ABSTRACT
Background:Diabetes mellitus(DM)affecting almost half a billion people worldwide and India is amongst the top ten countries of adults with diabetes. Metformin, the first-line therapy for diabetes, is associated with vitamin B12 malabsorption and subsequently, the development of vitamin B12 deficiency/insufficiency could manifest severe complications like neuropathy or anemia in the future. This study evaluatedthe effect of metformin on vitamin B12 and RBC indices in the North Indian population.Methods:This study was executed at a tertiary care hospital. 35 T2DM(type 2 DM)participants with ongoing metformin therapy were compared with 27 T2DM participants without metformin therapy. Participants were recruited from outpatient after diagnosis as per American diabetes association(ADA)criteria.Results:Metformin-treated participants had significantly low hemoglobin (t=2.096, df=60, 0.0403) compared to untreated participants. Similarly, MCHC was significantly lower in the metformin group (mean=33.28 gm/dl) compared to non-metformin group (mean=34.53 gm/dl) (t=2.745, df=60, p=0.0080). Moreover, there was a strong negative correlation (r=-0.4613, p=0.0053) among vitamin B12 and MCV in metformin group. There was no statistically significant correlation between vitamin B12 and RBC indices (MCV, MCH, MCHC) in the non-metformin group. Analyzing contingency table (Fisher抯 exact test), we found no major difference (p=0.2002) between two groups of vitamin B12 with an odds ratio of 2.026 (95% CI=0.7366 to 5.633). Unpaired ttest also confirmed insignificancy (t=0.04077, df=60, p=0.9676).Conclusions:Strong negative correlation was observed between vitamin B12 and MCV. Despite the insignificant difference of vitamin B12 between metformin and non-metformin groups, significantly lowMCHC was found in metformin-treated participants.
ABSTRACT
Introduction: Thyroid hormones influence the haematologicalindices under physiological conditions. The exact causeof anemia in thyroid dysfunction is not clearly understood.The aim of this study was to investigate the changes in thehaematological parameters in hypothyroidism, subclinicalhypothyroidism and hyperthyroidism and the mechanismsunderlying it.Material and methods: The study was performed on69 cases of clinical hypothyroidism, 15 cases of clinicalhyperthyroidism, 6 cases of subclinical hypothyroidism and99 healthy individuals selected as the control group. Patientswere grouped as hypothyroid and hyperthyroid based on theTSH measurements (0.3-5.5µIU/mL) by Chemiluminescencemethod. Based on TSH levels (<0.3µIU/mL), patients werecategorized as hyperthyroidism and TSH levels (>5.5µIU/mL) as hypothyroidism. Hemoglobin and complete bloodcount which includes PCV, MCV, MCH, MCHC, RDW wereestimated. The results were analysed by SPSS software.Results: Analysis of the data obtained showed statisticallysignificant difference (p<0.05) in Hb, PCV, RDW betweenthyroid cases and controls. The difference was not significant(p>0.05) for MCV, MCH and MCHC.Conclusion: Thyroid hormones have to be evaluated in casesof refractory anemia not responding to iron supplementation.
ABSTRACT
Alcohol consumption is common problem in Uganda. Among the types of alcohols consumed include beers, spirits, liqueurs, wines and traditional brew. These alcohols are easily accessible and consumed by many people including the HIV infected patients who are on the d4T/3TC/NVP regimen. The aim of this study was to determine the effect of chronic alcohol intake on the red blood cell count (RBC) and the RBC indices in the HIV-infected patients on d4T/3TC/NVP regimen. It was a case control study that used a repeated measures design model where serial measurements of the red blood cell count (RBC) and RBC indices were determined at 3 month interval for 9 months. A total of 41 HIV infected patients were recruited and grouped into two arms; the control group had 21 patients and the chronic alcohol group had 20 patients. The RBC and RBC indices of the whole blood were determined using automated hematological Coulter CBC-5 Hematology Analyzer system using standard procedures. The data was sorted into alcohol-use self reporting by WHO AUDIT tool and alcohol-use biomarkers groups. It was analysed using the SAS 2003 version 9.1 statistical package with the repeated measures fixed model. The means were compared using the student t-test. The mean MCV and MCH values in the chronic alcohol use group were higher than in the control group and there was a significant difference between the 2 groups (p<0.05) for both the WHO AUDIT tool group and chronic alcohol use biomarkers group. The mean RBC count, Hct, HGB and MCHC values in both the control and chronic alcohol use groups were within the normal reference ranges for both groups though the trend was lower in alcohol group. Chronic alcohol use affects the RBC and RBC indices in the HIV infected patients on d4T/3TC/NVP treatment regimen.