW	RDW and MCHC can be used as supplemental indications of declining glucose control in patients with T2DM
Arkew et al[44], 2022	MCV, MCH, MCHC, RDW	A significant inverse relationship between RBC parameters and glycemic control was found in T2DM
Nada et al[45], 2015	RDW	RDW measurements in diabetic hypertensive individuals following indapamide antihypertensive medication or thiazide and angiotensin receptor blocker therapy were equivalent
Wang et al[36], 2020	RDW	High RDW was linked to a high likelihood of developing diabetes in Chinese individuals
Zhao et al[42], 2022	RDW	The ratio of RDW to albumin was a risk factor for diabetic retinopathy patients
Yin et al[37], 2018	RDW	A lower likelihood of having poor glycemic control was observed in T2DM individuals whose RDW was larger
Bhutto et al[38], 2019	RDW	RDW, a cheap and easily accessible test that could be employed as a measure of glycemic level, had a strong connection with HbA1c
Atalay et al[43], 2018	RDW	RDW and RDW/MCV ratio were discovered to help predict diabetic ketoacidosis and to be linked with diabetic ketoacidosis
Akinsegun et al[46], 2014	Platelet count	Mean platelet volume was lower in cases than in controls while the mean platelet count was higher for diabetes therapy-receiving patients compared to non-diabetic controls
Rodriguez et al[47], 2020	Platelet count	MPV is strongly and consistently associated with diabetes
Sterner et al[48], 1998	Platelet count	Elevated platelet levels were linked to both female gender and early indications of diabetic nephropathy
Jindal et al[49], 2011	Platelet count	Platelet indices in diabetic and non-diabetic patients were significantly different
Lee et al[50], 2017	Platelet count	High blood glucose levels cause neutrophils to release S100 calcium-binding protein A8/A9, which then binds to the Kupffer cells' receptor for advanced glycation end products and increases the liver's synthesis of thrombopoietin
Kheradmand et al[51], 2021	WBC count	Substantial relationship between diabetes and WBC count
Twig et al[52], 2013	WBC count	WBC count among young healthy persons was a separate risk factor for diabetes occurrence
Vozarova et al[53], 2002	WBC count	High WBC indicated a deterioration of insulin action and the onset of type 2 diabetes in Pima Indians
Kuo et al[54], 2020	WBC count	Elevated WBC count was substantially linked with all four diabetes factors (glucose effectiveness, insulin resistance, and first- and second-phase insulin secretion) in Chinese young men
Veronelli et al[55], 2004	WBC count	Significance of weight loss in lowering WBC counts in patients with morbid obesity, impaired glucose tolerance, or T2DM
Park et al[56], 2021	WBC count	WBC count might help to identify non-obese people who were likely to develop T2DM
Andreone et al[57], 2018	Lymphocytes	The function of T-effector lymphocytes in adipose and hepatic tissues throughout diabetes mutually increases pancreatic-cell stress and exacerbates the condition
Giese et al[59], 2021	Lymphocytes	Significant increases in mitochondrial oxygen consumption rate (OCR) and increased basal glycolytic activity, indicate an altered metabolic immune cell profile in peripheral blood mononuclear cells from diabetic INSC94Y trangenic pigs
Wu et al[58], 2020	Lymphocytes	The diabetic group with COVID-19 had a lower lymphocyte count
Otton et al[60], 2002	Lymphocytes	The metabolism of lymphocytes taken from mesenteric lymph nodes of alloxan-induced diabetic rats changed since glucose and glutamine were crucial for lymphocyte function
Huang et al[65], 2016	Neutrophils	Antineutrophil therapy can inhibit or slow the progression of autoimmune diabetes and insulitis
Insuela et al[61], 2019	Neutrophils	Molecular pathways behind the degradation of neutrophil activities in diabetes and their connection to a high vulnerability to bacterial infections
Dowey et al[64], 2021	Neutrophils	Neutrophil targeting as a therapeutic approach reduces inflammation and boosts host immunity in diabetes patients to enhance infection clearance
Yu et al[62], 2020	Neutrophils	Neutrophil-mediated inflammation played a role in the development of diabetic kidney disease
Woo et al[63], 2011	Neutrophils	Neutrophil-mediated inflammation may be a key player in the etiology of DR
Valtierra et al[66], 2020	Monocytes	Effects of monocyte and macrophages on glycemic/metabolic control factors, non-obese participants, or T2DM
Min et al[67], 2012	Monocytes	Monocytes as a marker were affected by diabetes
Mokgalabon et al[68], 2020	Monocytes	Patients with T2DM had higher levels of monocyte activation
Kitahara et al[69], 1980	Monocytes	Increasing blood sugar levels in diabetic patients were linked to the metabolic activation of monocytes
Wan et al[70], 2020	Monocytes	Decreased peripheral blood monocyte levels in diabetes patients were linked to higher risks of diabetic retinopathy
Giulietti et al[71], 2007	Monocytes	Monocyte mediated inflammation was able to be controlled by 1,25-dihydroxyvitamin D in T2DM patients
Neuwirth et al[72], 2012	Eosinophils	Eosinophils may be a component of a complex innate immune cells network that is involved in the onset of diabetes
Ngamal et al[73], 2021	Eosinophils	Higher serum HbA1c levels were associated with a higher risk of developing complications from diabetes
Zhu et al[74], 2013	Eosinophils	Increased percentage of peripheral eosinophils was linked to a lower incidence of T2DM
Fukui et al[75], 2009	Eosinophils	Microalbuminuria (degree of albumin excretion rate) in men with T2DM may be related to allergic diseases
Babazadeh et al[76], 2021	Eosinophils	Relationship between eosinophil counts and HbA1c in patients with diabetes and coronary artery disease
Hussain et al[77], 2017	NLR	NLR can be employed as a disease monitoring technique when diabetes patients were being followed up
Rahar et al[78], 2021	NLR	NLR is a novel, basic, and relatively inexpensive marker that was useful for assessing systemic inflammation in diabetes and had a correlation with the severity of T2DM
Mertoglu et al[79], 2017	NLR	Patients with prediabetes and diabetes exhibited a marked increase in the inflammation marker NLR
Wang et al[81], 2020	NLR	As indicators of the systemic inflammatory response in patients without a linked family history, NLR and PLR were related to the presence of diabetic retinopathy
Li et al[82], 2020	NLR	Greater NLR values were a valid biomarker for the development of diabetic retinopathy
Jaaban et al[83], 2021	NLR	Elevated NLR and PLR were substantially related with diabetic nephropathy
Rahar et al[78], 2021	NLR	NLR was useful for assessing systemic inflammation in diabetes and correlated with the severity of diabetic nephropathy
Sefil et al[80], 2014	NLR	Elevated HbA1c combined with increased NLR observed in T2DM patients suggested that regulation of HbA1c and NLR might be significantly related
He et al[85], 2022	NLR	The presence of T2DM with higher NLR was linked to worse clinical outcomes
Umarani et al[87], 2020	NLR	NLR as an early and predictive marker for microvascular problems in individuals with diabetes mellitus
Wan et al[86], 2020	NLR	Greater NLR level was linked to a higher prevalence of cardiovascular disease and diabetic kidney disease in diabetic adults
Wang et al[88], 2020	NLR	Increased likelihood of clinically significant depression symptoms is independently linked to elevated levels of NLR in diabetics
Liu et al[89], 2020	NLR	NLR was an easier, quicker, and more effective diagnostic for prognosis prediction in T2DM patients with COVID-19
Du et al[90], 2021	PLR	PLR may facilitate the early detection of high-risk patients and offer recommendations for additional measures to prevent cognitive deterioration in T2DM patients
Atak et al[91], 2019	PLR	PLR may help predict the onset and control levels of T2DM
Elsayed et al[92], 2021	PLR	Greater NLR and PLR were linked to diabetes problems
Zeng et al[93], 2022	PLR	PLR might be an independent risk factor for assessing DR in people with T2DM
Jaaban et al[83], 2021	PLR	Increased NLR and PLR could be used as risk indicators for diabetic nephropathy prediction and prognosis
Zhang et al[94], 2021	PLR	PLR may serve as a useful marker for the early detection and evaluation of the severity of diabetic foot ulcer
Alfhili et al[95], 2022	MLR	Elevated MLRs were more likely to occur and associated with impaired fasting glycemia and hyperglycemia
Yue et al[96], 2015	MLR	MLR may be clinically and pathophysiological significant in DR; however, its prediction power was only moderate
Wang et al[97], 2022	MLR	MLR was significantly related to proliferative diabetic retinopathy in patients with T2DM
Wang et al[88], 2020	MLR	Elevated MLR and NLR may be poor predictors of clinical outcomes in patients with gestational diabetes mellitus
Kocak et al[98], 2020	MLR	MLR could act as a predictive and efficient marker for diabetic kidney injury in diabetic people
Alsayyad et al[99], 2019	MLR	In the early and intermediate phases of diabetic nephropathy, MLR may be used as a candidate for an inflammatory marker
Huang et al[100], 2020	MLR	MLR is a potent independent predictor of diabetic nephropathy

RBC: Red blood cell; T2DM: Type 2 diabetes mellitus; RDW: Red blood cell distribution width; MCV: Mean cellular/corpuscular volume; MCH: Mean cellular/corpuscular hemoglobin; MCHC: Mean corpuscular hemoglobin concentration; WBC: White blood cell; NLR: Neutrophil-to-lymphocyte ratio; PLR: Platelet-to-lymphocyte ratio; MLR: Monocyte-to-lymphocyte ratio.