Frequency distribution and association of Fat-mass and obesity (FTO) gene SNP rs-9939609 variant with Diabetes Mellitus Type-II population of Hyderabad, Sindh, Pakistan

BACKGROUND/AIM

Diabetes Mellitus (DM) is one of the important public health issues worldwide. The Fat mass obesity (FTO) gene rs-9939609 variant identified single nucleotide polymorphism (SNP) with the T to A missense mutation, and has a strong association with T2DM. FTO gene is present on chromosome "16q12.2" comprising of nine exons. FTO gene rs-9939609 a variant is commonly found in the Pakistani Population. The purpose of the study was to alert the population about the rs-9939609 variant SNP, having a strong association with T2DM.

MATERIAL AND METHODS

Total of 190 participants were included in the present cross-sectional study. To collect the samples non-probability convenience technique was used. subjects were recruited and divided into three groups, normal healthy subjects, obese and T2DM. The patients were selected from the Medicine department Jamshoro/Hyderabad by filling the pre-designed proforma, as well as verbal and written consent taken from study participants. To analysed the data ANOVA Post hoc (Tukey-test) was applied for comparison among groups (P < 0.05) and "SNP-STAT" online software was used for frequencies.

RESULTS

The BMI, neck circumference, waist circumference and lipid profile, fasting blood sugar and HbA1c was found significant (p < 0.001) in both genders as compared to control. Homozygous and heterozygous distribution of allelic and genotyping frequency was found in study participants. 37.9 %T/A, 57.4% T/T, and A/A were 4.7%. The FTO gene rs-9939609 variant amplified and have an increased risk of developing T2DM in the Sindh population. Codominant model odd ratio of T/A showed 2.42 (CI)1.23-3.84, with significant p < 0.032.

CONCLUSION

The present study concluded that the FTO gene SNP rs-9939609 variant was found in the population of Hyderabad, Sindh and having strong association with T2DM and obese individuals. Increase BMI, neck and waist circumference are the biomarkers of obesity and causative factors of T2DM.

Mean platelet volume and coronary artery disease

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.

Platelet distribution width, platelet count, and plateletcrit in diabetic retinopathy: A systematic review and meta-analysis of PRISMA guidelines

BACKGROUND

Screening and diagnosis of diabetic retinopathy (DR) mainly depends on fundus examination, which is not an intuitive and simple screening or diagnostic method. Recently, the relationship between platelet parameters and DR has become a hot topic. Whether platelet parameters have clinical value in DR is controversial.

METHODS

Literature was retrieved by formal search of electronic databases (PubMed, Embase, Cochrane library, Scopus, and CNKI) and by hand searching of reference lists of related articles from the beginning of building database to December 2017. Review manager 5.3 was utilized to deal with statistical data. This study was registered at International Prospective Register of Systematic Reviews (number: CRD42018093773).

RESULTS

This study included 1720 DR patients, 1477 type 2 diabetic mellitus (T2DM) without DR patients and 1456 health controls in 21 eligible studies. We found there was significant increase of platelet distribution width (PDW) level in the comparison of DR versus Control group (standard mean difference [SMD] [95% confidence interval [CI]] = 1.04 [0.68, 1.40]) and DR versus T2DM without DR group (SMD [95% CI] = 0.68 [0.40, 0.95]). For platelet count (PLT), it showed obvious decrease in the comparison of DR versus T2DM without DR group (SMD [95% CI] = -0.26 [-0.49, -0.03]) and no difference in comparison of DR versus Control (SMD [95% CI] = -0.26 [-0.51, -0.00]). Subgroup analysis showed that significant result of PDW level appeared in China and Turkey in all comparisons, while similar results of PLT only in China. In addition, PDW level was different in various DR-subtypes, obvious high level in proliferation DR.

CONCLUSIONS

We concluded that the guiding significance of PDW and PLT in diagnosis and monitor of DR, and especially, application of PDW to PDR management may have potential sense.

The relationship between mean platelet volume and diabetic retinopathy: a systematic review and meta-analysis

BACKGROUND

Diabetic retinopathy (DR) is one of the most common diseases causing blindness in the world, and most patients are already in advanced stage. Recent years, many studies reported mean platelet volume (MPV) may be associated with development of DR, but there was no consistent conclusion reached.

METHODS

Literature was retrieved by formally searching PubMed, Embase, Cochrane library and Scopus and by hand searching of reference lists of related articles. Finally, a total of 14 literatures included, and Review manager 5.3 and STATA 14.0 statistical software were utilized for processing.

RESULTS

Meta-analysis showed that MPV values in DR were significantly higher than health controls [SMD (95% CI) = 0.92 (0.60-1.24)] and type 2 diabetes mellitus without diabetic retinopathy (T2DM without DR) [SMD (95% CI) = 0.36 (0.19-0.53)]. Subgroup analysis indicated that MPV level in proliferative diabetic retinopathy (PDR) patients was higher than T2DM without DR patients [SMD (95% CI) = 0.48 (0.28, 0.68)], but this difference didn't appear in non-proliferative diabetic retinopathy (NPDR).

CONCLUSIONS

The study demonstrated that increased MPV level was significant associated with the development of DR, and it might reflect the severity of DR, which could be provided to monitor development and progression of DR clinically.

The relationship of blood cell-associated inflammatory indices and diabetic retinopathy: a Meta-analysis and systematic review

AIM

To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR).

METHODS

We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices.

RESULTS

A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR.

CONCLUSION

MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.

Update of inflammatory proliferative retinopathy: Ischemia, hypoxia and angiogenesis

Diabetic retinopathy (DR) and retinopathy of prematurity (ROP) present two examples of proliferative retinopathy, characterized by the same stages of progression; ischemia of the retinal vessels, leads to hypoxia and to correct the problem there is the setting up of uncontrolled angiogenesis, which subsequently causes blindness or even detachment of the retina. The difference is the following; that DR initiated by the metabolic complications that are due to hyperglycemia, and ROP is induced by overexposure of the neonatal retina to oxygen. In this review, we will demonstrate the physiopathological mechanism of the two forms of proliferative retinopathy DR and ROP, in particular the role of the CD40/CD40L axis and IL-1 on vascular complications and onset of inflammation of the retina, the implications of their effects on the onset of pathogenic angiogenesis, thus understanding the link between platelets and retinal ischemia. In addition, what are the therapeutic targets that could slow its progression?

The association of neutrophil to lymphocyte ratio, mean platelet volume, and platelet distribution width with diabetic retinopathy and nephropathy: a meta-analysis

The aim of the present study was to investigate the correlation of neutrophil to lymphocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW) with diabetic nephropathy (DN) and diabetic retinopathy (DR). We searched for eligible studies from PubMed, Embase, Web of Science, and CNKI up to 1 December 2017. Standardized mean difference (SMD) was calculated with a confidence interval (CI) of 95%. A total of 48 studies were included in our meta-analysis. Compared with patients with type Ⅱ diabetes mellitus (T2DM) and without DR, NLR, MPV, and PDW were higher in patients with DR (SMD = 0.77; 95% CI: 0.49-1.05; P<0.001; SMD = 0.68; 95% CI: 0.36-0.99; P<0.001; SMD = 0.52; 95% CI: 0.28-0.76; P<0.01). Compared with patients with T2DM and without DN, NLR, MPV, and PDW were higher in patients with DN (SMD = 0.63; 95% CI: 0.43-0.83; P<0.001; SMD = 0.81; 95% CI: 0.36-1.25; P<0.001; SMD = 0.70; 95% CI: 0.50-0.90; P<0.001). We also found that MPV was strongly associated with the severity of DR, and NLR was closely related to the degree of DN. Our findings indicated that NLR, MPV, and PDW could be recommended as inexpensive diagnostic biomarkers for DN and DR. However, considering several limitations in the present study, further high-quality clinical studies should be performed to investigate the relationship of NLR, MPV, and PDW to DN and DR.

Altered mean platelet volume in children with Henoch-Schonlein purpura and its association with disease activity

Background

Henoch-Schonlein purpura is a systemic small-vessel vasculitis that occurs mainly in children. A review of the literature has suggested a correlation between mean platelet volume and several inflammatory disorders. However, to the best of our knowledge, any potential correlation between mean platelet volume and Henoch-Schonlein purpura has not been reported in the literature. Therefore, our study aimed to evaluate the role of mean platelet volume concentrations in patients with Henoch-Schonlein purpura.

Methods

This study included 97 children with Henoch-Schonlein purpura and 120 healthy individuals as controls.

Results

Mean platelet volume concentrations were found to be significantly lower in Henoch-Schonlein purpura patients compared with healthy controls (8.1 ± 0.86 vs. 9.4 ± 0.81, P < 0.001). Similarly, significant negative correlations were observed between mean platelet volume and neutrophil count, platelet count and erythrocyte sedimentation rate in patients with Henoch-Schonlein purpura (r=−0.327, P = 0.001; r=−0.419, P < 0.001; r=−0.255, P = 0.012). Interestingly, mean platelet volume was significantly lower in the acute phase compared with the convalescent phase of Henoch-Schonlein purpura patients (7.8 ± 0.86 vs. 8.3 ± 0.77, P = 0.002). A cut-off value for mean platelet volume was 7.85 with area under the curve of 0.726 to identify acute phase vs. convalescent phase in patients with Henoch-Schonlein purpura. Mean platelet volume was independently associated with Henoch-Schonlein purpura in logistic regression analysis (odds ratio = 0.114, 95% confidence interval = 0.053–0.243, P < 0.001).

Conclusions

Our results suggest that mean platelet volume is inversely associated with disease in patients with Henoch-Schonlein purpura, and mean platelet volume may be a useful marker to identify active disease in Henoch-Schonlein purpura patients.