Introduction of new formulas and evaluation of the previous red blood cell indices and formulas in the differentiation between beta thalassemia trait and iron deficiency anemia in the Makkah region.

BACKGROUND: Many formulas from red blood cell (RCB) indices are instructed to differentiate between iron deficiency anemia (IDA) and beta thalassemia trait. None had 100% Youden index. AIM OF THE WORK: To introduce two new formulas and evaluate them in the differentiation between IDA and beta thalassemia trait in adults Saudi (male and female; male; female) in the Makkah region. Furthermore, to evaluate the previous formulas in our population. METHODS: A total of 249 participants, 91 with IDA, 123 with beta thalassemia trait, and 35 healthy persons. All subjected to complete blood count, measurement of iron profile, hemoglobin electrophoresis and hemoglobin A2 by column chromatography. The first new formula equal hemoglobin (Hb) + hematocrit (Hct) + RBC and second equals Hb + Hct + RBC-red cell distribution (RDW). The previous formula used is England and Fraser, Mentzer, Strivastava, Ehsani, Green and King, red cell distribution index, Ricerca, and Shine and Lal Results: In both men and women, the England and Fraser was the best with a Youden's index of 70.4%, followed by Green and King 67.4%. In men, the England and Fraser and our new formula 1 had the highest Youden' index 84.7% and 84.1%, respectively. In women, the England and Fraser and RDW index had the highest Youden' index 74% and 69.2%, respectively. CONCLUSION: The England and Fraser and our new formula 1 are the best formulas in men. The England and Fraser and RDW index are the best formulas in women.

Soluble endothelial protein C receptor and high sensitivity C reactive protein levels as markers of endothelial dysfunction in patients with type 1 and type 2 diabetes mellitus: their role in the prediction of vascular complications.

BACKGROUND AND OBJECTIVE: Endothelial dysfunction in diabetes mellitus (DM) is an important factor in the pathogenesis of micro and macrovascular complications. We aimed to measure soluble endothelial protein C receptor (sEPCR) and high sensitivity C reactive protein (hsCRP) levels as markers of endothelial damage in both types of diabetes mellitus and to determine if they can be used as predictors of vascular complications. METHODS: Fifty patients with DM, 20 with type 1 and 30 with type 2 as well as 30 healthy subjects were included. All were subjected to measurement of sEPCR and hsCRP by enzyme linked immunosorbent assay. RESULTS: sEPCR and hsCRP were significantly increased when compared to the control group in both types of DM. sEPCR was a significant predictor of macrovascular complications and thrombosis in type 1 p=0.02, and p=0.015, respectively. hsCRP was a significant predictor of macrovascular complications in type 2 p=0.04. CONCLUSION: Patients with type 1 and type 2 DM exhibit higher sEPCR and hsCRP levels compared to healthy controls which suggesting endothelial damage. sEPCR could be used as a predictor of macrovascular complications and thrombosis in type 1 DM, whereas, hsCRP might be used as a predictor of macrovascular complications in type 2 DM.