“MEAN PLATELET VOLUME CORRELATED TO GLYCEMIC CONTROL IN TYPE 2 DIABETES MELLITUS”

Abstract

Background: Diabetes mellitus (DM) is becoming a global pandemic. The number of people with diabetes in India increased from 26·0 million in 1990 to 65·0 million in 2016. Diabetes mellitus (DM) has been considered as a 'prothrombotic state' with enhanced platelet reactivity. Diabetic patients have an increased risk of developing micro and macro vascular diseases, and platelets may be involved as putative agents owing to their altered morphology, function and activation. It is an established fact that the value of glycated hemoglobin (HbA1c), a marker of long-term glucoregulation, should be kept below 7% in order to reduce the risk of micro and macrovascular complications in Type 2 Diabetes Mellitus (DMT2) patients. Mean platelet volume (MPV) has been correlated with vascular complications of DMT2. MPV as a marker of platelet size, function & activation may serve as another potential marker of risk of micro-vascular and macrovascular complications in DMT2 patients. Aims-To study correlation between MPV, and HbA1c in DMT2 patients. Methods- Over a period of 24 months, patients aged between 30 to 60 years, diagnosed with DMT2 and subtyped based on American Diabetic Association Criteria (ADA) as having HbA1c either less than 7% - DMT2 (Controlled group) or with HbA1c more than 7% - DMT2 (Uncontrolled group) were included in the present study. Non-diabetic patients ('Non Diabetic Group) were included based on their fasting and post prandial blood glucose levels and served as controls. Venous blood samples were tested for fasting, postprandial and random blood sugar estimation by GOD-POD method, MPV by automated cell counter and HbA1c by HPLC, within one hour of sampling. Results were statistically tested using (R) unpaired t Test by SPSS Software (version 22). Results- Among 236 patients studied, 66 were 'Non-diabetic controls' & 170 were having diabetes (DMT2). Of those having DMT2, 94 patients belonged to DMT2 (Uncontrolled group) 76 patients belonged to DMT2 (Controlled group). MPV in Non-diabetic group, DMT2 (Controlled group) and DMT2 (Uncontrolled group) was 10.01 ± 1.12 , 10.76 ± 1.11  and 11.67 ± 1.83  respectively. MPVwas signicantly higher in DMT2 group compared to Non-diabetic group (10.82 ± 1.31  vs 10.01 ± 1.12 , p < 0.0001), MPV was also signicantly higher in DMT2 (Uncontrolled group) compared to DMT2 (Controlled group) (11.67 ± 1.83  vs. 10.76 ± 1.11 , p < 0.0001). Conclusion- In the present study Mean Platelet Volume was found to be signicantly higher in Diabetes Mellitus Type 2 patient compared to Nondiabetic patients. Higher MPV also correlated with higher HbA1c, being higher in those with higher HbA1c. It can be concluded that MPV may be useful as inexpensive surrogate marker of HbA1c in the diagnosis and prognosis of vascular complications of DMT2 patients.