Hematological and Inflammatory Cytokine Profiles in Subjects with Type 2 Diabetes Mellitus in Port Harcourt, Nigeria

Aloy Simeon, Christopher; Gideon Christian, Serekara; Urekweru Ken-Ezihuo, Stella

Volume 18, Issue 3 (8-2026) IJDO 2026, 18(3): 156-167 | Back to browse issues page

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Aloy Simeon C, Gideon Christian S, Urekweru Ken-Ezihuo S. Hematological and Inflammatory Cytokine Profiles in Subjects with Type 2 Diabetes Mellitus in Port Harcourt, Nigeria. IJDO 2026; 18 (3) :156-167
URL: http://ijdo.ssu.ac.ir/article-1-1057-en.html

Hematological and Inflammatory Cytokine Profiles in Subjects with Type 2 Diabetes Mellitus in Port Harcourt, Nigeria

Christopher Aloy Simeon ^*

, Serekara Gideon Christian

, Stella Urekweru Ken-Ezihuo

Department of Hematology and Blood Transfusion Science, Faculty of Medical Laboratory Science, Rivers State University, Port Harcourt, Nigeria.

Abstract: (27 Views)

Objective: Type 2 diabetes mellitus (T2DM) is associated with chronic hyperglycemia and systemic inflammation, which contribute to hematological alterations and vascular complications. This study evaluated hematological indices, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in individuals with T2DM in Port Harcourt, Nigeria, and examined their relationship with glycated hemoglobin (HbA1c).
Materials and Methods: This case-control study involved 70 T2DM patients (HbA1c≥ 6.5%) and 70 age- and sex-matched healthy controls. Fasting blood glucose (FBG) was measured enzymatically, HbA1c by fluorescence immunoassay, complete blood count using an automated hematology analyzer, and cytokines by ELISA. Statistical analysis was performed using GraphPad Prism version 8.0.2, with effect sizes reported and P≤ 0.05 considered significant.
Results: T2DM subjects had significantly higher FBG, HbA1c, WBC, neutrophil percentage, and IL-1β, and significantly lower RBC, lymphocyte percentage, PLT, and PCT (adjusted P< 0.05). IL-1β was more than three-fold higher in diabetics, with a very large effect size. FBG increased significantly with longer disease duration (P= 0.008). HbA1c correlated positively with FBG (P< 0.001) WBC (P= 0.044), MPV (P= 0.006), and PDW (P= 0.015), and negatively with MCV (P= 0.019) and Mixed WBC population (P= 0.001).
Conclusion: This study simultaneously assessed complete blood count parameters alongside IL-1β and TNF-α in the same cohort. The findings demonstrate that T2DM in this population is characterized by clinically meaningful hematological and inflammatory alterations linked to poor glycemic control. Integrating routine complete blood count and selected inflammatory markers into diabetes monitoring may enhance early risk stratification, particularly in resource-limited settings.
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Keywords: Diabetes, Blood cell count, Interleukin-1beta, Inflammation

Type of Study: Research | Subject: Special
Received: 2026/08/22 | Accepted: 2026/08/19 | Published: 2026/08/19

References

1. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2018. Diabetes care. 2018;41(Supplement-1):S13-27. Doi.org/10.2337/dc18-S002.https://diabetesjournals.org/care/article/41/Supplement_1/S13/30088/2-Classification-and-Diagnosis-of-Diabetes [DOI:10.2337/dc18-S002]

2. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes research and clinical practice. 2022;183:109119. [DOI:10.1016/j.diabres.2021.109119]

3. International Diabetes Federation. Diabetes in Nigeria [Internet]. 2021 [cited 2024 Mar 27]. https://idf.org/our-network/regions-and-members/africa/members/nigeria/

4. Skyler JS, Bakris GL, Bonifacio E, Darsow T, Eckel RH, Groop L, et al. Differentiation of diabetes by pathophysiology, natural history, and prognosis. Diabetes. 2017;66(2):241-55. [DOI:10.2337/db16-0806]

5. Piero MN, Nzaro GM, Njagi JM. Diabetes mellitus-a devastating metabolic disorder. Asian Journal of Biomedical and Pharmaceutical Sciences.2014;4(40):1-7. [DOI:10.15272/ajbps.v4i40.645]

6. Akash MS, Rehman K, Liaqat A. Tumor necrosis factor‐alpha: role in development of insulin resistance and pathogenesis of type 2 diabetes mellitus. Journal of cellular biochemistry. 2018;119(1):105-10. [DOI:10.1002/jcb.26174]

7. Pang H, Luo S, Huang G, Xia Y, Xie Z, Zhou Z. Advances in knowledge of candidate genes acting at the beta-cell level in the pathogenesis of T1DM. Frontiers in endocrinology. 2020;11:119. [DOI:10.3389/fendo.2020.00119]

8. Asmah RH, Yeboah G, Asare-Anane H, Antwi-Baffour S, Archampong TN, Brown CA, et al. Relationship between oxidative stress and haematological indices in patients with diabetes in the Ghanaian population. Clinical diabetes and endocrinology. 2015;1(1):7. [DOI:10.1186/s40842-015-0008-2]

9. Kaur R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: molecular insights and therapeutic strategies. Cardiovascular diabetology. 2018;17(1):121. [DOI:10.1186/s12933-018-0763-3]

10. Ogunbusuyi BE, Oyegue KO, Fasoiro O, Adeyanju K, Akpor OB. Haemostatic and Haematological Parameters among Type 2 Diabetes Patients in A Tertiary Health Facility in Ondo State, Nigeria: A Cross-sectional Study. The Open Biomarkers Journal. 2023;13(1):e187531832307120. [DOI:10.2174/18753183-v13-230714-2023-1]

11. Umeji L, Paul A, Felix S, Umeji C, Folake A, Chrisitian O. Haematological profile of diabetes and non-diabetes patients in Abuja, Nigeria. International Journal of Research and Scientific Innovation. 2019;6(5):274-77. [DOI:10.21522/TIJAR.2014.06.02.Art007]

12. Aarushi B, Shankar H, Swati S. Comparative analysis of haematological parameters in diabetics and non diabetics and their correlation with fasting blood sugar levels and glycated haemoglobin.Indian Journal of Pathology: Research and Practice. 2020;9(1):121-6.

13. Rashed E, Alkout T, Eltomy S, Etekbali OR, Alkout AM. The effects of red blood cells parameters on HbA1c and random blood sugar levels in diabetics diagnosis. International Journal of Diabetes and Clinical Research. 2020;7:1-7. [DOI:10.23937/2377-3634/1410128]

14. Osman NA, Mansour MM. Measurement of some haematological parameters in diabetic patient attending military hospsital in Omdurman. Sudan University of Science and Technology Digital Repository. 2013;2013:0-1.

15. Kizilgul M, Sencar E, Ucan B, Beysel S, Ozcelik O, Ozbek M, et al. Components of the complete blood count in type 2 diabetes mellitus with inadequate glycemic control. Dicle Medical Journal. 2018;45(2):113-20. [DOI:10.5798/dicletip.410811]

16. Buch A, Kaur S, Nair R, Jain A. Platelet volume indices as predictive biomarkers for diabetic complications in Type 2 diabetic patients. Journal of laboratory physicians. 2017;9(02):084-8. [DOI:10.4103/0974-2727.199625]

17. Adane T, Asrie F, Getaneh Z, Getawa S. White blood cells and platelet profiles of diabetic patients at University of Gondar specialized referral hospital: A comparative cross‐sectional study. Journal of clinical laboratory Analysis. 2021;35(6):e23808. [DOI:10.1002/jcla.23808]

18. Biadgo B, Melku M, Abebe SM, Abebe M. Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes, metabolic syndrome and obesity: targets and therapy. 2016:91-9. [DOI:10.2147/DMSO.S97563]

19. Rafaqat S, Rafaqat S. Role of hematological parameters in pathogenesis of diabetes mellitus: a review of the literature. World Journal of Hematology. 2023;10(3):25-41. [DOI:10.5315/wjh.v10.i3.25]

20. Cheesbrough M. District laboratory practice in tropical countries, part 2. Cambridge university press; 2005. p. 295. [DOI:10.1017/CBO9780511581304]

21. Yuen VG, McNeill JH. Comparison of the glucose oxidase method for glucose determination by manual assay and automated analyzer. Journal of pharmacological and toxicological methods. 2000;44(3):543-6. [DOI:10.1016/S1056-8719(01)00117-4]

22. Cox KL, Devanarayan V, Kriauciunas A, Manetta J, Montrose C, Sittampalam S. Immunoassay methods. Assay guidance manual [Internet]. 2019. https://www.ncbi.nlm.nih.gov/books/NBK92434/.

23. Arkew M, Asmerom H, Tesfa T, Tsegaye S, Gemechu K, Bete T, et al. Red blood cell parameters and their correlation with glycemic control among type 2 diabetic adult patients in Eastern Ethiopia: a comparative cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2022 :3499-507. [DOI:10.2147/DMSO.S386093]

24. Alamri BN, Bahabri A, Aldereihim AA, Alabduljabbar M, Alsubaie MM, Alnaqeb D, et al. Hyperglycemia effect on red blood cells indices. European Review for Medical & Pharmacological Sciences. 2019;23(5):2139-50.

25. Harish Kumar S, Srinivasa SV, Prabhakar K. Haematological profile of diabetes and non-diabetes patients in rural tertiary centre. International Journal of Advances in Medicine. 2017;4(5):1271-5. [DOI:10.18203/2349-3933.ijam20174111]

26. Antoniadou C, Gavriilidis E, Ritis K, Tsilingiris D. Anemia in diabetes mellitus: Pathogenetic aspects and the value of early erythropoietin therapy. Metabolism Open. 2025;25:100344. [DOI:10.1016/j.metop.2024.100344]

27. Williams A, Bissinger R, Shamaa H, Patel S, Bourne L, Artunc F, et al. Pathophysiology of red blood cell dysfunction in diabetes and its complications. Pathophysiology. 2023;30(3):327-45. [DOI:10.3390/pathophysiology30030026]

28. Keeter WC, Moriarty AK, Galkina EV. Role of neutrophils in type 2 diabetes and associated atherosclerosis. The international journal of biochemistry & cell biology. 2021;141:106098. [DOI:10.1016/j.biocel.2021.106098]

29. Kolay SR, Sinha RP, Dubey NK. Diabetes and the immune system: Understanding the intricate relationship. Research and Reviews: Journal of Dairy Science and Technology. 2024;2(28):10-58532. [DOI:10.58532/nbennurrdch28]

30. Perakakis N, Harb H, Hale BG, Varga Z, Steenblock C, Kanczkowski W, et al. Mechanisms and clinical relevance of the bidirectional relationship of viral infections with metabolic diseases. The Lancet Diabetes & Endocrinology. 2023;11(9):675-93. [DOI:10.1016/S2213-8587(23)00154-7]

31. Ahmed O. Assessment of the differences of hematological variables and their correlation with glycemic control among type 2 diabetes mellitus patients in Iraq: Comparative cross-sectional study. International Journal of Secondary Metabolite. 2024;11(3):435-44. [DOI:10.21448/ijsm.1332875]

32. Kim JH, Bae HY, Kim SY. Clinical marker of platelet hyperreactivity in diabetes mellitus. Diabetes & Metabolism Journal. 2013;37(6):423-8. https://doi.org/10.4093/dmj.2017.41.6.423 [DOI:10.4093/dmj.2013.37.6.423]

33. Hekimsoy Z, Payzin B, Örnek T, Kandoğan G. Mean platelet volume in Type 2 diabetic patients. Journal of Diabetes and its Complications. 2004;18(3):173-6. [DOI:10.1016/S1056-8727(02)00282-9]

34. Sonmez O, Sonmez M. Role of platelets in immune system and inflammation. Porto biomedical journal. 2017;2(6):311-4. [DOI:10.1016/j.pbj.2017.05.005]

35. Demirtas L, Degirmenci H, Akbas EM, Ozcicek A, Timuroglu A, Gurel A, et al. Association of hematological indicies with diabetes, impaired glucose regulation and microvascular complications of diabetes. International journal of clinical and experimental medicine. 2015;8(7):11420.

36. Olana C, Seifu D, Menon MK, Natesan G. Abnormal hematological indices and anthropometric parameters associated with type 2 Diabetes. International Journal of Biomedical Advance Research. 2019;10(11):1-8.

37. Arkew M, Yemane T, Mengistu Y, Gemechu K, Tesfaye G. Hematological parameters of type 2 diabetic adult patients at Debre Berhan Referral Hospital, Northeast Ethiopia: A comparative cross-sectional study. PloS one. 2021;16(6):e0253286.. [DOI:10.1371/journal.pone.0253286]

38. Ebrahim H, Fiseha T, Ebrahim Y, Bisetegn H. Comparison of hematological parameters between type 2 diabetes mellitus patients and healthy controls at Dessie comprehensive specialized hospital, Northeast Ethiopia: Comparative cross-sectional study. Plos one. 2022;17(7):e0272145. [DOI:10.1371/journal.pone.0272145]

39. Zhao G, Dharmadhikari G, Maedler K, Meyer-Hermann M. Possible role of interleukin-1β in type 2 diabetes onset and implications for anti-inflammatory therapy strategies. PLoS computational biology. 2014;10(8):e1003798. [DOI:10.1371/journal.pcbi.1003798]

40. Tong HV, Luu NK, Son HA, Hoan NV, Hung TT, Velavan TP, et al. Adiponectin and pro‐inflammatory cytokines are modulated in Vietnamese patients with type 2 diabetes mellitus. Journal of diabetes investigation. 2017;8(3):295-305. [DOI:10.1111/jdi.12579]

41. Zhang Y, Yu XL, Zha J, Mao LZ, Chai JQ, Liu RT. Therapeutic vaccine against IL-1β improved glucose control in a mouse model of type 2 diabetes. Life sciences. 2018;192:68-74. [DOI:10.1016/j.lfs.2017.11.021]

42. Lanka N, Acharya P, Virani S, Afreen S, Perthiani A, Sangster E, et al. Safety and efficacy of canakinumab for the prevention and control of type 2 diabetes mellitus and its complications: A systematic review. Cureus. 2024;16(8):e67065. [DOI:10.7759/cureus.67065]

43. Battineni G, Sagaro GG, Chintalapudi N, Amenta F, Tomassoni D, Tayebati SK. Impact of obesity-induced inflammation on cardiovascular diseases (CVD). International journal of molecular sciences. 2021;22(9):4798. [DOI:10.3390/ijms22094798]

44. Babandina MM, Mainasara AS, Bakare M, Emeribe AU, Shuwa HA, Haruna S, et al. Evaluation of neutrophil phagocytic, complement functions, and cytokines expression among diabetic patients in Abuja, Nigeria. European Journal of Clinical and Experimental Medicine. 2019;17(3):229-35. [DOI:10.15584/ejcem.2019.3.5]

45. Hare MJ, Shaw JE, Zimmet PZ. Current controversies in the use of haemoglobin A1c. Journal of internal medicine. 2012;271(3):227-36. [DOI:10.1111/j.1365-2796.2012.02513.x]

46. Haider R, Abbas H, Shah SN. Beyond HbA1c: emerging parameters for improved glycemic assessment in diabetes mellitus. Archives of Clinical and Experimental Pathology. 2026;5(1). Doi:10.31579/2834-8508/053

47. Kiziltas O, Fidanci I. Relationship of HbA1c with Mean Platelet Volume and Leucocyte Count in Patients with Type 2 Diabetes Mellitus. Age (median (IQR). 2024;50:10-0.

48. Jiang H, Yan WH, Li CJ, Wang AP, Dou JT, Mu YM. Elevated white blood cell count is associated with higher risk of glucose metabolism disorders in middle-aged and elderly Chinese people. International journal of environmental research and public health. 2014;11(5):5497-509. [DOI:10.3390/ijerph110505497]

49. Cassano V, Armentaro G, Iembo D, Miceli S, Fiorentino TV, Succurro E, et al. Mean platelet volume (MPV) as new marker of diabetic macrovascular complications in patients with different glucose homeostasis: Platelets in cardiovascular risk. Cardiovascular Diabetology. 2024;23(1):89. [DOI:10.1186/s12933-024-02177-3]

50. Renuka P, Bag S. Hemorheological indices and glycated hemoglobin in type 2 diabetes mellitus. Biomedical and Pharmacology Journal. 2020;13(4):1899-902. [DOI:10.13005/bpj/2066]