Study of altered platelet morphology with changes in glycaemic status

Abstract

Background: Diabetes is a pandemic causing very high morbidity and mortality due to its complications which are a result of micro and macro angiopathy. Platelets play a key role in the vascular complications. These complications are attributed to platelet activation which can be recognised by an increase in platelet volume indices (PVI) including mean platelet volume (MPV) and platelet distribution width (PDW). Platelet indices can be potentially useful surrogate markers for the early diagnosis of thromboembolic and cardiovascular complications in diabetes. Methods: This is a cross-sectional study conducted for 2 years with total 930 subjects. The patients were segregated in 03 groups on basis of HbA1C as (a) Diabetic, (b) Non-Diabetic and (c) FG. Samples for HbA1C and platelet indices were collected using EDTA (ethylene diamine tetracetic acid) as anticoagulant and were processed on autoanalysers. Results:The study revealed a stepwise increase in the PVI from non-diabetics to IFG to diabetics. MPV and PDW were increased in the IFG cases as compared to the non-diabetic and were markedly increased in the diabetic patients. MPV and PDW of diabetics, IFG and non-diabetics were 17.60±2. 04, 11.76±0.73, 9.93±0.64 and 19.17±1.48, 15.49±0.67, 10.59±0.67 respectively with a significant p value 0.00. Significant positive correlation between PVI with glycaemic levels and duration of diabetes across the groups (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, the total platelet count was found to decrease with the increasing glycaemic levels with a p value <0.001. A significant negative correlation was found between glycaemic levels and total platelet count (PC-HbA1c r = -0.164). Conclusions: This study showed that platelet morphology is altered with increasing glycaemic levels. These changes can be known by measurements of PVI which is an important simple and effortless tool can be used more extensively to predict the acute vascular events and thereby help curb morbidity and mortality.

Assessment of the Platelet Parameters in Children With Type 1 Diabetes Mellitus

“…This large study of adults with T2DM reported that duration of diabetes was positively correlated with PDW and MPV. That study also reported positive correlation between PDW and HbA1c [3]. We observed no statistically significant difference in PDW between our study groups.…”

“…Mean platelet volume (MPV) is a marker of platelet function and activation. MPV and platelet distribution width (PDW) can be used as markers in the early diagnosis of diabetic complications in patients with type 2 diabetes mellitus (T2DM) [3]. Plateletcrit (PCT) levels are defined as an independent marker of vascular changes, particularly in the coronary arteries.…”

Study of Platelet Indices in Type 2 Diabetic Patients and Its Correlation With Vascular Complications

“…Other studies showed a mean MPV lesser than the present study whereas one study conducted by Sharma M et al (22) showed higher MPV than our study (table 2,3). Among controls, 46 out of 70 patients (65.7%) had MPV of < 10.5 fL and 24 out of 70 (24.2%) had MPV of ≥10.5 fL with a mean of 10.173±0.7134.…”

“…However, no statistical correlation was noted between MPV and age, duration of DM, FBS; PDW and age, duration of DM, FBS; P-LCR and age, duration of DM, FBS. (15) 10.43±1.03 9.2±0.91 0.001 Sharma M et al (22) 17.60±2.04 9.93±0.64 <0.001 Khode V et al (23) 9.54 ± 0.9 9.21 ± 0.6 0.018 Present study 11.377±1.1969 10.173±0.7134 0.0001 …”

The Study of Platelet Parameters- Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) in Type 2 Diabetes Mellitus

“…This suggests the association between the platelet size and diabetic vascular complications, thus indicating alterations in MPV reflect the state of thrombogenesis. [10] PDW can directly measure the variability of platelet size. Increased endothelial damage is seen in diabetes mellitus, which reduces the survival of platelets and increases turnover of younger platelets.…”