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Microscopy (Oxf). 2019 Mar 12. pii: dfz011. doi: 10.1093/jmicro/dfz011. [Epub ahead of print]

Altered erythrocyte morphology in Mexican adults with prediabetes and type 2 diabetes mellitus evaluated by scanning electron microscope.

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School of Medicine, Autonomous University of San Luis Potosí (Universidad Autónoma de San Luis Potosí), Avenida Venustiano Carranza 2405, Los Filtros, 78210, San Luis Potosí, S.L.P, Mexico.
Laboratory of Nanobiotechnology, Faculty of Medicine, Autonomous University of Guerrero (Universidad Autónoma de Guerrero), Acapulco, Guerrero, Mexico.
Faculty of Nursing and Nutrition, Autonomous University of San Luis Potosí (Universidad Autónoma de San Luis Potosí), Av. Niño Artillero 130. Zona Universitaria, 78240, San Luis Potosí, S.L.P, México.
Coordination for Innovation and Application of Science and Technology (CIACyT), Avenida Sierra Leona 550, Lomas 2ª sección, 78210, San Luis Potosí, S.L.P, México.
Faculty of Sciences, Autonomous University of San Luis Potosí (Universidad Autónoma de San Luis Potosí), Lateral Av. Salvador Nava, Lomas, 78290, San Luis Potosí, S.L.P, México.
National Institute of Public Health (Instituto Nacional de Salud Pública), Av. Universidad No.655 Col Sta. Ma. Ahuacatitlán. Cuernavaca, Morelos, México.



To evaluate the erythrocyte morphology in people with prediabetes, T2DM and healthy subjects in a Mexican population and its association with biochemical parameters.


Cross-sectional study consisted of three groups: healthy (HG), people with prediabetes (PG) and with T2DM (DMG). A blood sample was obtained from all participants to assess the erythrocyte morphology, and levels of HbA1c, glucose and lipid profile. Anthropometrical parameters were also evaluated.


It was observed that compared with healthy individuals, people with prediabetes presented a significant decrease in the diameter (-0.08 μm, P = 0.014) and height (-0.07 μm, P = 0.004), as well as people with T2DM (-0.33 μm, P < 0.001 in diameter; and -0.36 μm, P < 0.001 in height). Besides, it was found a significant difference in diameter (-0.25 μm, P < 0.001) and height (-0.29 μm, P < 0.001) between the PG and DMG. No significant differences in the axial ratio between groups. Also, HbA1c, glucose, triglycerides, cholesterol, LDL cholesterol, systolic blood pressure, weight, BMI, waist and hip circumference were significantly associated with diameter and height.


Erythrocyte morphological alterations can serve as an indicator of early diagnosis of T2DM and a factor implicated in the course of the clinical condition, so the correction of these alterations could serve as a treatment for prediabetes and T2DM. It is essential to promote constantly checkups of biochemical and anthropometrical parameters, as well as erythrocyte morphological alterations to prevent the onset of prediabetes and T2DM and possible clinical complications.


erythrocytes; morphology; prediabetes; scanning electron microscopy; type 2 diabetes mellitus


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