Can Mean Platelet Volume and Platelet Distribution Width be used as Predictive Markers for Impending Diabetic Vascular Complications?

Abstract

Introduction: Diabetes Mellitus (DM) has been considered as a prothrombotic state which has impact on a wide series of pathways regulating platelet function, the cornerstone is represented by increased platelet reactivity. Many hypothesis have attempted to explain the pathophysiological mechanism by which these hyperreactive platelets contribute to diabetic vascular complications. However, a comprehensive analysis of the relationship between platelet indices and diabetic status is still lacking. Aim: To analyse platelet indices with glycaemic status in type-2 DM patients and to establish the correlation between Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Fasting Blood Sugar (FBS) and Glycated haemoglobin (HbA1c) values. Materials and Methods: A cross-sectional study was carried out in SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India. Totally 450 subjects (150 controlled and 150 uncontrolled diabetics, 150 non-diabetics) were included and investigated for HbA1c, FBS and platelet indices. Statistical analysis using IBM SPSS software version 20.0. Statistical significant p-value was considered at <0.05. Results: Diabetics had higher mean platelet count when compared to non-diabetics. MPV and PDW among uncontrolled diabetics were significantly higher than controlled diabetics and non-diabetics. MPV, PDW and platelet count showed a significant positive correlation with both HbA1c and FBS. We observed a significant difference in PDW and MPV when compared with various grades of HbA1c. Conclusion: The MPV and PDW are increased in diabetics. They are simple and cost-effective tools that can be used as a good indicator of platelet activation and an independent predictor of impending vascular complications in DM.

Keywords

• diabetes
• fasting blood sugar
• glycated haemoglobin
• platelets