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Oxygen affinity of haemoglobin and red cell 2,3-diphosphoglycerate in childhood diabetes
Insights
Diabetic children show higher red blood cell 2,3-diphosphoglycerate (2,3-DPG) and inorganic phosphate levels. Despite increased 2,3-DPG, oxygen affinity remains unchanged due to elevated hemoglobin Alc, suggesting a compensatory mechanism in juvenile diabetes.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Biochemistry
Background:
- Type 1 diabetes mellitus is a chronic condition affecting children.
- Red blood cell metabolism and oxygen transport are crucial for overall health.
- Alterations in 2,3-diphosphoglycerate (2,3-DPG) levels can impact oxygen delivery.
Purpose of the Study:
- To investigate red cell 2,3-diphosphoglycerate (2,3-DPG) and oxygen haemoglobin dissociation curve (ODC) in diabetic children.
- To explore the relationship between 2,3-DPG, hemoglobin concentration, and plasma phosphate levels in juvenile diabetics.
- To identify factors influencing oxygen affinity in the red blood cells of diabetic children.
Main Methods:
- Determined 2,3-DPG levels and ODC parameters in 32 diabetic and 49 healthy children.
- Measured hemoglobin concentration, plasma glucose, and inorganic phosphate (Pi).
- Analyzed correlations between 2,3-DPG, Pi, hemoglobin concentration, and ODC parameters (P50).
Main Results:
- Diabetic children had significantly higher erythrocyte 2,3-DPG and plasma inorganic phosphate (Pi) compared to controls.
- A negative correlation was observed between 2,3-DPG and hemoglobin concentration in both groups.
- Despite increased 2,3-DPG, the average P50 (oxygen partial pressure at 50% saturation) did not increase in diabetics, suggesting a compensatory mechanism.
- Increased mean corpuscular hemoglobin concentration correlated with factors preventing decreased oxygen affinity.
Conclusions:
- Juvenile diabetics exhibit elevated red cell 2,3-DPG and plasma Pi.
- Increased hemoglobin Alc, a fraction with high oxygen affinity, may counteract the expected decrease in oxygen affinity caused by higher 2,3-DPG.
- These findings suggest a complex interplay of factors affecting oxygen transport in diabetic children.
Abstract:
Red cell 2,3-diphosphoglycerate (2,3-DPG) and the oxygen haemoglobin dissociation curve (ODC) were determined in 32 ambulatory, non-acidotic diabetic children and in 49 healthy children. Despite the fact that the diabetic children had, on average, an increased haemoglobin concentration, their erythrocytes contained significantly more 2,3-DPG than normal. Both in diabetic and in healthy children a negative relationship was found between the content of 2,3-DPG and the haemoglobin concentrations. No relationship was present between the plasma glucose and the 2,3-DPG concentration. The concentration of plasma inorganic phosphate (Pi) in the diabetic children was significantly higher than in the control children, and for all children there was a significant relationship between the 2,3-DPG and the Pi. In the diabetics 2,3-DPG was positively correlated to the P50 (7.40) and to the P50 (in vivo ph) of the ODC. However, despite the significant increase in 2,3-DPG among the diabetic children the average P50 (7.40) and P50 (in vivo pH) was not increased as compared with the control children. The inhibitory factor preventing the oxygen affinity from decreasing among the diabetics was strongly correlated to an increase in the mean corpuscular haemoglobin concentration. The result of this study suggests the presence of an increased amount of haemoglobin fraction with high oxygen affinity (haemoglobin Alc) in the red cells of juvenile diabetics.