The Clinical Characteristics of Anemia in Type 2 Diabetic Patients Without Overt Nephropathy

Ko, Eun Young; Kim, Se In; Jang, Yong Bum; Min, Kyoung Hun; Kim, Sung Hun; Lee, Kyu Sun; Kim, So Ri; Choi, Eun Kyoung; Park, Ji Hyun; Park, Tae Sun; Paek, Hong Sun

Abstract

BACKGROUND: It is well known that anemia occurs early in diabetic patients before they reach to end stage renal failure. This anemia is considered to be due to the reduced endogenous erythropoietin synthesis, tubulointerstitial damage, autonomic dysfunction, and to the use of angiotensin-converting- enzyme inhibitors. Because anemia has a significant impact on the quality of life for diabetic patients, we examined the clinical characteristics of anemia in those diabetic patients who did not have overt nephropathy.
METHODS
We retrospectively reviewed the medical records of 200 type 2 diabetic patients with anemia who had been followed up from 1998 to 2002 by Chonbuk University Medical School Hospital. We measured the total cholesterol, triglycerides, high density lipoprotein, low density lipoprotein, and the presence of complications (retinopathy or neuropathy) for about 90 diabetic patients who were under the age of 65, they were without other underlying disease and they had a hemoglobin concentration 110g/L, GFR 1.0 mL/s. We excluded the causes of anemia as being from malignancy, liver disease, coexisting iron deficiency, chronic inflammatory disease and chronic infection.
RESULTS
The clinical characteristics of the patients are as follows; the mean age was 59.6 +/- 8.4 years, the mean HbA1C was 9.4 +/- 2.3%, and the mean Hb concentration was 96 +/- 12 g/L. Our results showed that an inverse relation existeds between Hb concentration and total cholesterol (p<0.04), LDL cholesterol (p<0.05), age (p<0.02), and the duration of diabetes (p<0.01).Our results also showed that a linear relation existed between the Hb concentration, HDL cholesterol (p<0.02), and the GFR (p<0.01).
CONCLUSION
Diabrtic patients with anemia are in need of intensive management for the lipid and GFR that causes thair anemia.