Şükriye ÖZDE, İlknur ARSLANOĞLU
Northwestern Medical Journal - 2026;6(1):338-348
Aim: Disturbances in hematological indices and micronutrient status are frequently encountered during the routine follow-up of children with type 1 diabetes mellitus (T1DM). In clinical practice, these alterations often parallel poor glycemic control. Therefore, this study was designed to evaluate hematological parameters and micronutrient levels in pediatric patients with T1DM and to investigate their relationship with metabolic control. Materials and Methods: This retrospective analysis included 159 children and adolescents with T1DM followed at the Pediatric Endocrinology Clinic of Düzce University Faculty of Medicine, alongside 160 age- and sex-matched healthy controls. Laboratory data were obtained from medical records and included complete blood count parameters, lipid profile, ferritin, vitamin B??, and vitamin D levels. Glycemic control was classified as "good" for HbA1c <8.5% and "poor" for HbA1c >=8.5%. Statistical analyses were performed using SPSS version 22.0, with p<0.05 considered statistically significant. Results: In the study cohort, children with T1DM exhibited significantly higher mean platelet volume (MPV), white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI). In contrast, platelet count and vitamin B?? levels were significantly lower. Multivariate analysis demonstrated that MPV, hemoglobin, hematocrit, high-density lipoprotein (HDL) cholesterol, vitamin B??, SIRI, and NLR were independently associated with the presence of T1DM. In the ROC analysis, the area under the curve (AUC) for NLR was 0.791 (95% CI: 0.742-0.839), with a sensitivity of 71.1% and a specificity of 72.5% at a cutoff value of 1.46. When patients were stratified according to metabolic control, those with HbA1c >=8.5% were older, had higher glucose levels, and had a higher proportion of females, whereas hematocrit levels were lower. Conclusion: Hematological alterations and inflammatory indices appear to be closely associated with metabolic control in pediatric T1DM. Elevated MPV, SIRI, and NLR values suggest that hyperglycemia, particularly during adolescence, disrupts hematological homeostasis. In this context, the combined evaluation of hematological and inflammatory parameters may be clinically meaningful for identifying the presence of T1DM and delineating the burden of chronic low-grade inflammation. Supported by prospective studies, these findings may help guide individualized treatment strategies.
