Abstract
Purpose. To investigate whether platelet morphology or function is altered in patients with diabetic retinopathy (DR). Methods. This prospective study enrolled 85 healthy controls (HCs) (group 1) and 262 patients with Type 2 diabetes mellitus (T2DM). Patients were subclassified into three groups according to ocular findings: no DR (group 2; n = 88); nonproliferative DR (group 3; n = 88), and proliferative DR (group 4; n = 86). Mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (PLCR), plateletcrit (PCT) values, and platelet count were measured in the studied groups. Results. MPV, PDW, and PLCR levels were significantly altered in groups 2–4 compared with HCs (p < 0.05, p < 0.05, p < 0.05). Compared with group 2, both DR groups had higher MPV and PDW levels, with a significant difference between groups 2 and 4 for both MPV (p = 0.036) and PDW (p = 0.006). PLCR correlated with retinopathy stage, but no significant difference was found between the DR groups. Platelet count and PCT values were not significantly different between the groups (p > 0.05). Conclusion. Our findings suggest an association between mean platelet indices (MPI) (i.e., MPV, PDW, and PLCR) and DR stage. Therefore, MPI could be a beneficial prognostic marker of DR in patients with T2DM.
Highlights
Type 2 diabetes mellitus (T2DM) is an endocrine disease characterized by impaired insulin excretion by the pancreas and insulin resistance of body tissues [1]
Our findings suggest an association between mean platelet indices (MPI) (i.e., Mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (PLCR)) and diabetic retinopathy (DR) stage
Various parameters reflect the condition of platelets, including platelet count, plateletcrit, and mean platelet indices (MPI)
Summary
Type 2 diabetes mellitus (T2DM) is an endocrine disease characterized by impaired insulin excretion by the pancreas and insulin resistance of body tissues [1]. Chronic hyperglycemia leads to micro- and macrovascular complications in patients with T2DM; diabetic retinopathy (DR) is the most common and the specific microangiopathy [2]. Dyslipidemia, genetic factors, obesity, hypertension, smoking, proteinuria, and hypermetropic refractive changes may all play a role in development of DR development [3]. Abnormal insulin activation in patients with T2DM may increase platelet activation and precipitate microvascular complications [4]. Some authors have emphasized the importance of platelet dysfunction in macrovascular (cardiovascular disease [CVD], stroke, and peripheral artery disease [PAD]) and microvascular (nephropathy, neuropathy, and retinopathy) complications, which lead to increased morbidity and mortality in T2DM [4, 5]. Various parameters reflect the condition of platelets, including platelet count, plateletcrit, and mean platelet indices (MPI) (mean platelet volume [MPV], platelet distribution width [PDW], and platelet large cell ratio [PLCR])
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