Platelet counts are associated with arterial stiffness in Chinese Han population: a longitudinal study

Abstract

Background Determining the risk factors for brachial-ankle pulse wave velocity (baPWV) may help to identify people susceptible to diabetic atherosclerosis and could prevent diabetic macrovascular complications in the early stages. We aim to comprehensively investigate risk factors contributing to arterial stiffness in patients with and without diabetes. Methods BaPWV was measured in 5651 individuals who attended health check-ups at baseline and follow-up. Lasso regression was used to screen for risk factors. Mixed models and multiple linear regressions were subsequently established to evaluate the effect size of the potential risk factors on baPWV and PWV change rates. All analyses were stratified by diabetes. Mediation analysis was also conducted to demonstrate the mechanisms of arterial stiffness in patients with diabetes. Results In lasso regression, postprandial 2-h glucose (P2hG), systolic blood pressure (SBP) and age were associated with baPWV regardless of diabetes. Platelet counts (PLT), mean corpuscular volume (MCV) and coronary heart disease (CHD) were associated with baPWV in patients with diabetes. In the mixed models, PLT were positively associated with baPWV in patients with diabetes ( β platelet, perSD = 25.80; 18.26–33.33). Elevated PLTs could also significantly increase the PWV change rate in patients with diabetes ( β platelet, perSD = 54.05; 10.00–107.10). In mediation analysis, diabetes had a significant average direct effect on baPWV. The average causal mediation effect (ACME) of PLTs was 1.76, with a range of 0.17 to 3.70. Conclusions Elevated PLT counts can increase baPWV in diabetes and are a potential mediator between diabetes and atherosclerosis.

Higher platelet count, even within normal range, is associated with increased arterial stiffness in young and middle-aged adults

“…Although platelet activity is associated with CV diseases [ 16 , 33 ] and the process of atherogenesis [ 34 ], studies focusing on platelet-associated parameters such as platelet count and MPV with arterial stiffness in general population remain extremely limited [ 20 – 22 ]. Only two studies discussed the correlation between arterial stiffness and platelet count [ 20 , 22 ]. One study from Liu et al found that increased platelet count was positively related to baPWV value in subjects with diabetes but not those without [ 22 ] and the other study from Marina et al showed insignificant relationship between platelet count and arterial stiffness [ 20 ].…”

“…Only two studies discussed the correlation between arterial stiffness and platelet count [ 20 , 22 ]. One study from Liu et al found that increased platelet count was positively related to baPWV value in subjects with diabetes but not those without [ 22 ] and the other study from Marina et al showed insignificant relationship between platelet count and arterial stiffness [ 20 ]. However, the population was relatively old in both studies from Liu et al (mean age: 66.8 years for those without diabetes) and Mariana et al (mean age: 55.3 years and 54.7 years in males and females).…”

“…According to previous studies, platelet disorders with abnormally high and low platelet count, such as essential thrombocythemia and idiopathic thrombocytopenia purpura, were related to the risk of increased arterial stiffness [14,[30][31][32]. Although platelet activity is associated with CV diseases [16,33] and the process of atherogenesis [34], studies focusing on platelet-associated parameters such as platelet count and MPV with arterial stiffness in general population remain extremely limited [20][21][22]. Only two studies discussed the correlation between arterial stiffness and platelet count [20,22].…”

“…Only two studies discussed the correlation between arterial stiffness and platelet count [20,22]. One study from Liu et al found that increased platelet count was positively related to baPWV value in subjects with diabetes but not those without [22] and the other study from Marina et al…”

“…MPV was demonstrated to be associated with baPWV [ 20 , 21 ]. As for platelet count and arterial stiffness, only one cohort study showed that increased platelet count is related to higher baPWV values in elderly patients with diabetes [ 22 ]. However, although platelet counts were shown to be attenuated in the elderly [ 23 ] and MPV values may be easily affected by cigarette smoking [ 24 ], those confounders were not well considered in previous studies.…”