Complete blood counts with red blood cell determinants associate with reduced beta-cell function in seroconverted Swedish TEDDY children.

To investigate whether changes in complete blood count (CBC) in islet autoantibody positive children with increased genetic risk for type 1 diabetes are associated with oral glucose tolerance tests (OGTT) and HbA1c over time. The Environmental Determinants of Diabetes in the Young (TEDDY) study follows children with increased risk for type 1 diabetes in the United States, Germany, Sweden and Finland. In the current study, 89 Swedish TEDDY children (median age 8.8 years) positive for one or multiple islet autoantibodies were followed up to 5 (median 2.3) years for CBC, OGTT and HbA1c. A statistical mixed effect model was used to investigate the association between CBC and OGTT or HbA1c. HbA1c over time increased by the number of autoantibodies (p < .001). Reduction in mean corpuscular haemoglobin (MCH) and mean cell volume (MCV) was both associated with an increase in HbA1c (p < .001). A reduction in red blood cell (RBC) counts (p = .003), haemoglobin (p = .002) and haematocrit (p = .006) levels was associated with increased fasting glucose. Increased red blood cells, haemoglobin, haematocrit and MCH but decreased levels of red blood cell distribution widths (RDW) were all associated with increased fasting insulin. The decrease in RBC indices with increasing HbA1c and the decrease in RBC and its parameters with increasing fasting glucose in seroconverted children may reflect an insidious deterioration in glucose metabolism associated with islet beta‐cell autoimmunity. Islet beta cell autoantibody positive children with increased risk for developing type 1 diabetes have reduced red blood cell counts and parameters associated with impaired glucose metabolism.

研究1型糖尿病遗传风险增加的胰岛自身抗体阳性儿童的全血细胞计数（CBC）变化是否随时间与口服葡萄糖耐量试验（OGTT）和糖化血红蛋白（HbA1c）相关。 青少年糖尿病环境决定因素（TEDDY）研究对美国、德国、瑞典和芬兰1型糖尿病风险增加的儿童进行了跟踪。在当前研究中，对89名一种或多种胰岛自身抗体阳性的瑞典TEDDY儿童（中位年龄8.8岁）进行了长达5年（中位2.3年）的CBC、OGTT和HbA1c随访。采用统计混合效应模型研究CBC与OGTT或HbA1c之间的关联。 随着时间推移，糖化血红蛋白（HbA1c）随自身抗体数量增加而升高（p <.001）。平均红细胞血红蛋白量（MCH）和平均红细胞体积（MCV）的降低均与糖化血红蛋白（HbA1c）升高相关（p <.001）。红细胞（RBC）计数（p =.003）、血红蛋白（p =.002）和血细胞比容（p =.006）水平的降低与空腹血糖升高相关。红细胞、血红蛋白、血细胞比容和平均红细胞血红蛋白量增加，但红细胞分布宽度（RDW）水平降低均与空腹胰岛素升高相关。 在血清转化儿童中，红细胞指数随糖化血红蛋白（HbA1c）升高而降低，红细胞及其参数随空腹血糖升高而降低，可能反映了与胰岛β细胞自身免疫相关的糖代谢隐匿性恶化。 发生1型糖尿病风险增加的胰岛β细胞自身抗体阳性儿童红细胞计数及与糖代谢受损相关的参数降低。