Download PDF
CC BY-NC-ND 4.0 · J Lab Physicians 2017; 9(02): 084-088
DOI: 10.4103/0974-2727.199625
Original Article

Platelet volume indices as predictive biomarkers for diabetic complications in Type 2 diabetic patients

Archana Buch
Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
,
Supreet Kaur
Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
,
Rahul Nair
Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
,
Ambuj Jain
Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
› Author Affiliations Financial support and sponsorship Nil.
› Further Information
  PDF Download Permissions and Reprints

Abstract

BACKGROUND: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) are the indicators of increased platelet activity and can be considered as potential biomarkers for diabetic complications.

PURPOSE: To study PVI in Type 2 diabetics with and without complications in comparison to nondiabetic patients

MATERIALS AND METHODS: A case–control study was conducted on 300 Type 2 diabetics and 200 nondiabetics. Detailed clinical history regarding duration, hypertension, and complications was taken. PVI was obtained using automated cell counter. Fasting blood glucose, hemoglobin A1c, lipid profile, creatinine were also obtained. Diabetics were further categorized into patients with complications and without complications. Statistical analysis was performed by Statistical Package for the Social Sciences Version 17 (Chicago, IL) Student’s t-test and ANOVA test.

RESULTS: Platelet count was significantly decreased in diabetics (P = 0.005). MPV was significantly increased in diabetic patients with complications as compared to diabetics without complications and nondiabetic group (P < 0.0001). PDW showed statistically significant difference between diabetics with and without complications and nondiabetics (P < 0.0001). However, no statistically significant difference was observed in platelet-large cell ratio (P-LCR) among all the three study groups. We found statistically significant correlation of MPV with diabetic retinopathy (P = 0.000), nephropathy (P = 0.005), and diabetic foot (P = 0.048). PDW was significantly increased in diabetic retinopathy (P = 0.035) and nephropathy (P = 0.007). P-LCR had no statistically significant correlation with diabetic complications.

CONCLUSIONS: MPV and PDW are predictive biomarkers of diabetic vascular complications. They are more significant in microvascular complications than macrovascular complications.

Keywords

Diabetes - mean platelet volume - platelet distribution width and platelet large cell ratio - platelet volume indices


Publication History

Received: 15 February 2016

Accepted: 01 July 2016

Article published online:
19 February 2020

© 2017.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Adeghate E, Schattner P, Dunn E. An update on the etiology and epidemiology of diabetes mellitus. Ann N Y Acad Sci 2006;1084:1-29.
  • 2 Powers AC. Diabetes mellitus. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012. p. 2968-3002.
  • 3 Ostenson CG. The pathophysiology of type 2 diabetes mellitus: An overview. Acta Physiol Scand 2001;171:241-7.
  • 4 Marshall SM, Barth JH. Standardization of HbA1c measurements – A consensus statement. Diabet Med 2000;17:5-6.
  • 5 Ferroni P, Basili S, Falco A, Davì G. Platelet activation in type 2 diabetes mellitus. J Thromb Haemost 2004;2:1282-91.
  • 6 Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002;117:399-404.
  • 7 Aypak C, Türedi O, Bircan MA, Yüce A. Could mean platelet volume among complete blood count parameters be a surrogate marker of metabolic syndrome in pre-pubertal children? Platelets 2014;25:393-8.
  • 8 Li JY, Li Y, Jiang Z, Wang RT, Wang XS. Elevated mean platelet volume is associated with presence of colon cancer. Asian Pac J Cancer Prev 2014;15:10501-4.
  • 9 Li S, Zhu CG, Guo YL, Xu RX, Zhang Y, Sun J, et al. The relationship between the plasma PCSK9 levels and platelet indices in patients with stable coronary artery disease. J Atheroscler Thromb 2015;22:76-84.
  • 10 Zaccardi F, Rocca B, Pitocco D, Tanese L, Rizzi A, Ghirlanda G. Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: A meta-analysis. Diabetes Metab Res Rev 2015;31:402-10.
  • 11 Ergelen M, Uyarel H. Plateletcrit: A novel prognostic marker for acute coronary syndrome. Int J Cardiol 2014;177:161.
  • 12 American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2004;27:5-10.
  • 13 Saurabh S, Sarkar S, Selvaraj K, Kar SS, Kumar SG, Roy G. Effectiveness of foot care education among people with type 2 diabetes in rural Puducherry, India. Indian J Endocrinol Metab 2014;18:106-10.
  • 14 Dindar S, Cinemre H, Sengul E, Annakkaya AN. Mean platelet volume is associated with glycaemic control and retinopathy in patients with type 2 diabetes mellitus. West Indian Med J 2013;62:519-23.
  • 15 Meisinger C, Ruckert I, Stockl D, Thorand B, Peters A, Kowall B, et al. Hematological parameters and prediabetes and diabetes in adults from the general population. J Diabetes Metab 2014;5:335.
  • 16 Ferreiro JL, Gómez-Hospital JA, Angiolillo DJ. Platelet abnormalities in diabetes mellitus. Diab Vasc Dis Res 2010;7:251-9.
  • 17 Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: A systematic review and meta-analysis. J Thromb Haemost 2010;8:148-56.
  • 18 Martyn CN, Matthews DM, Popp-Snijders C, Tucker J, Ewing DJ, Clarke BF. Effects of sorbinil treatment on erythrocytes and platelets of persons with diabetes. Diabetes Care 1986;9:36-9.
  • 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;23:89-94.
  • 20 Shah B, Sha D, Xie D, Mohler ER 3rd, Berger JS. The relationship between diabetes, metabolic syndrome, and platelet activity as measured by mean platelet volume: The National Health and Nutrition Examination Survey, 1999-2004. Diabetes Care 2012;35:1074-8.
  • 21 Ünübol M, Ayhan M, Güney E. The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus. Platelets 2012;23:475-80.
  • 22 Bavbek N, Kargili A, Kaftan O, Karakurt F, Kosar A, Akcay A. Elevated concentrations of soluble adhesion molecules and large platelets in diabetic patients: Are they markers of vascular disease and diabetic nephropathy? Clin Appl Thromb Hemost 2007;13:391-7.
  • 23 Coban E, Bostan F, Ozdogan M. The mean platelet volume in subjects with impaired fasting glucose. Platelets 2006;17:67-9.
  • 24 Kodiatte TA, Manikyam UK, Rao SB, Jagadish TM, Reddy M, Lingaiah HK, et al. Mean platelet volume in Type 2 diabetes mellitus. J Lab Physicians 2012;4:5-9.
  • 25 Duerschmied D, Ahrens I, Mauler M, Brandt C, Weidner S, Bode C, et al. Serotonin Antagonism Improves Platelet Inhibition in Clopidogrel Low-Responders after Coronary Stent Placement: AnIn vitro Pilot Study. Available from: http://www.journals.plos.org/plosone/article?id=10.1371/journal.pone. 0032656. [Last accessed on 2016 Feb 11].
  • 26 Boos CJ, Beevers GD, Lip GY. Assessment of platelet activation indices using the ADVIATM 120 amongst 'high-risk' patients with hypertension. Ann Med 2007;39:72-8.
  • 27 Ravindran R, Krishnan LK. Increased platelet cholesterol and decreased percentage volume of platelets as a secondary risk factor for coronary artery disease. Pathophysiol Haemost Thromb 2007;36:45-51.
  • 28 Boden G. Role of fatty acids in the pathogenesis of insulin resistance and NIDDM. Diabetes 1997;46:3-10.
  • 29 Ates O, Kiki I, Bilen H, Keles M, Kocer I, Kulacoglu DN, et al. Association of mean platelet volume with the degree of retinopathy in patients with diabetes mellitus. Eur J Gen Med 2009;6:99-102.