Perfil de índices plaquetários em pacientes hiperglicêmicos atendidos em um laboratório escola de Fortaleza

Abstract

Diabetes mellitus (DM) is a set of metabolic disorders characterized by persistent hyperglycemia due to dysfunction in insulin production by the pancreas or the cells' response to insulin. Chronic hyperglycemia can result in endothelial damage, leading to a series of complications. The main role of platelets (PLT) is hemostasis against vascular injury, forming a plug at the site of injury. According to the Ministry of Health, changes in PLT morphology and function are considered one of the causes of micro and macrovascular complications in individuals with DM. This study aims to evaluate platelet indices in hyperglycemic patients treated at a school laboratory, as well as their correlation with other laboratory parameters. It is a retrospective observational analytical study conducted at a school laboratory in the municipality of Fortaleza, using secondary data from hyperglycemic patients treated between June 2022 and April 2023. The population consisted of secondary data from laboratory test records performed by the school laboratory during the study period. The sample consisted of 112 eligible records for analysis, in which access to complete blood counts, lipid profiles, and glucose profiles was available from the databases (Esmeralda Visual® Platform) for variable collection. The 112 selected samples were divided into a hyperglycemic group, with fasting glucose ≥126mg/dL and HbA1c ≥6.5%, and a Normoglycemic Group, with fasting glucose <100mg/dL and HbA1c <6.5%, according to the guidelines of the Brazilian Diabetes Society. Out of the 112 samples, 53 patients were hyperglycemic, and 59 individuals were normoglycemic, with a predominance of females in both groups. The mean values of glycated hemoglobin, leukocytes, and neutrophils in hyperglycemic patients were 7.44 ± 1.98%, 7,376 ± 2,302 leuc/mm³, and 4,482 ± 1,821 mm³, respectively. Platelet counts were found to be slightly higher in the hyperglycemic patient group. The RNL and RNL*PLAQ parameters in the hyperglycemic group had average values of 2.31 ± 1.41 and 571.3 ± 369.1, respectively. A difference (p= 0.0114) in the inflammatory biomarker between the low and high glucose tertiles was observed. The positive correlations between the markers HbA1C, PDW, RNL, and RNL*PLAQ with serum glucose levels in hyperglycemic patients indicate the possibility of using these indices as indicators of glycemic control and potential risk markers for diabetes-related complications.