Platelet volume indices: markers of carotid atherosclerosis in type 2 diabetes mellitus?
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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 platelet activity and may have a role in subclinical atherosclerosis and microvascular complications in type 2 diabetes mellitus (T2DM). We evaluated PVI in diabetics for their association with carotid intima media thickness (CIMT) and micro-vascular complications.
Methods. Participants — 105 T2DM patients and age, gender matched 105 controls were evaluated by history and complete blood counts (CBC) including PVI, blood sugars, HbA1c, lipid profile and microvascular complications. PVI were compared between cases and controls. Carotid Doppler was done and CIMT was correlated with PVI.
Results. PVI were found significantly higher in diabetic patients compared to controls. Mean MPV in cases vs. controls was (11.09 ± 1.02 fL vs. 10.28 ± 0.96 fL, p ≤ 0.001), mean PDW (13.46 ± 1.96 fL vs. 12.85 ± 3.54 fL, p = 0.12), mean P-LCR (31.92 ± 6.23% vs. 27.94 ± 5.94%, p ≤ 0.001). CIMT showed a positive significant association with MPV, PDW and PLCR, dyslipidemia and negative with glycemic control. PVI, especially MPV was significantly elevated in those with neuropathy, nephropathy and retinopathy.
Conclusion. PVI i.e. MPV, PDW, P-LCR are increased in diabetic patients. They correlate positively with CIMT, implying cardiovascular risk. PVI have a positive association with microvascular complications also. PVI as determined by simple automated CBC can be used as markers of subclinical atherosclerosis and predictor of future cardiovascular events in T2DM.
Keywords: T2DMPVIincreased CIMTmicrovascular complications
References
- Ghoshal K, Bhattacharyya M. Overview of platelet physiology: its hemostatic and nonhemostatic role in disease pathogenesis. Scientific World Journal. 2014: 781857.
- Vinik AI, Erbas T, Park TS, et al. Platelet dysfunction in type 2 diabetes. Diabetes Care. 2001; 24(8): 1476–1485.
- Giles H, Smith RE, Martin JF. Platelet glycoprotein IIb-IIIa and size are increased in acute myocardial infarction. Eur J Clin Invest. 1994; 24(1): 69–72.
- Mylotte D, Kavanagh GF, Peace AJ, et al. Platelet reactivity in type 2 diabetes mellitus: a comparative analysis with survivors of myocardial infarction and the role of glycaemic control. Platelets. 2012; 23(6): 439–446.
- Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: its expected values and correlation with parallel red blood cell parameters. Clin Appl Thromb Hemost. 2004; 10(2): 175–178.
- Schneider DJ. Factors contributing to increased platelet reactivity in people with diabetes. Diabetes Care. 2009; 32(4): 525–527.
- Kodiatte TA, Manikyam UK, Rao SB, et al. Mean platelet volume in type 2 diabetes mellitus. J Lab Physicians. 2012; 4(1): 5–9.
- Papanas N, Symeonidis G, Maltezos E, et al. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets. 2004; 15(8): 475–478.
- Alhadas K, Santos S, Freitas M, et al. Are platelet indices useful in the evaluation of type 2 diabetic patients? Jornal Brasileiro de Patologia e Medicina Laboratorial. 2016; 52(2): 96–102.
- Hekimsoy Z, Payzin B, Ornek T, et al. Mean platelet volume in type 2 diabetic patients. J Diabetes Complications. 2004; 18(3): 173–176.
- Jindal S, Gupta S, Gupta R, et al. Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications. Hematology. 2011; 16(2): 86–89.
- Lippi G, Meschi T, Borghi L. Mean platelet volume increases with aging in a large population study. Thromb Res. 2012; 129(4): e159–e160.
- Bain BJ. Platelet count and platelet size in males and females. Scand J Haematol. 1985; 35(1): 77–79.
- Nechita A, Delcea C, Enache V, et al. Metabolic syndrome and mean platelet volume variation in patients with chest pain and negative cardiac enzymes. J Med Life. 2013; 6(2): 156–160.
- Swaminathan A, Amitkumar K, Ganapathy S, et al. Evaluation of mean platelet volume and other platelet parameters in subjects with Type-2 diabetes mellitus. Natl J Physiol Pharm Pharmacol. 2017; 7(1): 51–54.
- ManojSaluja, yogesh kumar swami, SR meena. Study of impact of glycemic status (HbA1c) on platelet activity measured by mean platelet volume & vascular complications in diabetics. JAPI. 2019; 67: 26–29.
- Ferreiro JL, Gómez-Hospital JA, Angiolillo DJ. Platelet abnormalities in diabetes mellitus. Diab Vasc Dis Res. 2010; 7(4): 251–259.
- Sarangi R, Mahapatra S, Padhi S. Association of plasma fibrinogen and serum high-sensitivity C-reactive protein in type 2 diabetes mellitus. J Curr Res Sci Medi. 2015: 21–26.
- Wan H. Zhang L, Yi T, Zhang L. The relationship between the level of mean platelet volume and the carotid artery intima-media thickness in patients with type 2 diabetes mellitus. Int J Diabetes Dev Ctries. 2017; 37(2): 137–140.
- Adam G, Kocak E, Reşorlu M, et al. Evaluation of platelet distribution width and mean platelet volume in patients with carotid artery stenosis. Angiology. 2015; 66(4): 375–378.
- Yılmaz F, Köklü E, Kizilirmak Yilmaz F, et al. Evaluation of mean platelet volume and platelet distribution width in patients with asymptomatic intermediate carotid artery plaque. Kardiol Pol. 2017; 75(1): 35–41.
- Kim ES, Mo EY, Moon SD, et al. Mean platelet volume is closely associated with serum glucose level but not with arterial stiffness and carotid atherosclerosis in patients with type 2 diabetes. J Clin Endocrinol Metab. 2015; 100(9): 3502–3508.
- Yüksel Kalkan G, Gür M, Baykan AO, et al. Mean platelet volume is associated with aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease. Anatol J Cardiol. 2015; 15(9): 753–758.
- Alvitigala BY, Azra MA, Kottahachchi DU, et al. A study of association between platelet volume indices and ST elevation myocardial infarction. Int J Cardiol Heart Vasc. 2018; 21: 7–10.
- Jain H, Chatterjee S, Das TK. Study of platelet count and platelet volume indices in the spectrum of coronary artery diseases and its clinicopathological correlation. Niger J Cardiol. 2018; 15(1): 63.
- Ateş O, Kiki İ, Bilen H, et al. Association of mean platelet volume with the degree of retinopathy in patients with diabetes mellitus. Eur J Gen Med Eur J Gen Med. 2009; 6(2): 99–102.
- Buch A, Kaur S, Nair R, et al. Platelet volume indices as predictive biomarkers for diabetic complications in Type 2 diabetic patients. J Lab Physicians. 2017; 9(2): 84–88.