Relationship of hemogram derived inflammatory parameters with frailty scales in patients with diabetes mellitus

Background: Frailty is one of the important problems of the elderly population. The patient's physical and psychological state, sociodemographic characteristics, chronic diseases and their complications affect frailty. Cellular aging and inflammatory processes caused by aging have an important role in the pathophysiology of frailty syndrome. Type 2 diabetes (T2DM) is also a chronic disease that causes inflammation. In this study, frailty according to Tilburg and Frail scales in elderly T2DM patients; we aimed to evaluate its relationship with inflammatory parameters in the hemogram. Material and the Method: We enrolled geritric T2DM patients who applied to Bolu Abant İzzet Baysal University Medical Faculty Hospital Internal Medicine outpatient clinic between June and November 2021 to our study. Sociodemographic characteristics, laboratory parameters and anthropometric measurements of the patients were recorded. Frailities of patients were determined using the Tilburg and Frail frailty scales. Study parameters were compared between fragile and non-fragile groups. Results: In our study,we enrolled 64 patients. Increasing age in geriatric T2DM patients increased frailty according to Tilburg frailty scale (TFS) (p=0.001). Singles were significantly more fragile than married people according to TFS (p=0.007). The presence of diabetic neuropathy was significantly associated with frailty according to TFS (p=0.04). PDW (p=0.03) and PLR (p=0.03) values of hemogram parameters were found to be significantly lower in laboratory tests of patients who were frail compared to TFS. PDW (p=0.007) and MPV (p=0.005) values of frail patients were found to be significantly lower according to the Frail frailty scale (FFS). The MPV values of the patients (r=-0.254, p=0.04) were negatively correlated with the Frail score. There was no significant difference between frail and non-frail patients in other demographic, anthropometric and laboratory measurements according to both scales (p>0.05 for all). PDW showed frailty with 60% sensitivity and 61% specificity under the cut-off value of 11.8; PLR showed frailty with 65% sensitivity and 59% specificity under the cut-off value 145.6 compared to TFS. PDW showed frailty with 65% sensitivity and 67% specificity under the cut-off value of 11.6; MPV showed frailty with 65% sensitivity and 67% specificity under the cut-off value of 10.2 compared to FFS. Conclusion: T2DM and aging are events that trigger inflammation in the body. The degree of inflammation is a determining factor in whether patients are frail or not. In our study, changes in platelet activation played an important role in the pathogenesis of frailty, as PDW and PLR were low in frail according to TFS, PDW and MPV were low in frail compared to FFS, and there was a significant correlation between MPV decrease and the increase in Frail score. The relationship between PDW, MPV and PLR, which are inflammation markers, and frailty scales in our study supports this and reveals that more comprehensive studies are needed on this subject. Keywords: Tilburg, Frail, Type 2 Diabetes Mellitus, Frailty, Hemogram, Inflammation