Title: Mean Platelet Volume – Predictor of Impending Diabetic Vascular Complications

Authors: E. Sumanraj, S.Periasammy

 DOI: https://dx.doi.org/10.18535/jmscr/v7i10.115

Abstract

   

Introduction: Diabetes Mellitus (DM) is a prothrombotic state which has influence on pathways regulating platelet function, that is represented by increased platelet reactivity. Many studies have tried to explain the pathophysiology of these hyperreactive platelets contributing to diabetic vascular complications. However, a comprehensive analysis of the relationship between Mean platelet volume and glycemic status is still lacking.

Aim: To determine the Mean Platelet volume (MPV) in diabetics compared to Non-diabetics and to find out, among the Diabetics if there is an association between MPV and micro, macrovascular complications of Diabetes and to determine the correlation of MPV with Fasting blood sugar, postprandial blood sugar, Glycosylated Hb (HbA1c), Body mass index and duration of Diabetes.

Materials and Method: A total of 100 patients (Study – 50; Control - 50) admitted in medicine wards of Rajah Muthiah Medical College, Annamalai Nagar, Chidambaram from September 2017 to October 2018 were studied. Our patients were on treatment with insulin or OHAs. All the patients were put through a detailed clinical evaluation. Height, weight were measured in all subjects and BMI was calculated.

Results: Diabetics had elevated MPV in comparison to non-diabetics. MPV was significantly higher among uncontrolled diabetics than patients with good glycemic control and non-diabetics. MPV showed a significant positive correlation with HbA1c, FBS and PPBS. We observed a significant difference in MPV among various grades of HbA1c.

Conclusion: The MPV is increased in diabetics. It is a simple and inexpensive tool that can be used as a good indicator of platelet hyperactivity and predictor of upcoming vascular complications in DM.

Keywords: Diabetes Mellitus, Mean Platelet volume.

References

  1. Wild SH, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27 (10):2569.
  2. Colwell JA, Nesto RW. The platelet in diabetes. Focus on prevention of ischemic events. Diabetes Care. 2003;26(7):2181-88.
  3. Barutta F, Bruno G, Matullo G, Chaturvedi N, Grimaldi S, Schalkwijk C, et al. MicroRNA-126 and micro-/macrovascular complications of type 1 diabetes in the EURODIAB prospective complications study. Acta Diabetol. 2017;54(2):133-39.
  4. Mitchell RN. Hemodynamic disorders, thromboembolic disease and shock. In: Kumar V, Abbas AK, Fausto N, Aster JC, editors. Robbins and Cotran pathologic basis of disease. 8th ed. New Delhi. Elsevier. 2010. pp. 111-34.
  5. 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.
  6. Pomero F, Di Minno MN, Fenoglio L, Gianni M, Ageno W, Dentali F. Is diabetes a hypercoagulable state? a critical appraisal. Acta Diabetol. 2015;52(6):1007-16.
  7. Handin RI. Disorders of the platelet and vessel wall. Harrison’s principles of internal medicine. 16th ed. New York: McGraw Hill. 2005;673-74.
  8. Frojmovic MM, Milton JG. Human platelet size, shape, and related functions in health and disease. Physiol Rev. 1982;62(1):185-261.
  9. 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(8):600-06.
  10. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010;14(1):28-32.
  11. Yilmaz M, Delibas IB, Isaoglu U, Ingec M, Borekci B, Ulug P. Relationship between mean platelet volume and recurrent miscarriage: a preliminary study. Arch Med Sci. 2015;11:989-93.
  12. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. J Am Med Assoc. 2002;287(19):2570-81.
  13. Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications. 2009;23:89-94.
  14. Winocour PD, Watala C, Kinlough-Rathbone RL. Membrane fluidity is related to the extent of glycation of proteins, but not to alterations in the cholesterol to phospholipid molar ratio in isolated platelet membranes from diabetic and control subjects. Thromb Haemost. 1992;67:567-71.
  15. Westerbacka J, Yki-Järvinen H, Turpeinen A, Rissanen A, Vehkavaara S, [16]Syrja lä M, et al. Inhibition of plateletcollagen interaction: an in vivo action of insulin abolished by insulin resistance in obesity. Arterioscler Thromb Vasc Biol. 2002;22:167-172.
  16. Handin RI, Karabin R, Boxer GJ. Enhancement of platelet function by superoxide anion. J Clin Invest.1977; 59:959-65.
  17. Martin JF. Platelet heterogeneity in vascular disease. Martin JF, Towbridge A, eds. Platelet heterogeneity: Biology and Pathology. London, UK. Springer-Verlag. 1990;205:26.
  18. Hekimsoy Z, Payzinb B, Ornek T, Kandogan G. Mean platelet volume in type 2 diabetic patients. J Diabetes Complications. 2004;18:173-76.
  19. Bae SH, Lee J, Roh KH, Kim J. Platelet activation in patients with diabetic retinopathy. Korean J Ophthalmol. 2003;17:140-44.

Corresponding Author

E Sumanraj

Postgraduate, Department of General Medicine, RMMCH, Annamalai Nagar, Chidambaram, Tamil Nadu