ICJIM
Intercontinental Journal of Internal Medicine

The Intercontinental Journal of Internal Medicine aims to publish issues related to all fields of internal medicine of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Original Article
Assessment of systemic inflammatory and immune biomarkers and alterations in calcium and parathyroid hormone in hemodialysis patients with type 2 diabetes mellitus
Abstract
Aims: Chronic systemic inflammation and mineral metabolism disturbances are prevalent in hemodialysis patients. The presence of Type 2 Diabetes Mellitus (T2DM) may further exacerbate inflammatory burden and disrupt calcium-parathyroid hormone (Ca-PTH) homeostasis. This study aimed to assess systemic and immune-inflammatory indices together with Ca-PTH levels in hemodialysis patients with T2DM.
Methods: This retrospective multicenter study included 211 maintenance hemodialysis patients, including 97 with T2DM and 114 without diabetes. Inflammatory and immune-related indices, including the PIV, SIRI, SII, NLR, PLR, LMR, NMR, MPVLR, MHR, SII/albumin ratio, and CRP/albumin ratio were evaluated together with hematological parameters, biochemical markers, and mineral metabolism parameters.
Results: Hemodialysis patients with T2DM demonstrated notably elevated concentrations of SIRI, PIV, MHR, IMA, and monocytes compared to their non-diabetic counterparts (p<0.05). ROC analysis showed modest discriminatory performance for SIRI (AUC=0.586) and PIV (AUC=0.583), with PIV demonstrating 71% sensitivity at a cut-off value of 25.28. In contrast, serum calcium and PTH levels were significantly lower in the T2DM, with calcium emerging as the strongest negative predictor. SIRI and PIV were positively associated with leukocyte-related inflammatory markers, whereas calcium and PTH correlated with hemoglobin, hematocrit, albumin, and phosphorus.
Conclusion: T2DM in hemodialysis patients is marked by intensified systemic inflammatory burden and suppression of the Ca-PTH axis. Reduced calcium and PTH levels may reflect disturbances in mineral metabolism and a predisposition to adynamic bone disease. These findings underscore the value of integrating inflammatory indices with Ca–PTH parameters to better elucidate diabetes-associated inflammatory burden and mineral metabolism disturbances in hemodialysis patients.

Keywords : Diabetes, hemodialysis, systemic inflammatory and immune indices, PTH, calcium, mineral metabolism

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Article available in :
Volume 4, Issue 2, 2026
Page : 28-33
https://doi.org/10.51271/ICJIM-0072
Article Information
Received : 15 Mar 2026
Accepted : 20 Nis 2026
Published : 26 May 2026
Corresponding Author :

Funda Bulut Arıkan: Department of Physiology, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkiye

[email protected]
Citation : Bulut Arıkan F, Öztürk H. Assessment of systemic inflammatory and immune biomarkers and alterations in calcium and parathyroid hormone in hemodialysis patients with type 2 diabetes mellitus. Intercont J Int Med. 2026;4(2):28-33. doi:10.51271/ICJIM-0072

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