The prognostic value of red blood cell characteristics on diabetic retinopathy development and progression in type 2 diabetes mellitus

Article type: Research Article

Authors: Blaslov, Kristina^{a; b; *} | Kruljac, Ivan^{a; b} | Mirošević, Gorana^a | Gaćina, Petar^{c; d} | Kolonić, Slobodanka Ostojić^{e; b} | Vrkljan, Milan^{a; b}

Affiliations: [a] Department of Endocrinology, Diabetology and Metabolic Diseases “Mladen Sekso”, University Hospital Centre “Sestre Milosrdnice”, Zagreb, Croatia | [b] School of Medicine, University of Zagreb, Zagreb, Croatia | [c] Department of Haematology, University Hospital Centre “Sestre Milosrdnice”, Zagreb, Croatia | [d] School of Dental Medicine, University of Zagreb, Zagreb, Croatia | [e] Department of Haematology, University Hospital Merkur, Zagreb, Croatia

Correspondence: [*] Corresponding author: Kristina Blaslov, MD, PhD, Department of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sestre Milosrdnice”, Vinogradska cesta 29, HR- 10000 Zagreb, Croatia. Tel.: +385 13787127; Fax: +385 13787177; E-mail: [email protected].

Abstract: BACKGROUNDAlthough it is considered that the pathogenesis of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) is primarily due to chronic hyperglycemia resulting in vascular changes and retinal ischemia, the red blood cells (RBCs) disorders might also represent an important pathophysiological risk factor. OBJECTIVETo evaluate whether the RBC properties contribute to DR development and progression in T2DM. METHODSThis prospective observational study comprised 247 persons with T2DM free of DR or with non proliferative DR without any signs of anaemia. The patients were reacessed after 60-months. RESULTSThe mean age of our study population was 56 years, 54.9% males with diabetes duration of 11,18±1,28 years. During the follow up, 16 (5.84%) participants developed non proliferative DR and 9 (3.64%) progressed to PDR while the mean corpuscular volume (MCV) and red cell distribution width (RDW) MCV rose. Both MCV and RDW correlated positively with HbA1c (r = 0,468, p = 0.003 and r = 0.521, p < 0.001), while Cox regression analysis revealed that besides age, diabetes duration, HbA1c, hypertension and dyslipidemia presence, MCV and RDW are also associated with the risk of DR development and progression (HR 1.057 and 1.237, p < 0.001). CONCLUSIONSWe clearly demonstrated that RBC’s characteristics might represent a risk factor for DR development and progression.

Keywords: Diabetic retinopathy, red blood cells, mean corpuscular volume, red cell volume distribution width

DOI: 10.3233/CH-180422

Journal: Clinical Hemorheology and Microcirculation, vol. 71, no. 4, pp. 475-481, 2019