Relationship between Mean Platelet Volume and Critical Limb Ischemia in Diabetes Mellitus Patients

Muhammad Berian Rachmanadi; Muhamad Taufik Ismail; Vita Yanti Anggraeni

doi:10.1055/s-0041-1726468

International Journal of Angiology, Table of Contents

Int J Angiol 2021; 30(04): 257-261
DOI: 10.1055/s-0041-1726468

Original Article

Relationship between Mean Platelet Volume and Critical Limb Ischemia in Diabetes Mellitus Patients

Muhammad Berian Rachmanadi

¹Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

,

Muhamad Taufik Ismail

²Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia

,

Vita Yanti Anggraeni

²Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Dr. Sardjito Hospital, Yogyakarta, Indonesia

› Author Affiliations

Abstract

The prevalence of diabetes mellitus continues to increase from year to year. Critical limb ischemia (CLI) is one of the complications of diabetes mellitus with a high mortality rate and requires amputation if not treated properly. Mean platelet volume (MPV) is an indicator of platelet activation and is expected to be a predictor of CLI in diabetes mellitus patients.

This article investigates the relationship between MPV and the incidence of CLI in diabetes mellitus patients.

This case–control study was conducted using the vascular registry of Dr. Sardjito Hospital, Yogyakarta, Indonesia, from January 2016 to December 2016. The relationship between MPV and the incidence of CLI was analyzed using bivariate and multivariate analysis.

There was a significant association between MPV and incidence of CLI in diabetes mellitus patient both on bivariate analysis (p = 0.035) and multivariate analysis (p = 0.029). Diabetes mellitus patients with MPV values of ≥ 9.8 fl had a protective effect to prevent the incidence of CLI (bivariate analysis: odds ratio [OR] = 0.366, 95% confidence interval [CI] = 0.142–0.943; multivariate analysis: adjusted OR = 0.288, 95% CI = 0.09–0.88). Confounding factors such as sex, age, obesity, and use of antiplatelet agents were not associated with the incidence of CLI (p > 0.05). Meanwhile, history of dyslipidemia as a confounding factor was significantly associated with the incidence of CLI (p < 0.05).

Low MPV was found to be significantly associated with the incidence of CLI in diabetes mellitus patients.

Keywords

diabetes mellitus - critical limb ischemia - mean platelet volume - case–control

Full Text

References

References
1 IDF. IDF Diabetes Atlas. 7th ed.. 2015.
2 Heart.org. About Peripheral Artery Disease (PAD). American Heart Association. 2016 . Accessed February 4, 2017 at: http://www.heart.org/HEARTORG/Conditions/VascularHealth/PeripheralArteryDisease/About-Peripheral-Artery-Disease-PAD_UCM_301301_Article.jsp#.WMwLKTt97Dc.
3 Varu VN, Hogg ME, Kibbe MR. Critical limb ischemia. J Vasc Surg 2010; 51 (01) 230-241
4 Bowers BL, Valentine RJ, Myers SI, Chervu A, Clagett GP. The natural history of patients with claudication with toe pressures of 40 mm Hg or less. J Vasc Surg 1993; 18 (03) 506-511
5 Criqui MH, Denenberg JO, Langer RD, Fronek A. The epidemiology of peripheral arterial disease: importance of identifying the population at risk. Vasc Med 1997; 2 (03) 221-226
6 Dormandy JA, Murray GD. Reprinted article “The fate of the claudicant--a prospective study of 1969 claudicants”. Eur J Vasc Endovasc Surg 2011; 42 (Suppl. 01) S4-S6
7 Dormandy JA, Thomas P. What is the natural history of a critically ischemic patient with and without his leg?. In: Greenhalgh R, Jamieson C, Nicolaides A. eds. Limb Salvage and Amputation for Vascular Disease. London: WB Saunders; 1988: 11-26
8 Hirsch AT, Haskal ZJ, Hertzer NR. et al; American Association for Vascular Surgery, Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, ACC/AHA Task Force on Practice Guidelines Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease, American Association of Cardiovascular and Pulmonary Rehabilitation, National Heart, Lung, and Blood Institute, Society for Vascular Nursing, TransAtlantic Inter-Society Consensus, Vascular Disease Foundation. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 2006; 113 (11) e463-e654
9 Burger H, Maricek C. Disability and rehabilitation: return to work after lower limb amputation. Disabil Rehabil 2007; 29 (17) 1323-1329
10 Teraa M, Conte MS, Moll FL, Verhaar MC. Critical limb ischemia: current trends and future directions. J Am Heart Assoc 2016; 5 (02) 9
11 Chu SG, Becker RC, Berger PB. et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost 2010; 8 (01) 148-156
12 Lilly LS. ed. Pathophysiology of Heart Disease. 5th ed.. Philadelphia: Lippincott Williams & Wilkins; 2011
13 Rief P, Raggam RB, Avian A. et al. Low mean platelet volume is associated with critical limb ischemia in peripheral arterial occlusive disease. Sci Rep 2018; 8 (01) 6718
14 Ranjith MP, DivyaRaj R, Mathew D, George B, Krishnan MN. Mean platelet volume and cardiovascular outcomes in acute myocardial infarction. Heart Asia 2016; 8 (01) 16-20
15 Degerli V, Ergin I, Duran FY, Ustuner MA, Duran O. Could mean platelet volume be a reliable indicator for acute mesenteric ischemia diagnosis? A case-control study. BioMed Res Int 2016; 2016: 9810280
16 Arican Ozluk O, Ber I, Peker T. et al. Mean platelet volume levels in the presence of angiographically documented peripheral artery disease. Int J Clin Exp Med 2015; 8 (02) 2899-2904
17 Suades R, Padró T, Vilahur G, Badimon L. Circulating and platelet-derived microparticles in human blood enhance thrombosis on atherosclerotic plaques. Thromb Haemost 2012; 108 (06) 1208-1219
18 Li S, Wei J, Zhang C. et al. Cell-derived microparticles in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Cell Physiol Biochem 2016; 39 (06) 2439-2450
19 Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications 2009; 23 (02) 89-94
20 Ferroni P, Basili S, Davi G. Platelet activation, inflammatory mediators and hypercholesterolemia. Curr Vasc Pharmacol 2003; 1 (02) 157-169
21 Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation?. Curr Pharm Des 2011; 17 (01) 47-58