Influence of Vitamin D status on hematological markers of inflammation in prediabetes

Objectives: Inflammation is the integral pathophysiological component of prediabetes. Hemogram is a routinely performed lab test, cheap and convenient to reproduce; hence hematological indices are useful to monitor the disease process. Vitamin D modulates inflammatory mediators and hence can impact the progression of prediabetes to type 2 diabetes mellitus. The study intends to find the association of hematological indices with glycemic control and vitamin D status in prediabetic subjects. Methods: Retrospective study was done on 270 prediabetic patients based on HbA1c (5.7 - 6.4%) and 299 normoglycemic subjects. Chi square analysis and t test were used to compare hematological indices in two groups. ANOVA used for comparison of variables under three Vitamin D categories, sufficient (>75 nmol/L), insufficient (50-74.9 nmol/L), deficient (<50 nmol). Regression analysis was done to find odds ratio for prediabetes. Results: Vitamin D was lower in prediabetic subjects (57.91 +/- 20.83; p value <0.05). Neutrophil lymphocyte ratio (2.10 +/- 0.85; p value <0.05), platelet lymphocyte ratio (137.70 +/- 43.70; p value <0.05), mean platelet volume (8.55 +/- 3.00; p value <0.001), red cell distribution width (12.65 +/- 1.31; p value 0.05) were higher in prediabetes group. Neutrophil lymphocyte ratio, platelet lymphocyte ratio and red cell distribution width showed statistically significant rising trend with declining vitamin D level in prediabetic subjects. Mean platelet volume was significant predictor of prediabetes. Conclusions: Neutrophil lymphocyte ratio, platelet lymphocyte ratio and red cell distribution width and mean platelet volume are novel inflammatory markers to monitor prediabetic patients but should be considered along with Vitamin D status.