DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160513

Study of altered platelet morphology with changes in glycaemic status

Mitakshara Sharma, Sanjeev Narang, S. K. Nema

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.

 


Keywords


MPV, PDW, PVI, IFG, HbA1C, Diabetes

Full Text:

PDF

References


Maitra A. The Endocrine System. Robbins & Cotran Pathologic Basis of Disease. 2010;8:1097-164.

Yngen M. Platelet Hyperactivity in Diabetes Mellitus. European Cardiology. 2005;1:1-6.

International Diabetes Federation: Diabetes Atlas. 6th edition. From: http://www.idf.org/diabetesatlas.

Ulutas KT. Evaluation of mean platelet volume in patients with type 2 diabetes mellitus and blood glucose regulation: a marker for atherosclerosis. Int J Clin Exp Med. 2014;7(4):955-61.

Kakouros N, Rade JJ. Platelet Function in Patients with Diabetes Mellitus: From a Theoretical to a Practical Perspective. International Journal of Endocrinology. 2011.

American diabetes association: Diagnosis and classification of diabetes mellitus. Diabetes Care 2008;31(1).

Saboor M, Ilyas MS. Platelets structural, Functional and Metabolic Alterations in Diabetes Mellitus. Pak J Physiol. 2012;8(2).

Zuberi BF. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fasting glucose and non-diabetic subjects. Singapore Medical Journal. 2008;49(2):114-6.

Dalamaga M, Karmaniolas K. Platelet markers correlate with glycemic Indices in diabetic, but not diabetic-myelodysplastic patients with normal platelet count. Disease Markers. 2010;29:55-61.

Ferroni P, Basili S. Platelet activation in type 2 diabetes mellitus. J Thromb Haemost. 2004;2:1282-1291.

Kodiatte TA, Manikyam UK. Mean platelet volume in type II DM. J Lab Physicians. 2012;4:5-9.

Colwell JA, Nesto RW. The platelet in diabetes focus on ischemic events. Diabetes Care. 2003;26:2181-88.

Ferreiro JL, Gómez JA. Platelet abnormalities in diabetes mellitus. Diabetes Vasc Dis Res. 2010;7(4):251-9.

Vagdatli E. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010;14(1):28-32.

Shimodaira M, Niwa T, Nakajima K, Kobayashi M, Hanyu N, Nakayama T. Correlation between mean platelet volume and fasting plasma glucose levels in prediabetic and normoglycemic individuals. Cardiovasc Diabetol. 2013;12:14.

Kim KY. Mean platelet volume in the normal state and in various clinical disorders. Yonsei Medical Journal. 1986;27(3).