Abstract
Aim The aim of the study was to assess markers of anemia in type 1 diabetes (T1D) children, compare them to results obtained in the control group, and estimate their relation to BMI SDS. Methods 94 (59% ♀) T1D children without other autoimmune disorders, aged 12.5 ± 4.1 years, T1D duration: 4.2 ± 3.6 years, HbA1c 7.3 ± 1.5% (57 ± 12.6 mmol/mol). Sex- and age-matched controls (43 children). In all children, anthropometric measurements, the blood count, iron turnover parameters, and vitamin B12 concentration were taken. Results T1DM children had significantly higher red cell distribution width (RDW) (13.6 versus 12.6%; p < 0.001), hepcidin (0.25 versus 0.12 ng/ml; p < 0.001), and vitamin B12 concentrations (459 versus 397 pg/ml; p < 0.01) and lower TIBC (59.09 versus 68.15 μmol/l; p < 0.001) than in the control group. Logistic regression revealed that RDW, TIBC (both p < 0.001), and hepcidin (p < 0.05) significantly differentiated both groups. In T1DM children, BMI SDS negatively correlated with vitamin B12 (p < 0.01) concentration and mean corpuscular hemoglobin concentration (p < 0.05) and positively with TIBC (p < 0.01) and HbA1c (p < 0.001). Conclusions Patients and controls differed especially in terms of RDW and TIBC. In studied T1DM children, BMI SDS was associated to iron metabolism parameters and vitamin B12 concentration.
Highlights
Type 1 diabetes (T1D), because of the rising incidence, remains a challenge for diabetologists as well as for pediatricians and general practitioners, who more and more often face the challenge to take optimal care for young patients with this disease [1, 2]
Despite that both studied groups differed in terms of the red cell distribution width (RDW), which was significantly higher in children with T1D (13.6 (95% Cl 13.3, 13.8) versus 12.6 (95% Cl 12.4, 12.9) p < 0 001) (Table 1)
Despite results remaining within normal ranges, we revealed statistically significant differences in terms of RDW, total iron-binding capacity (TIBC), and hepcidin in comparison to the control subjects, which partially confirms the initial research hypothesis
Summary
Type 1 diabetes (T1D), because of the rising incidence, remains a challenge for diabetologists as well as for pediatricians and general practitioners, who more and more often face the challenge to take optimal care for young patients with this disease [1, 2]. In order to diagnose this condition, it is enough to perform a simple blood count and to search for its causes; besides the standard assessment of the iron serum concentration, it is worth to broaden the diagnostics by the assessment of the parameters of iron metabolism. The interpretation of such results is not easy. Adequate interpretation of the HbA1c measurement, Journal of Diabetes Research that is routinely performed during diabetes control visits, requires to know the patient’s serum iron concentration, because the presence of iron deficiency anemia correlates with higher HbA1c values [7].
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