Exp Clin Endocrinol Diabetes 2016; 124(09): 548-556
DOI: 10.1055/s-0042-108187
Article
© Georg Thieme Verlag KG Stuttgart · New York

Diagnosis of Diabetes Mellitus by Extraction of Morphological Features of Red Blood Cells Using an Artificial Neural Network

Vinupritha Palanisamy
1   SRM, Biomedical Engineering, Chennai, India
,
Anburajan Mariamichael
1   SRM, Biomedical Engineering, Chennai, India
› Author Affiliations
Further Information

Publication History

received 07 November 2015
first decision 06 May 2016

accepted 09 May 2016

Publication Date:
29 June 2016 (online)

Abstract

Background and Aim: Diabetes mellitus is a metabolic disorder characterized by varying hyperglycemias either due to insufficient secretion of insulin by the pancreas or improper utilization of glucose. The study was aimed to investigate the association of morphological features of erythrocytes among normal and diabetic subjects and its gender-based changes and thereby to develop a computer aided tool to diagnose diabetes using features extracted from RBC.

Materials and Methods: The study involved 138 normal and 144 diabetic subjects. The blood was drawn from the subjects and the blood smear prepared was digitized using Zeiss fluorescent microscope. The digitized images were pre-processed and texture segmentation was performed to extract the various morphological features. The Pearson correlation test was performed and subsequently, classification of subjects as normal and diabetes was carried out by a neural network classifier based on the features that demonstrated significance at the level of P<0.05.

Result: The proposed system demonstrated an overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 93.3, 93.71, 92.8, 93.1 and 93.5% respectively.

Conclusion: The morphological features exhibited a statistically significant difference (P<0.01) between the normal and diabetic cells, suggesting that it could be helpful in the diagnosis of Diabetes mellitus using a computer aided system.

 
  • References

  • 1 Roglic G, Unwin N, Bennett PH et al. The burden of mortality attributable to diabetes: realistic estimates for the year 2000. Diabetes Care 2005; 28: 2130-2135
  • 2 Danaei G, Finucane MM, Lu Y et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet 2011; 378: 31-40
  • 3 Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 2006; 3: e442
  • 4 King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 1998; 21: 1414-1431
  • 5 Mehta SR, Kashyap AS, Das S. Diabetes mellitus in India: the modern scourge. MJAFI 2009; 65: 50-54
  • 6 Davey G, Ramachandran A, Snehalatha C et al. Familial aggregation of central obesity in Southern Indians. International Journal of Obesity 2000; 24: 1523-1527
  • 7 Saladin K. Anatomy and Physiology: The unity of form and function. NY: McGraw-Hill; 2007. 4th chap. 18 680-696
  • 8 Babu N, Singh M. Influence of hyperglycemia on aggregation, deformability and shape parameters of erythrocytes. Clin Hemorheol Microcirc 2004; 31: 273-280
  • 9 Manjunatha M, Singh M. Digital analysis of induced erythrocyte shape changes in hypercholesterolemia under in vitro conditions. Current science 2000; 79: 1588-1591
  • 10 Kanakaraj P, Singh M. Influence of hypercholesterolemia on morphological and rheological characteristics of erythrocytes. Atherosclerosis 1989; 76: 209-218
  • 11 Bessis M. Red-cell shapes. An illustrated classification and its rationale. Nouv Rev Fr Hematol 1972; 12: 721-745
  • 12 Marchesi VT. The red cell membrane skeleton: Recent progress. Blood 1983; 61: 1-11
  • 13 Lowe GDO, Boca R. Clinical Blood Rheology. FL, USA: CRC Press; 1988
  • 14 Chien S, Dormandy J, Ernst E et al. Clinical Hemorheology. 1987 M. Nijhoff Boston
  • 15 Stoltz JF, Singh M, Riha P. Hemorheology in Practice. ISO press; 1999
  • 16 De Keijzer MH, van der Meer W. Automated counting of nucleated red blood cells in blood samples of newborns. Clin Lab Haematol 2002; 24: 343-345
  • 17 Domino EF, Sharp RR, Lipper S et al. NMR chemistry analysis of red blood cell constituents in normal subjects and lithium-treated psychiatric patients. Biol Psychiatry 1985; 20: 1277-1283
  • 18 Sveta K, Petra K, Jens V et al. Gene expression analysis of human red blood cells. Int J Med Sci 2009; 6: 156-159
  • 19 Muthuramakrishnan M, Chandan C, Ranjan RP et al. Hybrid segmentation, characterization and classification of basal cell nuclei from histo pathological images of normal oral mucosa and oral submucous fibrosis. Expert Systems with Applications 2012; 39: 1062-1077
  • 20 Gordon SA, Lominadze D, Saari JT et al. Impaired deformability of copper-deficient neutrophils. Exp Biol Med (Maywood) 2005; 230: 543-548
  • 21 Edison M, Jeeva JB, Singh M. Digital analysis of changes by Plasmodium vivax malaria in erythrocytes. Indian J Exp Biol 2011; 49: 11-15
  • 22 Narayanan B. Influence of cholesterol on shape parameters of erythrocytes in hyperglycemic subjects. Turk J Hematol 2009; 26: 77-81
  • 23 Wheeless LL, Robinson RD, Lapets OP et al. Classification of red blood cells as normal, sickle, or other abnormal, using a single image analysis feature. Cytometry 1994; 17: 159-166
  • 24 Trinder P. Determination of blood glucose using an oxidase-peroxidase system with a non-carcinogenic chromogen. J Clin Pathol 1969; 22: 158-161
  • 25 Yuvraj V, Indumathi J, Singh M. Effects of cigarette smoking on morphology and aggregation of erythrocytes. Clin Hemorheol Microcirc 2012; 51: 169-175
  • 26 Bry L, Chen PC, Sacks DB. Effects of haemoglobin variants and chemically modified derivatives on assays for glycol haemoglobin. Clin Chem 2001; 47: 153-163
  • 27 Nathan DM, Kuenen J, Borg R et al. Translating the A1C assay into estimated average glucose values. Diabetes Care 2008; 31: 1473-1478
  • 28 Singh M, Shin S. Changes in erythrocyte aggregation and deformability in diabetes mellitus: a brief review. Indian J Exp Biol 2009; 47: 7-15
  • 29 American Diabetes Association . Standards of medical care in diabetes-2011. Diabetes Care 2011; 34 (Suppl. 01) S11-S61
  • 30 Mohan V, Vijayachandrika V, Gokulakrishnan K et al. A1C cut points to define various glucose intolerance groups in Asian Indians. Diabetes Care 2010; 33: 515-519
  • 31 Alexandratou E, Yova D, Cokkinos DV. Morphometric characteristics of red blood cells as diagnostic factors for coronary artery disease. Clin Hemo-rheol Microcirc 1999; 21: 383-388
  • 32 Sapthagirivasan V, Anburajan M. Diagnosis of osteoporosis by extraction of trabecular features from hip radiographs using support vector machine: an investigation panorama with DXA. Comput Biol Med 2013; 43: 1910-1919
  • 33 Renuka Devi R, Rajagopal V, Senthilkumar M et al. Computerized shape analysis of erythrocytes and their formed aggregates in patients infected with P.Vivax malaria. Advanced Computing: An International Journal 2011; 2: 2