Increased platelet volume — Sign of impaired thrombopoiesis in diabetes mellitus

Abstract

Increased functional properties of diabetic platelets might be already conditioned during thrombopoiesis in the stem cell system. This hypothesis was studied by recording the distribution characteristics of the peripheral platelet pool in 218 diabetic patients versus 51 controls. Furthermore, platelet membrane coating with the stem cell marker glycoprotein IB was analyzed in 41 diabetic subjects and compared to 23 healthy volunteers. A consistent, significant shift of the volume distribution to larger platelets was found in diabetics: Mean platelet volume (MPV) - 7.9 +/- 0.9 versus 7.2 +/- 0.8 [fl]; Megathrombocyte index (MTI) - 20.4 +/- 2.8 versus 18.1 +/- 2.5 [fl]. These deviations were present in all patient subsets, however did not correlate to parameters of glucose metabolism. Whole blood platelet count was increased in the patient group; 195.0 +/- 59.5 versus 184.0 +/- 37.5 x 10(3) plts/ul. Coating with glycoprotein IB receptors correlated significantly to platelet size in platelets of both controls and diabetics (r normal = 0.52 +/- 0.07; r diabetic = 0.46 +/- 0.1). The quantitative expression of glycoprotein IB was significantly enhanced in the diabetic group: 54,500 x 1.28 +/- 1 versus 39,100 x 1.3 +/- 1 molecules per platelet. In conclusion, these findings strongly support the assumption of diabetic stem cell dysfunction of the megakaryocytic series and progenitor cells resulting in platelets with primarily increased potency to adhere and aggregate in diabetes mellitus.

Increased mean platelet volume in type 2 diabetes mellitus

“…Association of increased platelet volume and reduced platelet survival in diabetic patients has been reported by Jones et al [27]. We found the number of platelets were smaller in diabetic patients similar to the results of Tschöpe et al [28], this difference was not statistically meaningful. Our examination of the diabetic group showed a negative linear relationship between MPV and the number of platelets (p=0.006).…”

The Relationship Between Microvascular Complications in Type 2 Diabetes with Mean Platelet Volume, Red Blood Cell Distribution Width, Neutrophile Lymphocyte Ratio

“…12 In their study, Tschope et al showed that erythrocytes were large and glycoprotein membrane receptors (CD62, CD63, thrombospondin) were much in diabetic patients and accordingly platelet activation was increased. 13 In our study, consistently with the previous studies we observed higher levels of MPV in diabetic patients compared with nondiabetic patients. Every 1 unit increase in MPV was found to increase the risk for DM by 1.63 folds and demonstrated the correlation between MPV and DM.…”

Liver enzymes, mean platelet volume, and red cell distribution width in gestational diabetes

“…Increased MPV, on the other hand, may be explained by the osmotic swelling effect of hyperglycemia as well as the effects of insulin, which increases platelet turnover, resulting in an increase in the number of younger and consequently larger platelets (9). Tschope et al (25) also suggested that glycoprotein IB expression, which plays an important role in thrombus formation, increases in patients with diabetes.…”

“…It has been suggested that platelets and the coagulation system are important determinants of atherogenesis and atherothrombosis (25). Although diabetes is considered a "prothrombotic state", the underlying mechanism behind increased platelet reactivity and higher MPV in diabetic subjects is not completely understood (9).…”