Platelet indices in diabetes mellitus: indicators of diabetic microvascular complications

Abstract

Background and objective: Diabetes mellitus (DM) has been considered as a ‘prothrombotic state’ with enhanced platelet reactivity. Mean platelet volume (MPV) has been evaluated in DM and correlated with retinopathy. This study was aimed at evaluating platelet indices in diabetic versus non‐diabetic patients and assessing their utility as indicators of presence of complications in patients with DM.Methods: This study included 75 subjects with DM (50 with one or more microvascular complications) and 50 non‐selected patients from the hospital as controls. Anticoagulated blood (ethylene diamine tetracetic acid) was collected and analyzed in an automated blood cell counter for platelet count and indices [MPV, platelet distribution width (PDW) and platelet‐large cell ratio].Results: MPV, PDW and platelet‐large cell ratio were all significantly higher in diabetic patients compared to the control subjects (P<0·05 for all). Among the diabetics, PDW was higher in those with complications as compared to those without (P = 0·006). On stepwise discriminant analysis using age, duration of diabetes, platelet count and platelet indices, ∼78·6% of patients with diabetic complications were accurately classified. Interestingly, only two input variables (PDW and MPV) qualified for the final discriminant model.Conclusion: Platelet indices, especially PDW, are different between diabetics and controls as well as between diabetics with and without microvascular complications. Discriminant analysis using PDW and MPV could classify majority of patients with diabetic complications.