Study of Platelet Indices in Type 2 Diabetic Patients and Its Correlation With Vascular Complications
Keywords:
Diabetes Mellitus, Platelet Indices, Mean Platelet Volume, Platelet Distribution Width, Platelet Large Cell Ratio
Abstract
BACKGROUND: Diabetes Mellitus is a metabolic syndrome characterized by hyperglycemia resulting in macrovascular and microvascular complications. Altered platelet morphology and functions have been linked with the pathological processes and high risk of vascular disease.Platelet indices (Mean platelet volume-MPV, Platelet distribution width-PDW and Platelet large cell ratio-PLCR) are determinants of platelet functionality.METHODS: The aim of this study was to study the platelet indices (MPV, PDW, P-LCR) in type - 2 diabetic patients with vascular complications and compare them in diabetic patients without vascular complications. The present study was conducted on 70 diabetic patients with vascular complications and 70 diabetic patients without vascular complications for a period of one year and eight months in department of pathology, JSShospital, Mysore. Patients were divided into cases and controls depending on the presence or absence of macrovascular complications (Myocardial infarction , stroke, peripheral arterial disease) and microvascular complications (retinopathy, nephropathy and neuropathy).Platelet indices (MPV, PDW, P-LCR) were measured using an Automated Blood Counter. FBS and HbA1C levels were collected from the clinical proforma.RESULT: Platelet indices were significantly higher in diabetic patients with vascular complications compared to those without complications [11.37±1.19 fL vs 10.17±0.71 fL (P=0.0001), 13.90±2.99 fL vs 11.28±1.55 fL (P=0.0001), 35.61±9.35% vs 26.14±5.79% (P=0.0001) respectively].CONCLUSION: The present study showed a significantly higher MPV, PDW and P-LCR in diabetic patients with vascular complications compared to those without complications. This indicates that elevated platelet indices could be the cause for vascular complications. Hence MPV, PDW, P-LCR can be used as simple and cost effective predictive parameters of platelet activation to monitor and predict the risk of vascular complications. DOI: 10.21276/APALM.1297References
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2.Jabeen F, Fawwad A, Rizvi H et al. 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):152-6.
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4.Cobon E, Bostan F, Ozdogan M. The mean Platelet volume in subjects with impaired fasting glucose. Platelet. 2006;17(1):67-69.
5.Winter WE, Signorino MR. Diabetes mellitus: pathophysiology, etiologies, Complications, management. J Clinical Chemistry. 2003;49(2):347.
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7.Camur NK, Demirtunc R, Konuralp C, Eskiser A, Basaran Y. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit. 2005;11(8):387-392.
8.Bae S, Lee J, Roh K et al. Platelet activation in patients with diabetic retinopathy. Korean J Ophthalmol. 2003;17:140-4.
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11.Hekimsoy Z, Payzinb B, Ornek T et al. Mean Platelet Volume in Type 2 Diabetes Mellitus. J Diabetes complications. 2004;18:173-6.
12.Boos CJ, Lip GY. Assesment of mean platelet volume in coronary artery disease- What does it mean? Thrombo Res 2007;120:11-3.
13.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):114-116.
14.Dindar S, Cinemre H, Sengul E et al. Volumen Medio de Plaquetas está Asociado con el Control Glucémico y la Retinopatía en Pacientes con Diabetes Mellitus Tipo 2.West Indian Med J. 2013; 62 (6): 519.
15.Khandekar MM, Khurana AS, Deshmukh S D et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol. 2006;59:146–149.
16.Bath P, Algert C, Chapman N et al. Association ofmean platelet volume with risk ofstroke among 3134 individualswith history of cerebrovasculardiseases –Stroke. American heart association J. 2004;35:622-626.
17.Khuwaja AK, Rafique G, White F, Azam SI. Macrovascular complications and their associated factors among persons with type 2 diabetes in Karachi, Pakistan- a multi-center study. J Pak Med Assoc. 2004;54(2):60-66.
18.Ozder A, Eker H. Investigation of mean platelet volume in patients with type 2 diabetes mellitus and in subjects with impaired fasting glucose: a cost-effective; tool in primary health care? Int J Clin Exp Med. 2014;7(8):2292-2297.
19.Ulutas K, Dokuyucu R, Sefil F 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.
20.Sari M, Lindarto D, Gatot D. Mean platelet volume increases in proliferative retinopathy among diabetes mellitus subjects. Univ Med. 2014;33:43-8.
21.Agrawal B, Manchanda B, Garg A et al. Mean platelet volume in acute myocardial infarction: a case-controlled study. Journal of Cardiovascular Research.2015;1:4.
22.Sharma M, Narang S, Neema s et al.Study of altered platelet morphology with changes in glycaemic status. Int J Res Med Sci. 2016;4(3):757-761.
23.Khode V, Sindhur J, Kanbur D et al. Mean platelet volume and other platelet volume indices in patients with stable coronary artery disease and acute myocardial infarction: A case control study. J Cardiovasc Dis Res. 2012;3:272-5.
24.Yilmaz T, Yilmaz A. Relationship between Altered Platelet Morphological Parameters and Retinopathy in Patients with Type 2 Diabetes Mellitus. Journal of Ophthalmology. 2016;4:1-5.
2.Jabeen F, Fawwad A, Rizvi H et al. 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):152-6.
3.Park BJ, Shim JY, Lee HR, Jung DH, Lee JH, Lee YJ. The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: A focus on gender differences. Platelets. 2012;23(1):45-50.
4.Cobon E, Bostan F, Ozdogan M. The mean Platelet volume in subjects with impaired fasting glucose. Platelet. 2006;17(1):67-69.
5.Winter WE, Signorino MR. Diabetes mellitus: pathophysiology, etiologies, Complications, management. J Clinical Chemistry. 2003;49(2):347.
6.Shera AS, Jawad F, Maqsood A, Jamal S, Azfar M, Ahmed U. Prevalence of chronic complications and associated factors in type 2 diabetes. J Pak Med Assoc. 2004;54(2):54-59.
7.Camur NK, Demirtunc R, Konuralp C, Eskiser A, Basaran Y. Could mean platelet volume be a predictive marker for acute myocardial infarction? Med Sci Monit. 2005;11(8):387-392.
8.Bae S, Lee J, Roh K et al. Platelet activation in patients with diabetic retinopathy. Korean J Ophthalmol. 2003;17:140-4.
9.Maitra A. The Endocrine System. In: Kumar V, Abbas AK, Fausto N, Aster JC, editors. Robbins and Cotran Pathologic Basis of Disease. 8th ed. New Delhi: Elsevier; 2010;1097-164.
10.Mahsud MAJ, Khan A, Hussain J.Haematological changes in Tobacco using Type 2 diabetic patients. Gomal J Med Sci 2010;8:8-11.
11.Hekimsoy Z, Payzinb B, Ornek T et al. Mean Platelet Volume in Type 2 Diabetes Mellitus. J Diabetes complications. 2004;18:173-6.
12.Boos CJ, Lip GY. Assesment of mean platelet volume in coronary artery disease- What does it mean? Thrombo Res 2007;120:11-3.
13.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):114-116.
14.Dindar S, Cinemre H, Sengul E et al. Volumen Medio de Plaquetas está Asociado con el Control Glucémico y la Retinopatía en Pacientes con Diabetes Mellitus Tipo 2.West Indian Med J. 2013; 62 (6): 519.
15.Khandekar MM, Khurana AS, Deshmukh S D et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol. 2006;59:146–149.
16.Bath P, Algert C, Chapman N et al. Association ofmean platelet volume with risk ofstroke among 3134 individualswith history of cerebrovasculardiseases –Stroke. American heart association J. 2004;35:622-626.
17.Khuwaja AK, Rafique G, White F, Azam SI. Macrovascular complications and their associated factors among persons with type 2 diabetes in Karachi, Pakistan- a multi-center study. J Pak Med Assoc. 2004;54(2):60-66.
18.Ozder A, Eker H. Investigation of mean platelet volume in patients with type 2 diabetes mellitus and in subjects with impaired fasting glucose: a cost-effective; tool in primary health care? Int J Clin Exp Med. 2014;7(8):2292-2297.
19.Ulutas K, Dokuyucu R, Sefil F 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.
20.Sari M, Lindarto D, Gatot D. Mean platelet volume increases in proliferative retinopathy among diabetes mellitus subjects. Univ Med. 2014;33:43-8.
21.Agrawal B, Manchanda B, Garg A et al. Mean platelet volume in acute myocardial infarction: a case-controlled study. Journal of Cardiovascular Research.2015;1:4.
22.Sharma M, Narang S, Neema s et al.Study of altered platelet morphology with changes in glycaemic status. Int J Res Med Sci. 2016;4(3):757-761.
23.Khode V, Sindhur J, Kanbur D et al. Mean platelet volume and other platelet volume indices in patients with stable coronary artery disease and acute myocardial infarction: A case control study. J Cardiovasc Dis Res. 2012;3:272-5.
24.Yilmaz T, Yilmaz A. Relationship between Altered Platelet Morphological Parameters and Retinopathy in Patients with Type 2 Diabetes Mellitus. Journal of Ophthalmology. 2016;4:1-5.
Published
2017-10-30
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