Serum erythropoietin in diabetic patients : relationship to hemoglobin levels and autonomic neuropathy

Abstract EN

This study was planned in order to identify if there is an effect of autonomic neuropathy on erythropoietin (EPO) release in response to reduced hemoglobin in diabetic patients without renal affection.

60 subjects were recruited in this study divided into 4 groups matching each other as regard age and gender: 20 diabetic patients chosen with autonomic neuropathy but without renal affection (DM-AU), another 20 noncomplicated diabetics as diabetic control group (DM-C) matching the former as regard duration of diabetes, 20 non-diabetic anemic control group (AC) and 20 healthy control group (HC). Thorough clinical examination -stressing on the special tests of autonomic neuropathy-together with the following investigations were done for everyone: complete blood picture, FBS, 2PP, HbAlc, serum ferritin, TSH, Comb’s test, renal function tests, abdominal ultrasonography and serum EPO. Both the diabetic groups (DM-AU & DM-C) were poorly controlled as regard their mid-term glycemic state with a mean glycated Hb (HbAjc) of 14.17+3.87% and 11.87±3.44%, respectively.

Difference between DM-AU and DM-C groups as regard type of diabetes showed a significant difference (P < 0.01), where 65% vs.

20% were type 1 and 35% vs.

80% were type 2, respectively. Mean Hb level in DM-AU group was significantly lower than DM-C (10.98±1.84 gm/dl with a normocytic normochromic picture vs.

14.46±1.23 gm/dl, respectively, P < 0.05).

AC group showed a mean Hb of 8.30±2.32 gm/dl (range 3.6-12.5 gm/dl) with a microcytic hypochromic picture.

HC group showed mean Hb of 13.38+1.4 gm/dl (range 12-16 gm/dl).

Serum ferritin, TSH and reties were within normal values in both DM-AU and DM-C groups.

Comb’s test was negative in all cases.