Evaluation of Mean Platelet Volume in Diabetes Mellitus and Its Role in Microvascular Complications
Keywords:
Diabetes mellitus, mean platelet volume, microvascular complications, platelets, fasting blood glucose.
Abstract
BACKGROUND Diabetes mellitus (DM) is a metabolic disorder characterised by hyperglycaemia. The hyperglycaemia results in altered platelet function as reflected in the platelet indices (mean platelet volume-MPV, platelet distribution width and plateletcrit). Altered platelet function has also been implicated in the occurrence of diabetic vascular complications. Evaluation of platelet indices may serve to provide an insight into the pathogenesis of DM as well as possibly evaluate the risk of progression of the disease. The aim of the current study was to evaluate the MPV in patients with DM and compare it with a non-diabetic control group. We also attempted to determine the association between MPV and microvascular complications within the diabetic cohort. METHODS The study was carried out on patients with diabetes mellitus, attending the medicine out-patient department. Relevant history was taken and fasting blood glucose and hematological parameters (platelet indices and complete blood counts) were assessed as a part of the routine investigations requested by the physician itself. A total of 320 diabetics were screened for the study. After applying exclusion criteria, 52 diabetics were included in the study. We also included 62 non-diabetic, age and sex matched controls in the study. Statistical analysis was performed. RESULTS AND CONCLUSION: MPV levels were significantly higher in diabetic patients when compared to non-diabetic controls. Also, within the diabetic group, MPV values were significantly higher in diabetics with microvascular complications (24 patients) as opposed to the ones without. MPV is a simple, convenient and cost-effective routine hematological investigation which plays a significant role in the pathogenesis of diabetes mellitus and may serve as a useful prognostic marker to herald the onset of microvascular complications in the diabetic population.References
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8. Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Med J. 2008; 49 (2):114-16.
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14. Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship be-tween glycaemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Com-plications. 2009; 23: 89–94.
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22. Schneider DJ. Factors contributing to increased platelet reactivity in people with diabetes. Diabetes Care. 2009; 32: 525–27.
23. Kakouros N, Rade JJ, Kourliouros A, Resar JR. Platelet function in patients with diabetes mellitus: from atheoretical to a practical perspective. Int J Endocrinol. 2011; 2011: 742719.
24. Radha RKN, Selvam D. MPV in Uncontrolled & Controlled Diabetics- Its Role as an Indicator of Vascular Complication. J Clin Diagn Res. 2016; 10 (8):22–26.
25. Ates O, Kiki I, Bilen H, Keles M, Koçer I, Kulaçoglu 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.
26. Cadirci K, Olcaysu O, Yigit D, Carlioglu A, Senay AD. Mean platelet volume in type 2 diabetic patient: is there a relationship between mean platelet volume and diabetic microvascular complications? Endocrine abstracts 2014;35:448
27. Colwell JA, Nesto RW. The platelet in diabetes-focus on prevention of ischemic events. Diabetes Care. 2003; 26: 2181–88.
28. Chang HA, Hwang HS, Park HK, Chun MY, Sung JY. The Role of Mean Platelet Volume as a Predicting Factor of Asymptomatic Coronary Artery Disease. Korean J Fam Med. 2010; 31: 600–06.
29. Cadirci K, Olcaysu O, Yigit D, Carlioglu A, Durmaz SA. Mean platelet volume in type 2 diabetic patient: is there a relationship between mean platelet volume and diabetic microvascular complications? Endocrine Abstracts. 2014; 35: 448.
2. Abhijeet S, Kaveeshwar, Cornwal J. The current state of diabetes mellitus in India. Australasian Med J. 2014; 7(1):45-48.
3. Papanas N, Symeonidis G, Maltezos E, Mavridis G, Karavageli E, Vosnakidis T, et al. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets. 2004; 15 (8):475-78.
4. Hekimsoy Z, Payzin B, Ornek T, Kandogan G. Mean platelet volume in Type 2 diabetic patients. J Diabetes Complications. 2004;18 (3):173-76.
5. Shera AS, Jawad F, Maqsood A, et al. Prevalence of chronic complications and associated factors in Type 2 diabetes. J Pak Med Assoc. 2004; 54:54-9.
6. Khandekar MM, Khurana AS, Deshmukh SD, Kakrani AL, Katdare AD, Inamdar AK. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol 2006; 59: 146–149.
7. Citirik M, Beyazyildiz E, Simsek M, Beyazyildiz O, Haznedaroglu IC. MPV may reflect subclinical platelet activation in diabetic patients with and without diabetic retinopathy. Eye. 2015; 29: 376-379.
8. Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Med J. 2008; 49 (2):114-16.
9. Jabeen F, Fawwad A, Rizvi HA, Alvi F. Role of platelet indices, glycemic control and hs-CRP in pathogenesis of vascular complications in type-2 diabetic patients. Pak J Med Sci. 2013; 29 (1):152-156.
10. Ulutas KT, Dokuyucu R, Sefil F, Yengil E, Sumbul AT, Rizaoglu H et al. Evaluation of mean platelet volume in patients with type 2 diabetes mellitus and blood glucose regulation: a marker for atherosclerosis? Int J Clin Exp Med 2014; 7(4):955-961.
11. Calverley DC, Thienelt CD. Platelet structure and function in Haemostasis and thrombosis. Wintrobe's Clinical Haematology. 12th ed. Philadelphia: Lippincott Williams &wilkins; 2009; 490-527.
12. Colwell JA, Winocour PD, Halushka PV. Do platelets have anything to do with diabetic microvascular disease? Diabetes. 1983; 32(2):14-9.
13. Sharpe PC, Trinick T. Mean platelet volume in diabetes mellitus. J Med. 1993; 86 (11):739-42.
14. Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship be-tween glycaemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Com-plications. 2009; 23: 89–94.
15. Jindal S, Gupta S, Gupta R, Kakkar A, Singh HV, Gupta K, Singh S. Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications. Haematology. 2011; 16 (2):86-9.
16. Vernekar PV, Vaidya K. Comparison of Mean Platelet Volume in Type 2 Diabetics on Insulin Therapy. J Clin Diagn Res. 2013; 7 (12): 2839–40.
17. 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 (4):402–10.
18. 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 (6):519-23.
19. Akkerman JW, Gorter G, Sixma JJ. Regulation of glycolytic flux in human platelets: re-lation between energy production by glyco (geno) lysis and energy consumption. Bio-chim Biophys Acta. 1978; 541(2):241-50.
20. Davi G, Santilli F, Vazzanna N. Diabetes mellitus. Platelets. 3rd ed. London: Elsevier; 2013; 711-31.
21. Vinik AI, Erbas T, Park TS, Nolan R, Pittenger GL. Platelet dysfunction in type 2 diabetes. Diabetes Care. 2001; 24: 1476–85.
22. Schneider DJ. Factors contributing to increased platelet reactivity in people with diabetes. Diabetes Care. 2009; 32: 525–27.
23. Kakouros N, Rade JJ, Kourliouros A, Resar JR. Platelet function in patients with diabetes mellitus: from atheoretical to a practical perspective. Int J Endocrinol. 2011; 2011: 742719.
24. Radha RKN, Selvam D. MPV in Uncontrolled & Controlled Diabetics- Its Role as an Indicator of Vascular Complication. J Clin Diagn Res. 2016; 10 (8):22–26.
25. Ates O, Kiki I, Bilen H, Keles M, Koçer I, Kulaçoglu 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.
26. Cadirci K, Olcaysu O, Yigit D, Carlioglu A, Senay AD. Mean platelet volume in type 2 diabetic patient: is there a relationship between mean platelet volume and diabetic microvascular complications? Endocrine abstracts 2014;35:448
27. Colwell JA, Nesto RW. The platelet in diabetes-focus on prevention of ischemic events. Diabetes Care. 2003; 26: 2181–88.
28. Chang HA, Hwang HS, Park HK, Chun MY, Sung JY. The Role of Mean Platelet Volume as a Predicting Factor of Asymptomatic Coronary Artery Disease. Korean J Fam Med. 2010; 31: 600–06.
29. Cadirci K, Olcaysu O, Yigit D, Carlioglu A, Durmaz SA. Mean platelet volume in type 2 diabetic patient: is there a relationship between mean platelet volume and diabetic microvascular complications? Endocrine Abstracts. 2014; 35: 448.
Published
29-11-2018
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