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20 Jyothi et al. | Journal of Clinical and Translational Research 2024; 10(1): 18-24
IL, USA). Neutrophil–lymphocyte ratio (NLR) was calculated by Table 1. Demographic, anthropometry, biochemical and hematological
dividing the number of neutrophils by lymphocytes. parameters in diabetic and non-diabetic subjects
Considering a 15% difference in serum retinol levels between Parameters (unit) Type 2 diabetic Non‑diabetic P
cases and controls, the sample size calculated was 85 in each arm subjects subjects
with an alpha error of 0.05 and 90% power of the study [13]. Age (years) 43 (37, 59) 43 (36, 59) 0.959
The data were analyzed using SPSS version 25.0. All data were T2DM duration (years) 3 (2, 5) - -
tested for normality using the Kolmogorov–Smirnov test. Most of BMI (kg/m²) 25.4 (22.8, 27.9) 25.3 (22.2, 26.7) 0.285
the data were not normally distributed, so the data are expressed Waist circumference (cm)
as median with interquartile range (IQR) values. The difference Male (N=48,49) 90.5 (87.0, 95.0) 86.0 (83.0, 94.0) 0.088
between the two groups was assessed with Mann–Whitney U-test Female (N=37,36) 82.0 (78.0, 88.5) 83.0 (73.0, 92.0) 0.808
(2-tailed). A P-value of less than 0.05 was considered statistically Waist-hip ratio
significant. Male 0.96 (0.92, 0.99) 0.94 (0.91, 0.98) 0.358

3. Results Female 0.89 (0.85, 0.90) 0.90 (0.83, 0.93) 0.526
Systolic BP (mm/Hg) 120 (114, 130) 120 (110, 130) 0.111
The participants were selected after screening 335 patients. Diastolic BP (mm/Hg) 80 (70, 83) 80 (70, 81) 0.252
They were selected on the basis of their glycated hemoglobin HbA1c (%) 8.1 (7.15,9.65) 5.1 (4.8, 5.4) <0.001
levels; 85 treatment-naive T2DM and 85 normal healthy FPG (mg/dL) 165.0 (138.5, 221.0) 96.0 (90.0, 101.5) <0.001
individuals were recruited in the study (Figure 1). A total of 165 Serum retinol (μg/dL) 31.4 (27.8, 41.5) 32.53 (26.0, 40.5) 0.863
subjects were excluded due to one or more exclusion criteria. WBC (10 /μL) 8.3 (7.0, 9.7) 7.4 (6.8, 8.7) 0.014
3
The demographic and general clinical characteristics of T2DM RBC (10 /μL)
6
and control are expressed as median with IQR values in Table 1. Male 5.3 (4.8, 5.6) 5.2 (4.8, 5.5) 0.613
There was no significant difference in median values of BMI, WC, Female 4.7 (4.4, 5.1) 4.5 (4.2, 4.8) 0.066
WHR, systolic and diastolic blood pressure (SBP and DBP), serum Hb (g/dL)
retinol, RBC, Hb, HCT, MCV, MCH, MCHC, PLT, RDW-CV, Male 14.1 (12.7, 15.1) 13.5 (13.1, 15.1) 0.920
PDW, MPV, P-LCR, PCT, neutrophils, lymphocytes, eosinophils, Female 12.4 (10.9, 13.2) 11.9 (10.9, 12.7) 0.357
and NLR between T2DM and control subjects. However, there
were a significant increase in median values of HbA1c, FPG, and HCT (%)
WBC and a significant decrease in median values of monocytes in Male 44.8 (41.0, 47.3) 44.2 (41.6, 46.8) 0.843
subjects with T2DM as compared to controls (Table 1). Female 40.3 (36.1, 41.8) 38.7 (35.8, 41.7) 0.508
In T2DM patients, the eosinophil count was significantly MCV (fL) 85.1 (80, 89.4) 87.2 (81.5, 90.2) 0.315
negatively correlated with FPG (Table 2). In controls (non- MCH (pg) 27.0 (24.4, 28.4) 27.2 (25.1, 28.5) 0.448
diabetic subjects), there was a significant positive correlation MCHC (g/dL) 31.1 (30.3, 32) 31.1 (30.2, 32.0) 0.745
between serum retinol, RBC, Hb, HCT, MCV, MCH, MCHC, Platelet count (10≥/μL) 277.0 (229.5, 326.5) 280.0 (235.0, 327.5) 0.959
and HbA1c (Table 2). A significant negative correlation between RDW-CV (%) 14.0 (13.2, 15.1) 14.3 (13.5, 15.1) 0.277
RDW-CV and HbA1c was also observed in controls (Table 2). PDW (fL) 13.35 (11.3, 16.5) 13.85 (10.93, 17.45) 0.735
Further, in subjects with non-diabetes, WBC count was negatively MPV (fL) 11.0 (9.8, 12.3) 11.25 (10.15, 12.50) 0.267
correlated with FPG (Table 2). The T2DM group had a significant P-LCR (%) 33.9 (23.8, 43.1) 35.4 (25.4, 45.2) 0.256
negative correlation between eosinophil count and FBG. In both PCT (%) 0.31 (0.25, 0.37) 0.32 (0.27, 0.36) 0.548
groups, there was a significant positive correlation between FPG Neutrophils (%) 62.6 (56.5, 69.5) 62.5 (56.8, 66.4) 0.252
and HbA1c (not shown in the Table 2). Lymphocytes (%) 28.9 (23.0, 36.1) 29.9 (26.6, 35.2) 0.255
4. Discussion Monocytes (%) 2.2 (1.3, 3.0) 2.6 (1.6, 3.5) 0.034
Eosinophils (%) 3.5 (1.6, 6.3) 2.9 (2.1, 5.2) 0.888
In this case–control study, we found no statistically significant Basophils (%) 0.3 (0.2, 0.5) 0.4 (0.3, 0.5) 0.079
difference in serum retinol levels between T2DM and non- NLR ratio 2.2 (1.6, 2.9) 2.1 (1.6, 2.5) 0.193
diabetic individuals, and the serum retinol levels of both groups Data are given as median and IQR (Interquartile range).
remained within normal limits. This finding was consistent with Abbreviations: BMI: Body mass index; FPG: Fasting blood glucose; Hb: Hemoglobin;
other studies where normal serum retinol level was observed in HbA1c: Glycated hemoglobin; HCT: Hematocrit; MCH: Mean corpuscular hemoglobin;
MCHC: Mean corpuscular hemoglobin concentration; MCV: Mean corpuscular volume;
T2DM patients [13-15]. Despite the report of lower serum retinol MPV: Mean platelet volume; NLR, Neutrophil/lymphocyte ratio; PCT: Plateletcrit;
levels in diabetic individuals than in healthy controls [16], the PDW: Platelet distribution width; P-LCR: Platelet larger cell ratio; RBC: Red blood cell;
liver retinol levels were found to be higher in diabetic animal RDW-CV: Red cell distribution width–coefficient of variation; T2DM: Type 2 diabetes
mellitus; WBC: White blood cell
model, suggesting that the liver inhibits retinol mobilization in
people with diabetes. There is no difference in serum retinol levels range in individuals with adequate liver vitamin A stores [17]. In
between subjects with T2DM and non-diabetes, probably because this study, however, there was a significant positive correlation
serum retinol levels are typically maintained within a narrow between serum retinol level and HbA1c in healthy controls,
DOI: https://doi.org/10.36922/jctr.00194