Serial values of hematologic variables and deep venous thrombosis: Red cell distribution width is associated with deep venous thrombosis

Abstract Introduction As 30 to 50% of deep venous thrombosis (DVT) cases remain idiopathic, an increased focus on hematologic variables may therefore reveal novel correlates of DVT. Very few studies have investigated the association of hematological parameters with DVT and the causal relationship between them is still to be elucidated. Therefore, we aimed to investigate the association between serial values of hematologic variables and DVT. Methods Complete blood count parameters were serially measured at baseline and then at approximately 3-month intervals for 12 months in 152 adults with the first episode of DVT and 152 age- and sex-matched controls. The odds ratio (OR) with the 95% confidence interval (95%CI) was calculated as a measure of association between hematological parameters and DVT. Results The red cell distribution width (RDW) was the only hematologic variable which showed an independent and consistent association with DVT at all time points (multivariable-adjusted OR [95%CI] 3.38 [1.28 - 8.91] at baseline, 2.24 [0.85 - 5.92] at 3 months and 2.12 [0.81 - 5.55] at 12 months for RDW > 14.0%). This association was higher for provoked DVT than unprovoked DVT and for DVT plus pulmonary embolism than DVT alone. No significant correlation was found between the high RDW and classical thrombotic risk factors, except malignancy. Conclusions We demonstrated an independent and consistent association of the high RDW with the first episode of DVT in adult patients. The study was probably underpowered to evaluate the association between the high RDW and recurrent DVT. Further large studies with long follow-up are needed to confirm this association.

Potential risk factors for peripheral neuropathy in patients with type 2 diabetes mellitus: a case control study from central Rajasthan

Background: Peripheral neuropathy is one of the most common and debilitating but preventable complications of diabetes mellitus, with significant morbidity as it often leads to foot ulceration and amputation. Therefore, this study was aimed to identify the potential risk factors for diabetic peripheral neuropathy (DPN) which can affect its progression.Methods: This case-control study was conducted on 240 patients with type 2 diabetes mellitus which included 120 patients with clinical evidence of DPN as cases and 120 patients without clinical evidence of DPN as controls. DPN was assessed clinically by neuropathic symptoms and neurological examination using 10 g 5.07 Semmes朩einstein monofilament and vibration digital biothesiometer. Data regarding presence of potential risk factors were collected from all participants and analyzed using logistic regression analysis to measure an association with DPN.Results: A significant and independent association of advancing age, longer duration of diabetes, hyperglycemia, poor glycemic control, autonomic neuropathy and retinopathy with DPN (p<0.05) was observed. Hypertension, dyslipidemia, smoking, gender, body mass index, method of diabetes control and angiotensin converting enzyme inhibitor usage were not found be associated with DPN.Conclusions: Since hyperglycemia and poor glycemic control were only modifiable risk factors for DPN, intensive glycemic control and primary prevention are the cornerstones for reducing the incidence or slowing the progression of neuropathy and improving quality of life in diabetic patients.