Platelet Indices and Its Association with Microvascular Complications Among Type 2 Diabetes Mellitus Patients in Northeast Ethiopia: A Cross-Sectional Study

Abstract

Purpose Platelet indices have been shown to be associated with complications of diabetes mellitus (DM). However, the clinical relevance of platelet indices for assessing the risk of being microvascular complications among patients with DM is largely overlooked. Hence this study aimed to determine the association of platelet indices with microvascular complications among type 2 DM patients. Patients and Methods A hospital-based cross-sectional study was conducted among 352 type 2 DM patients from April 1 to May 30/2019 at Debre Berhan Referral Hospital. Data were collected by interview, physical measurements, document review, and laboratory tests. Then the data were entered into Epi-data manager-4.4.1.0 and exported into SPSS-25 for analysis. Platelet indices were compared between participants with and without microvascular complications using an independent t -test. A logistic regression model was used to assess the association between microvascular complications and platelet indices. All inferences were considered statistically significant at P<0.05. Results One hundred seventeen (33.2%) of participants were suffering from at least one microvascular complications. The mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) were significantly increased in DM patients with complications as compared to without complications (13.57±2.17fl vs. 11.76±1.93fl), (16.57±2.49fl vs. 14.97±2.41fl) and (28.09±7.58% vs. 24.19±6.46%), respectively (all are P˂0.001). In multivariate logistic regression analysis, MPV (AOR=1.68, 95% CI: 1.37–2.05), PDW (AOR=1.37, 95% CI: 1.15–1.63), P-LCR (AOR=1.07, 95% CI: 1.01–1.14), age (AOR=1.07, 95% CI: 1.01–1.12), and duration of DM (AOR=1.31, 95% CI: 1.18–1.46) were significantly associated with the presence of microvascular complications. Conclusion MPV, PDW, and P-LCR were significantly higher among type 2 DM patients with microvascular complications. This indicates that platelet indices can be used as prognostic markers of vascular complications and can be used as simple and cost-effective parameters to predict microvascular complications particularly in patients with old age and long duration of DM.

Mechanisms of the therapeutic effect of platelet-rich plasma in macular hole surgery

“…В стационарном режиме эти более крупные тромбоциты выделяют больше тромбоксана-2 (активатора агрегации тромбоцитов). К более крупным и метаболически активным относятся молодые тромбоциты и зрелые отросчатые тромбоциты в состоянии активации [33][34][35][36][37].…”

“…Чем выше будут показатели IPF, P-LCR, MPV, PDW, тем больше в крови пациента более крупных и молодых тромбоцитов, которые отражают более высокий уровень метаболической, ферментативной и функциональной активности. Молодые и крупные тромбоциты содержат больше -гранул, максимально обогащенных медиаторами [35,39]. Таким образом, чем выше будут показатели PLT, IPF, P-LCR, MPV, PDW, тем более биологически активной будет получаемая БоТП.…”

“…Таким образом, чем выше будут показатели PLT, IPF, P-LCR, MPV, PDW, тем более биологически активной будет получаемая БоТП. Но в то же время циркуляция более крупных и молодых клеток, отражающая активность тромбоцитов, считается предиктором тромботических событий у пациента [35,37,40]. Индексы объема тромбоцитов MPV, PDW и P-LCR при их повышении являются прогностическими маркерами тромботических состояний и сосудистых осложнений на фоне сердечно-сосудистых заболеваний, сахарного диабета, метаболического синдрома [34-36, 39, 40, 41].…”

Frequency of Proteinuria in Newly Diagnosed Diabetic Patients

“…Two hundred eighty-five patients were evaluated in our research, and proteinuriawas seen in 114 patients (40%).This is per other studies, which have also shown proteinuria as a common complication. [11][12][13][14][15] Multiple studies have been performed worldwide to know the exact prevalence of proteinuria in diabetic patients at the time of presentations. In one study, it appeared to be25.6% [16], while in another study, it was 57.44%.…”

Platelet Indices as Predictors of Diabetic Kidney Disease in Type 2 Diabetes Mellitus

“…The relation between increased PDW and MPV with diseases connected to endothelial dysfunction including diabetes, coronary artery disease [CAD], and cancer has been shown in numerous studies [4] . In some recently published research, patients with diabetic nephropathy had higher platelet indices such as PDW and MPV [5] .…”