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Reddy KS, Bentoor SN, Sakthivadivel V. Platelet indices as an accouterment for monitoring short-term glycemic levels and as an economical alternative to HbA1c. J Family Med Prim Care 2023; 12:561-566. [PMID: 37122658 PMCID: PMC10131959 DOI: 10.4103/jfmpc.jfmpc_1717_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 12/09/2022] [Accepted: 01/11/2023] [Indexed: 05/02/2023] Open
Abstract
Background India is facing a galloping diabetes epidemic with an estimated 62 million patients and is projected to explode beyond 85 million by the year 2030. There is platelet dysfunction with platelet hyper-reactivity in diabetes mellitus. Aim To assess for any correlation between HbA1c levels with various platelet indices like mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Material and Methods Applying inclusion and exclusion criteria, diabetes mellitus patients have undergone detailed history, clinical examination, and laboratory investigations. Data is statistically analyzed for levels of HbA1c and their correlation to platelet indices. Results 58.7% study population is with HbA1c levels of more than 8%. In patients with normal range HbA1c levels between 4-6%, the MPV, PDW, and P-LCR are found to be 9.9 ± 0.97 fl, 10.84 ± 2.08 fl, and 23.75 ± 7.99%, respectively. In patients with HbA1c levels of 6.1 to 7%, the MPV, PDW, and P-LCR are found to be 10.22 ± 1.04 fl, 11.79 ± 1.8 fl, and 26.36 ± 7.05%, respectively. In patients with HbA1c levels of 7.1 to 8%, the MPV, PDW, and P-LCR values are found to be 10.21 ± 1.06 fl, 12.03 ± 2.52 fl, and 26.65 ± 8.05%, respectively. In patients with poor glycemic control with HbA1c levels more than 8%, the MPV, PDW, and P-LCR are found to be 10.64 ± 1.1 fl, 12.81 ± 2.61 fl, and 30.26 ± 8.24%, respectively. Conclusion In type 2 diabetes mellitus patients, HbA1c is positively correlated with platelet indices.
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Affiliation(s)
- Kotha Sugunakar Reddy
- Department of General Medicine, All India Institute of Medical Sciences - Bibinagar, Hyderabad, Telangana, India
- Address for correspondence: Dr. Kotha Sugunakar Reddy, Senior Resident, Department of General Medicine, All India Institute of Medical Sciences - Bibinagar, Hyderabad, Telangana, India. E-mail:
| | - SanjeevKumar N. Bentoor
- Department of General Medicine, Shri B M Patil Medical College, BLDE, Vijayapura, Karnataka, India
| | - Varatharajan Sakthivadivel
- Department of General Medicine, All India Institute of Medical Sciences - Bibinagar, Hyderabad, Telangana, India
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Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima-Media Thickness and Arterial Stiffness in Prediabetes. J Clin Med 2022; 11:jcm11102870. [PMID: 35628995 PMCID: PMC9142942 DOI: 10.3390/jcm11102870] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 01/25/2023] Open
Abstract
Alterations of glucose homeostasis are associated with subclinical vascular damage; however, the role of platelet reactivity in this process has not been fully investigated. In this cross-sectional study, we evaluated the correlation between markers of platelet reactivity and inflammation and markers of vascular disease in subjects with prediabetes. Markers of platelet reactivity such as 11-dehydro-thromboxane B2 urinary levels (11-dh-TXB2) and mean platelet volume (MPV) and inflammatory indexes such as platelet-to-lymphocyte ratio (PLR) were evaluated in subjects with prediabetes (n = 48), new-onset type 2 diabetes (NODM, n = 60) and controls (n = 62). Furthermore, we assessed the cardiovascular risk profile of the study population with arterial stiffness and quality intima–media thickness (qIMT). Subjects with prediabetes and NODM exhibited higher 11-dh-TXB2 urinary levels and MPV and a proinflammatory profile with an increased PLR, high-sensitivity C-reactive protein, ferritin and fibrinogen. Furthermore, after multiple regression analyses, we found that urinary 11-dh-TXB2 was one of the major determinants of IMT and arterial stiffness parameters. In conclusion, subjects with prediabetes exhibit increased platelet reactivity as well as a proinflammatory profile. Furthermore, this condition is associated with early markers of cardiovascular disease.
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Pogorzelska K, Krętowska A, Krawczuk-Rybak M, Sawicka-Żukowska M. Characteristics of platelet indices and their prognostic significance in selected medical condition - a systematic review. Adv Med Sci 2020; 65:310-315. [PMID: 32505856 DOI: 10.1016/j.advms.2020.05.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/22/2020] [Accepted: 05/06/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Platelets, also called thrombocytes, are produced in bone marrow and are the second most numerous blood cells which circulate in blood and play a pivotal role in hemostasis, wound healing, angiogenesis. There is a large body of evidence that platelets are likely to contribute to inflammation in multiple diseases. Also, recent studies revealed the association between platelet indices (PI) and inflammation. METHODS PubMed, Scopus and Google Scholar databases were searched and only papers published in the last 10 years were consequently analyzed. RESULTS The most frequently evaluated parameters are mean platelet volume (MPV), platelet diversity index (PDW), plateletcrit (PCT) and the presence of larger platelets (P-LCRs platelet larger cell ratio). The values of platelet indices (PI) were elevated in patients suffering from type 2 diabetes mellitus, myocardial infarction, cancers or acute surgical conditions, such as appendicitis. The measurement of PIs does not generate additional costs and can be performed during routine cell blood count, not requiring additional blood samples. CONCLUSIONS Platelet indices may have prognostic and predictive value in numerous conditions.
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Affiliation(s)
- Karolina Pogorzelska
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Anna Krętowska
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
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Abstract
PURPOSE OF REVIEW To critically review the literature describing links between mean platelet volume (MPV) and cardiovascular disease (CVD). We will focus on coronary artery disease (CAD). The MPV is measured routinely as part of a routine blood count. RECENT FINDINGS There is accumulating evidence showing that the MPV may predict CVD, as well as outcomes in patients with CAD. There is also evidence linking MPV and comorbidities (e.g. diabetes mellitus and impaired glycaemic control) that are expected in patients with CAD. The effect on MPV of drugs commonly used to treat CAD has not been clarified, but there is some evidence that they may exert a beneficial effect on the MPV. More specifically, the MPV may predict the effect of antiplatelet drugs (e.g. clopidogrel). There is also evidence relating MPV to stroke, atrial fibrillation, coronary artery ectasia and periprocedural outcomes after percutaneous coronary intervention (PCI). SUMMARY Measuring the MPV may prove useful in CVD risk assessment in patients with established CAD or at risk of developing CAD. Overall, there is evidence pointing to the role of MPV as a contributor rather than simple marker of CVD.
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Gao E, Hou J, Zhou Y, Ma J, Li T, Zhang J, Wang L, Chen W, Yuan J. Mediation effect of platelet indices on the association of daytime nap duration with 10-year ASCVD risk. Platelets 2020; 32:82-89. [PMID: 32009507 DOI: 10.1080/09537104.2020.1719055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Daytime nap is associated with the risk of atherosclerotic cardiovascular disease (ASCVD). However, the contribution of platelet to the association of daytime nap with ASCVD remains unclear. We analyzed the mediation effect of abnormal platelet indices on the association between daytime nap and 10-year ASCVD risk. The participants of this study were 2445 adults aged 30 to 74 years without ASCVD from the baseline Wuhan residents (n = 3053) of the Wuhan-Zhuhai (WHZH) Cohort Study. Participants completed the questionnaire and physical examination (including blood pressure, height, weight, and blood biochemical indicators). We assessed the association of daytime nap or nocturnal sleep duration with 10-year ASCVD risk and mediation effects of platelet indices on the associations using generalized linear models (GLM). Individuals with daytime nap duration of 30 or 60 min had a 1.37- (95%CI: 1.05, 1.78) or 1.44- (95%CI: 1.17, 1.78) fold increased risk of 10-year ASCVD compared with non-nappers. As compared with non-nappers, MPV values or MPV/PLT ratio mediated 15.29% or 6.18% of the association of daytime nap duration of 30 min with 10-year ADCVD risk as well as 19.21% or 7.61% of the association of daytime nap duration of 60 min with 10-year ADCVD risk (all p < .05). Platelet might partially contribute to increased 10-year ASCVD risk in individuals with daytime nap duration of 30 or 60 min.
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Affiliation(s)
- Erwei Gao
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jian Hou
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Yun Zhou
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jixuan Ma
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Tian Li
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jiafei Zhang
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Lu Wang
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Weihong Chen
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
| | - Jing Yuan
- Department of Occupational and Environmental Health, Huazhong University of Science and Technology , Wuhan, PR. China.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, PR. China
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Cho AJ, Choi MJ, Lee YK, Hoon HC, Koo JR, Yoon JW, Noh JW. Effects of aspirin resistance and mean platelet volume on vascular access failure in hemodialysis patients. Korean J Intern Med 2019; 34:1304-1312. [PMID: 30025441 PMCID: PMC6823566 DOI: 10.3904/kjim.2018.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/05/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Maintaining the patency of vascular access (VA) in hemodialysis (HD) patients is important and can be life-saving. We investigated the effects of aspirin resistance and mean platelet volume (MPV) on VA failure in HD patients. METHODS We enrolled 163 patients on maintenance HD. VA failure was defined as thrombosis or a decrease of > 50% of the normal vessel diameter, as revealed by angiography. RESULTS Aspirin resistance was observed in 17 of 109 patients in whom this parameter was measured, and was not significantly associated with VA failure (p = 0.051). The mean MPV was 9.15 ± 0.05 fL. The 163 patients were grouped by the median MPV value (9.08 fL) at baseline; patients with higher MPVs (n = 82) had lower platelet counts (p = 0.002) and albumin levels (p = 0.009). During 34 months of follow-up, 65 VA failures (39.9%) occurred. The Kaplan-Meier curve revealed significant differences between the two groups in terms of cumulative VA failure (54.1% vs. 35.3%, p = 0.018). On multivariate analysis, the MPV (hazard ratio [HR], 1.794; 95% confidence interval [CI], 1.066 to 3.020; p = 0.028), platelet count (HR, 1.003; 95% CI, 1.001 to 1.006; p = 0.01), and smoking status (HR, 1.894; 95% CI, 1.019 to 3.519; p = 0.043) independently predicted VA failure. CONCLUSION A high MPV was associated with an increased risk of VA failure, whereas aspirin resistance showed only a weak association. The MPV may predict VA survival in HD patients.
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Affiliation(s)
- AJin Cho
- Division of Nephrology, Department of Internal Medicine, Hallym University College of Medicine and Hallym University Kidney Research Institute, Hallym University Medical Center, Seoul, Korea
| | - Myung Jin Choi
- Division of Nephrology, Department of Internal Medicine, Hallym University College of Medicine and Hallym University Kidney Research Institute, Hallym University Medical Center, Seoul, Korea
| | - Young-Ki Lee
- Division of Nephrology, Department of Internal Medicine, Hallym University College of Medicine and Hallym University Kidney Research Institute, Hallym University Medical Center, Seoul, Korea
| | - Han Chae Hoon
- Division of Nephrology, Department of Internal Medicine, Hallym University College of Medicine and Hallym University Kidney Research Institute, Hallym University Medical Center, Seoul, Korea
| | - Ja-Ryong Koo
- Division of Nephrology, Department of Internal Medicine, Hallym University College of Medicine and Hallym University Kidney Research Institute, Hallym University Medical Center, Seoul, Korea
| | - Jong-Woo Yoon
- Division of Nephrology, Department of Internal Medicine, Hallym University College of Medicine and Hallym University Kidney Research Institute, Hallym University Medical Center, Seoul, Korea
- Correspondence to Jung-Woo Noh, M.D. Division of Nephrology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea Tel: +82-2-829-5108 Fax: +82-2-829-5309 E-mail:
| | - Jung-Woo Noh
- Division of Nephrology, Department of Internal Medicine, Hallym University College of Medicine and Hallym University Kidney Research Institute, Hallym University Medical Center, Seoul, Korea
- Correspondence to Jung-Woo Noh, M.D. Division of Nephrology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, 1 Singil-ro, Yeongdeungpo-gu, Seoul 07441, Korea Tel: +82-2-829-5108 Fax: +82-2-829-5309 E-mail:
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Biswas P, Chakraborty AK, Mukherjee A, Pal B, Maji D, De M. Elevated Vascular Endothelial Growth Factor Level in Association with Mean Platelet Volume Are Emerging Risk Factors for Vascular Complications in T2DM Patients. Health (London) 2019. [DOI: 10.4236/health.2019.1111116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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