MEAN PLATELET VOLUME AS A COST-EFFECTIVE BIOMARKER FOR CARDIOVASCULAR RISK STRATIFICATION IN TYPE 2 DIABETES MELLITUS: A CROSS-SECTIONAL STUDY OF 933 SUBJECTS
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Keywords
diabetes mellitus, mean platelet volume, HbA1c, thrombosis, cardiovascular complications, biomarker
Abstract
Diabetes mellitus is a major global health problem affecting over 463 million people worldwide. The mortality and morbidity associated with diabetes is mainly due to vascular disorders which can be traced back to platelet activity and aggregation potential. Mean platelet volume (MPV), measured by hematology analyzers, serves as a marker of platelet function and activation.
Aim: To compare MPV between patients with type 2 diabetes mellitus and normoglycemic individuals and establish its correlation with glycemic control parameters.
Materials and Methods: This observational prospective study included 386 diabetic patients and 547 normoglycemic controls over six months. Blood samples were analyzed for MPV using Sysmex-XT 2000i hematology analyzer. HbA1c values were determined using D10 Biorad system. Statistical analysis included unpaired t-tests, correlation analysis, and multivariate regression using GraphPad Prism software. Results: Mean MPV was significantly higher in diabetics compared to controls (10.34 ± 0.9 fL vs 8.1 ± 0.3 fL, p<0.0001). Strong positive correlations were observed between MPV and HbA1c levels (r=0.742, p<0.0001), fasting glucose (r=0.681, p<0.0001), and diabetes duration (r=0.598, p<0.0001). Diabetic patients with complications showed higher MPV values than those without complications (11.2 ± 1.1 fL vs 9.8 ± 0.8 fL, p<0.001).
Conclusion: Elevated MPV reflects platelet hyperactivity leading to increased thrombotic vascular complications in diabetic patients. MPV demonstrates strong correlation with glycemic control and can serve as an independent predictor of diabetic complications. This cost-effective parameter should be routinely evaluated for cardiovascular risk stratification.
References
2. Demirtunc R, Duman D, Basar M, Bilgi M. The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications. 2009;23:89-94.
3. Grundy SM. Hypertriglyceridemia, atherogenic dyslipidemia, and the metabolic syndrome. Am J Cardiol. 1998;81(6B):18B-25B.
4. 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;49:114-6.
5. Carr ME. Diabetes mellitus: a hypercoagulable state. J Diabetes Complications. 2001;15(1):44-54.
6. Hekimsoy Z, Payzin B, Ornek T, Kandogan G. Mean platelet volume in type 2 diabetic patients. J Diabetes Complications. 2004;18:173-6.
7. Torun AN, Eren MA, Ulaş T, Demir M, Arslan I, Sabuncu T. Mean platelet volume in various degrees of disturbed carbohydrate metabolism. Turk J Endocrinol Metab. 2012;16:6-9.
8. Vinik AI, Erbas T, Park TS, Nolan R, Pittenger GL. Platelet dysfunction in type 2 diabetes. Diabetes Care. 2001;24:1476-85.
9. Kaveeshwar S, Cornwall J. The current state of diabetes mellitus in India. Australas Med J. 2014;7(1):14-5.
10. World Health Organization. Diabetes Fact Sheet [Internet]. Geneva: WHO; 2011. Available from: http://www.who.int/mediacentre/factsheets/fs312/en/
11. Akinbami A, Dada AO, John-Olabode S, Oshinaike O, Adediran A, Odesanya M, et al. Mean platelet volume and platelet counts in type 2 diabetes mellitus on treatment and non-diabetic controls in Lagos, Nigeria. Pan Afr Med J. 2014;18:42.
12. 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.
13. Beckman JA, Creager M, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology and management. JAMA. 2002;287(19):2570-81.
14. Jindal S, Gupta S, Gupta R, Kakkar A, Singh HV, Gupta K, et al. Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications. Hematology. 2011;16(2):86-9.
15. Shetty A, Vijaya C, Jayalakshmi VJ, Lekha MB. Comparison of mean platelet volume, platelet count, total leucocyte and neutrophil counts in normoglycemics, impaired fasting glucose and diabetics. Int J Sci Study. 2014;2(2):24-7.
16. Shimodaira M, Niwa T, Nakajima K, Kobayashi M, Hanyu N, Nakayama T. Correlation between mean platelet volume and fasting plasma glucose levels in prediabetic and normoglycemic individuals. Cardiovasc Diabetol. 2013;11:12-4.
17. Lekston A, Hudzik B, Hawranek M, Szkodzinski J, Gorol J, Wilczek K, et al. Prognostic significance of mean platelet volume in diabetic patients with ST-elevation myocardial infarction. J Diabetes Complications. 2014;28(5):652-7.
18. Ateş O, Kiki I, Bilen H, Keleş M, Koçer I, Kulaçoğlu 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.
19. 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;15:475-8.
20. Shah B, Sha D, Xie D, Emile R, Mohler ER, Berger JS. The relationship between diabetes, metabolic syndrome, and platelet activity as measured by mean platelet volume: the NHANES 1999-2004. Diabetes Care. 2012;35(5):1074-8.
21. Thomas AK, Udaya KM, Suraksha BR, Thej MJ, Madheri R, Harendra KML, et al. Mean platelet volume in type 2 diabetes mellitus. J Lab Physicians. 2012;4(1):5-9.
22. Bae SH, Lee J, Roh KH, Kim J. Platelet activation in patients with diabetic retinopathy. Korean J Ophthalmol. 2003;17:140-4.
23. Colwell JA, Nesto RW. The platelet in diabetes: focus on prevention of ischemic events. Diabetes Care. 2003;26:2181-8.
24. 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;31:600-6.
25. Kakouros N, Rade JJ, Kourliouros A, Resar JR. Platelet function in patients with diabetes mellitus: from a theoretical to a practical perspective. Int J Endocrinol. 2011;2011:742719.
26. Kodiatte TA, Manikyam UK, Lakshmaiah V. Mean platelet volume in type 2 diabetes mellitus. J Lab Physicians. 2012;4(1):5-9.
27. International Diabetes Federation. IDF Diabetes Atlas, 10th edn. Brussels, Belgium: International Diabetes Federation; 2021.
28. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract. 2019;157:107843.
29. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47-58.
30. 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(1):148-56.
31. Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J. 2001;22(17):1561-71.
32. Martin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res. 1983;32(5):443-60.
33. Jakubowski JA, Thompson CB, Vaillancourt R, Valeri CR, Deykin D. Arachidonic acid metabolism by platelets of differing size. Br J Haematol. 1983;53(3):503-11.
34. Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996;7(2):157-61.
35. Senaran H, Ileri M, Altinbas A, Kosar A, Yetkin E, Ozturk M, et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol. 2001;24(5):405-8.
36. 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(2):399-404.
37. Tavil Y, Sen N, Yazici HU, Hizal F, Abaci A, Cengel A. Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res. 2007;120(2):245-50.
38. Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY. Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol. 2004;44(2):415-22.
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Abhishek Chowdhury
Associate Professor, Department of Pathology Manipal Tata Medical College, Jamshedpur
Jyotirmoy Ghanta
Associate Professor, Dept of Respiratory Medicine ICARE Institute of Medical Sciences and Research & Dr. B.C Roy Hospital, Haldia, West Bengal.
Bidisha Banerjee
Senior resident, Dept of Gynaecology and Obstetrics, Nil Ratan Sircar Medical College and Hospital, Kolkata, West Bengal.