Platelet Large Cell Ratio Research Articles

Platelet-large cell ratio predicts no-reflow in patients undergoing primary coronary angioplasty for ST-segment elevation myocardial infarction

Abstract Background Increased platelet indices have been shown to reflect higher degree of platelet activation and have been related to poorer short- and long-term outcomes in patients presenting with ST-segment elevation myocardial infarction (STEMI). Purpose We aimed to evaluate the ability of a validated marker of platelet activation (i.e., the platelet-large cell ratio [P-LCR]) to predict the occurrence of no-reflow in patients undergoing primary percutaneous coronary intervention (pPCI) for STEMI. The ability of P-LCR to predict other markers of thrombotic charge (i.e., use of glycoprotein IIb/IIIa inhibitors and/or thrombus aspiration) was also investigated. Methods Use of glycoprotein IIb/IIIa inhibitors and/or thrombus aspiration, occurrence of the ‘no-reflow’ phenomenon and P-LCR values on admission were recorded in 836 consecutive patients treated by pPCI for STEMI. Patients’ demographic data and symptom onset-to-cardiac catheterization laboratory time intervals were also recorded. Correlations between P-LCR values and the presence of thrombotic charge markers were evaluated. Results No-reflow occurred in 124 (14.8%) of the study patients; glycoprotein IIb/IIIa inhibitors and thrombus aspiration were used in 228 (27.3%) and in 289 (34.5%) of patients, respectively. Mean P-LCR values were 27.1 ± 7.6%. P-LCR values on admission were significantly higher in patients who presented no-reflow than in those who did not (29.1 ± 5.6% vs. 25.3 ± 5.8%, p = 0.03). Similarly, P-LCR were significantly higher in patients in whom glycoprotein IIb/IIIa inhibitors (29.5 ± 6.1% vs. 25.2 ± 5.3%, p = 0.04) and/or thrombus aspiration (28.4 ± 5.7% vs. 24.8 ± 5.4%, p = 0.03) were used. A P-LCR value ≥26.9% predicted the occurrence of no-reflow with 70.9% sensitivity and 55.4% specificity (p = 0.04). Conclusions In the present cohort, P-LCR values on admission predicted the presence of thrombotic charge markers in patients undergoing pPCI for STEMI. Evaluating P-LCR on admission could help identify patients at increased risk of no-reflow, in whom more intensive antiplatelet strategies may be of interest.

Platelet Indices in Patients With Gram-Negative and Gram-Positive Sepsis: A Retrospective Cross-Sectional Study.

Different inflammatory processes and sepsis can significantly affect the number of platelets and platelet indices. Therefore, in this study, total platelet count (PLT), thrombocrit (Pct), platelet distribution width (PDW), mean platelet volume (MPV), and platelet-large cell ratio (P-LCR) were analyzed in patients with Gram-negative and Gram-positive bacterial sepsis and in sterile blood cultures. Inclusion criteria were an increased number of inflammatory parameters (elevated values ​​of leukocytes,C-reactive protein (CRP), procalcitonin (PCT), andpositive blood culture. Exclusion criteria were patients who did not have elevated values ​​of inflammatory parameters and did not have a positive blood culture.Samples were collected from patients who had sepsis confirmed by blood cultures at the Department of Microbiology and Molecular Diagnostics at University Clinical Hospital Mostar in the period from 2019 to 2022. Three groups were analyzed, patients who had sterile blood cultures, patients with blood cultures with isolated Gram-positive bacteria, and patients with blood cultures with isolated Gram-negative bacteria. Specific infectious agents were identified for each group of patients. In addition to the above, PLT, Pct, MPV, PDW, P-LCR, PCT, CRP, the total number of leukocytes, and the number of neutrophil leukocytes were analyzed in each group. The values of PCT, CRP, and the number of neutrophile leukocytes were significantly higher in patients with Gram-negative sepsis as compared to Gram-positive sepsis and to control group. Patients with sepsis have decreased PLT and Ptc and increased values of MPV, PDW, and P-LCR. In sepsis caused by the Gram-negative bacteria, i.e., Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii, the values of the same parameters were more changed compared to sepsis caused by Gram-positive bacteria, i.e., Streptococcus pneumoniae, Enterococcus spp., and methicillin-resistant Staphylococcus aureus (MRSA). When comparing Gram-negative negative bacteria, PLT was lowest in sepsis caused by Escherichia coli, the PDW value was highest in sepsis caused by Acinetobacter baumannii, and MPV and P-LCR were the highest in sepsis caused by Klebsiella pneumoniae. Our study showed that platelet indices are significantly changed in patients with sepsis. Patients with sepsis have decreased values of PLT and Pct and increased values of MPV, PDW, and P-LCR, indicating an increase in thrombocyte production. Moreover, the results were more prominent in sepsis caused by Gram-negative bacteria compared to sepsis caused by Gram-positive bacteria.

A study to determine utility of platelet indices in differentiating hyperdestructive and hypoproductive thrombocytopenia.

Background: Thrombocytopenia by definition signifies a platelet count below 1,50,000/mm3 but this does not reflect the underlying pathology. Management of these patients significantly depends on identifying the primary cause of thrombocytopenia. With advances in automation, analyzers can now measure platelet parameters like mean platelet volume, Platelet distribution width, and Platelet large cell ratio which are potential biomarkers of platelet morphology. Presently, these non-invasive and cost-efficient diagnostic markers are quite underused. The study aimed to understand the relationship of instrument-derived platelet parameters with respect to the categorizing of thrombocytopenia based on underlying pathophysiology. Materials and methods: A prospective study was conducted from September 2018 to October 2020consisting of 315 cases of hyperdestructive thrombocytopenia and 54 cases of hypoproductive thrombocytopenia. After collecting the important clinical details, platelet count along with instrument-derived platelet indices was noted. A comparison of platelet indices was done between the two groups. Results: In the hyper-destructive group, the mean platelet indices were found to be significantly higher in comparison to the hypo-productive group. No significant correlation was obtained between the platelet count severity and various platelet indices. Mean platelet volume had the highest sensitivity and specificity in differentiating hyper-destructive thrombocytopenia from the hypo-productive group. Conclusions: Platelet indices aid in distinguishing hyper-destructive from hypo-productive causes of thrombocytopenia. Of the three indices analyzed, Mean platelet volume was shown to be a better parameter in differentiating the two groups.

A study to determine utility of platelet indices in differentiating hyperdestructive and hypoproductive thrombocytopenia.

Background: Thrombocytopenia by definition signifies a platelet count below 1,50,000/mm3 but this does not reflect the underlying pathology. Management of these patients significantly depends on identifying the primary cause of thrombocytopenia. With advances in automation, analyzers can now measure platelet parameters like mean platelet volume, Platelet distribution width, and Platelet large cell ratio which are potential biomarkers of platelet morphology. Presently, these non-invasive and cost-efficient diagnostic markers are quite underused. The study aimed to understand the relationship of instrument-derived platelet parameters with respect to the categorizing of thrombocytopenia based on underlying pathophysiology. Materials and methods: A prospective study was conducted from September 2018 to October 2020consisting of 315 cases of hyperdestructive thrombocytopenia and 54 cases of hypoproductive thrombocytopenia. After collecting the important clinical details, platelet count along with instrument-derived platelet indices was noted. A comparison of platelet indices was done between the two groups. Results: In the hyper-destructive group, the mean platelet indices were found to be significantly higher in comparison to the hypo-productive group. No significant correlation was obtained between the platelet count severity and various platelet indices. Mean platelet volume had the highest sensitivity and specificity in differentiating hyper-destructive thrombocytopenia from the hypo-productive group. Conclusions: Platelet indices aid in distinguishing hyper-destructive from hypo-productive causes of thrombocytopenia. Of the three indices analyzed, Mean platelet volume was shown to be a better parameter in differentiating the two groups.

Correlation between blood cell indices and adiponectin and leptin levels in COVID-19.

Adipose tissue (AT) is a major metabolic organ, functioning through autocrine, paracrine, and endocrine mechanisms. This study investigated the relationship between adipokine levels and blood cell indices, particularly platelets, in individuals with COVID-19. Another aim was to enhance the understanding of AT's endocrine function during dynamic pathological changes, such as acute viral infections like COVID-19. The study was conducted as a cross-sectional analysis at the Clinical Center Vojvodina in 2021 and 2022, including 76 consecutive SARS-CoV-2-positive patients of both sexes. Study parameters were determined from peripheral venous blood samples routinely collected upon hospital admission. The results showed that leptin levels were significantly positively correlated with body mass index (BMI) (ρ = 0.421, P < 0.001) and body fat mass (BFM) (ρ = 0.547, P < 0.001). Simultaneously, a significant negative correlation was observed between adiponectin levels and BMI (ρ = -0.430, P < 0.001). Additionally, a significant positive correlation was found between leptin levels and mean platelet volume (MPV) (ρ = 0.307, P < 0.05), platelet distribution width (PDW) (ρ = 0.325, P < 0.05), and platelet-large cell ratio (P-LCR) (ρ = 0.305, P < 0.05). Leptin's impact on platelet indices was confirmed in both simple and multiple linear regression models, where leptin exhibited a slightly higher beta coefficient than BMI. In contrast, adiponectin levels were negatively correlated with hematocrit (HCT) (ρ = -0.329, P < 0.05). These findings may provide further insight into the previously suspected role of AT in the complex cascade of COVID-19 pathogenesis and platelet activation.

Platelet indices as a predictor in patients with aplastic anemia and immune thrombocytopenic purpura: a retrospective case–control study

Background and objectivesPlatelet indices are widely available and relatively cheap platelet parameters. The critical objective of this study is to assess the reliability of platelet indices as biomarkers for diagnosis and prognosis in adult thrombocytopenic patients.MethodsA retrospective case–control study, including 81 immune thrombocytopenia (ITP) cases, 50 aplastic anemia (AA) cases, and 150 participants as a control group. This study included patients admitted from 2016 to 2021 to the Clinical Hematology Unit, Department of Internal Medicine, University Hospital. The collected data included sociodemographic information, clinical data, laboratory data, and an assessment of the therapeutic response in the studied groups.ResultsFor the diagnosis of adult thrombocytopenic patients, platelet distribution width (PDW) showed the best diagnostic accuracy (85% for ITP and 91.9% for AA) at cutoff points of 14.9% and 17.2%, respectively. This was followed by mean platelet volume (MPV) with diagnostic accuracies of 77% for ITP and 89.3% for AA at a cutoff point of 9.4 fl. Platelet large cell ratio (PLCR) demonstrated insignificant accuracy in diagnosing either ITP or AA.ConclusionPlatelet indices can play a crucial influence in the diagnosis, not the prognosis, of adult thrombocytopenia.Trial registrationNCT05116033. https://classic.clinicaltrials.gov/ct2/show/NCT05116033

Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital, Ethiopia.

Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality. It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices. However, the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context, and evidence for their role as predictors of poor glycemic status in diabetic patients is limited. To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia, from June 15 to August 12, 2022. A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus (T2DM) and 87 non-diabetic controls. The systematic random sampling technique was used to select par-ticipants. Data were collected using structured questionnaires, physical measurements, checklists, and laboratory tests. Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers, respectively. The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear. Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. The χ 2 test, Mann-Whitney U test, Kruskal-Wallis test, post hoc test, Spearman correlation, and receiver operating characteristic curve were used for analysis. A P value < 0.05 was considered statistically significant. The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (PLCR), and plateletcrit (PCT) compared to healthy individuals (P < 0.001). Furthermore, these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls. We also observed significant correlations between these indices and various anthropometric and clinical variables. Our findings suggest that PDW, with a cut-off value of 15.75 fL and an area under the curve (AUC) of 0.803, MPV, with a cut-off value of 12.25 fL and an AUC of 0.774, PLCR, with a cut-off value of 36.3% and an AUC of 0.775, and PCT, with a cut-off value of 0.24% and an AUC of 0.761, can serve as predictors of poor glycemic control in patients with diabetes mellitus. The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes. Therefore, regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.

Immature platelet fraction in patients diagnosed with COVID-19.

The recent pandemic caused by the newly identified virus, SARS-Cov-2 is associated with thromboembolic events. Patients infected with COVID-19 have been found to have thrombocytopenia. A decrease in platelet count may be caused by increased destruction and consumption of platelets or by decreased production of platelets in the bone marrow. Immature platelet fraction (IPF) is a new platelet parameter that is an indicator for peripheral destruction and consumption of platelets. To assess the immature platelet fraction (IPF) in patients infected with COVID-19. The present study is a retrospective study where secondary data obtained from previous laboratory records of COVID-positive patients admitted at a tertiary care hospital in Delhi from 4 January to 4 February 2022 was analyzed. Sixty-eight COVID-positive patients were included. Platelet parameters included from the automated hematology analyzer Mindray were platelet count, mean platelet volume (MPV), immature platelet fraction (IPF), and platelet large cell ratio (P-LCR). Data was analyzed using SPSS Version 25. A P value less than 0.05 was considered statistically significant. In the present study mild thrombocytopenia was noted in 40% of the patients infected with COVID-19 admitted to the hospital. The median platelet count in these patients was found to be 91,000/mm3 (64,000-1,31,000). Low platelet count was associated with a significantly higher IPF, MPV, PDW, P-LCR, and a significantly lower PCT as compared to patients infected with COVID-19 with normal platelet count. There was a significant increase in IPF with a decrease in platelet count (P value < 0.05). A significant increase in IPF was noted with an increase in MPV and P-LCR (P value < 0.05). The present study suggests that thrombocytopenia in patients infected with COVID-19 may probably be due to peripheral destruction and consumption of platelets.

HLA class I expression on human platelets is highly variable and correlates with distinct allele group frequencies.

Human leukocyte antigen (HLA) class I molecules are expressed on platelets and can represent a source of alloimmunization in recipients of platelet transfusions. HLA mismatch between donors and recipients may be associated with the induction of anti-HLA antibodies, which can culminate in refractoriness to platelet transfusions. In the present study we analyzed HLA allele group frequencies and HLA expression levels on human platelets from blood donors. Platelet-rich plasma was collected from 139 donors to monitor platelet HLA class I expression by flow cytometry. DNA from donors with high and low platelet HLA expression was used in the genotype studies. Frequencies of large and normal-sized platelet subpopulations were determined and HLA class I expression was studied. Mean platelet volume (MPV) and platelet large-cell ratio (P-LCR) were analyzed in both groups of donors. The analysis showed variable platelet HLA class I expression with significant differences among donors. HLA class I allele group frequencies in donors with high and low platelet HLA expression showed distinctive genotypic features strictly related to expression level. The main allele groups found in samples with high platelet HLA class I expression were HLA-A*02, -A*68, -B*15, -B*49, and -C*03. Platelet HLA class I expression did not change over time or during freezing-thawing cycles. The analysis of platelet subpopulations showed a statistically significant higher expression of HLA class I molecules on large platelets than on normal-sized platelets. Moreover, donors with high HLA class I expression showed a higher frequency of large platelets (p<0.0001). The analysis of P-LCR in both groups of donors showed a statistically significant difference (p<0.05) within high HLA-expressing donors. Our data suggest an allele-dependent expression of HLA class I molecules on human platelets with distinct HLA allele group frequencies and different platelet subpopulation frequencies among blood donors.

The Relationship Between Platelet Indices, Hormonal Status, and Insulin Resistance in Adolescents with Polycystic Ovary Syndrome: A Retrospective Case-Control Study

Aim: This study aimed to investigate the relationship between polycystic ovary syndrome in adolescents, a disease caused by inflammation and insulin resistance that is associated with metabolic disorders, and platelet indices, which provide information about platelet activity. Materials and methods: Patients with oligoovulation, hyperandrogenemia, or clinical signs of hyperandrogenism (hirsutism, acne, etc.) and polycystic appearance with ≥ 20 small follicles ≥ 2∼ 9 mm in diameter in both ovaries on ultrasound according to the newly updated Rotterdam criteria were included in the study with a diagnosis of polycystic ovary syndrome and formed PCOS group. Patients with similar age groups and body mass index (BMI) values who presented to the clinic for non-PCOS symptoms (vaginitis, dysmenorrhea, cystitis), whose complete blood count was checked during hormone testing, and who did not meet the Rotterdam criteria were selected as the control group. Platelet indices found in routine blood count parameters (platelet large cell ratio (P-LCR), platelet distribution width (PDW) and mean platelet volume (MPV)) were analyzed between the two groups. In addition, the relationship between these indices and hormone status and insulin resistance in PCOS patients was analyzed. Patients with diabetes mellitus, hypertension, malignant diseases, cardiovascular diseases, essential thrombocytopenia or other blood diseases and patients taking medication were excluded. Results: In the study of 123 patients, there was no statistically significant difference between the groups in terms of age and body mass index (p:&gt;0.05). When hemogram parameters were compared between the groups, hemogram parameters such as P-LCR (p: 0.002), PDW (p: 0.011) and MPV (p: 0.007), which indicate platelet activity, were statistically significantly higher in the PCOS group. When the data of PCOS patients were analyzed, platelet indices were found to be higher in the group with high insulin resistance (p:

Clinical and hematological characteristics of children infected with the omicron variant of SARS-CoV-2: role of the combination of the neutrophil: lymphocyte ratio and eosinophil count in distinguishing severe COVID-19.

Investigate the clinical/hematological characteristics of children infected with the Omicron variant of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) and identify an effective indicator to distinguish coronavirus disease 2019 (COVID-19) severity in children. A retrospective study was conducted through electronic medical records from pediatric patients. The demographic, clinical, and routine blood test (RBT) features of children diagnosed by real-time PCR for SARS-CoV-2 were collected. Data of 261 patients were analyzed. The most common abnormality shown by RBTs was increased monocyte count (68%). Children had "mild-moderate" or "severe" forms of COVID-19. Prevalence of abnormal neutrophil count (p = 0.048), eosinophil count (p = 0.006), mean corpuscular volume (p = 0.033), mean platelet volume (p = 0.006), platelet-large cell ratio (p = 0.043), and red blood cell distribution width-standard deviation (p = 0.031) were significantly different in the two types. A combination of the neutrophil: lymphocyte ratio (NLR) and eosinophil count for diagnosing severe COVID-19 presented the largest AUC (0.688, 95% CI = 0.599-0.777; p < 0.001), and the AUC increased with a decrease in age. Combination of the NLR and eosinophil count might be a promising indicator for identifying severe COVID-19 in children at infection onset.

Tracking bioaerosol exposure among municipal solid waste workers using hematological and inflammatory biomarkers

High levels of bioaerosols may exist in the air of municipal solid waste (MSW) management facilities, constituting a significant occupational hazard for workers. In this study, we investigated the potential association between exposure to bioaerosols and inflammatory biomarkers among municipal solid waste workers (MSWWs) at both the landfill site and the municipal solid waste transfer station (MSWTS), in comparison to a control group without exposure. Air sampling was conducted at six points around the landfill, two points at the MSWTS, and one point in a public park (as a control area) during the spring and summer of 2019. The results of our study revealed that airborne pathogens were highly prevalent at the sampling points, especially in the active zone and leachate collection pond. Aspergillus species were the predominant fungal species detected in this study, with the highest occurrence observed for Aspergillus flavus (83.3%), Aspergillus niger, and Aspergillus fumigatus (75.0%). Furthermore, Staphylococcus species accounted for over 75% of the total bacterial bioaerosols detected across all study areas. The blood test results of workers revealed a significant increase in platelets (PLT), immunoglobulin G (IgG), white blood cells (WBC), neutrophils, basophils, and high-sensitivity C-reactive protein (hs-CRP) compared to the control group. Conversely, platelet distribution width (PDW), mean platelet volume (MPV), and platelet-large cell ratio (P-LCR) in the exposed subjects exhibited a decreasing trend compared to the control group. These findings suggest a potential association between exposure to bioaerosols, particularly in the vicinity of open dumpsites, and elevated levels of hematologic and inflammatory markers in circulation. Furthermore, the influence of smoking status and confounding factors appears to be significant in both the control and exposure groups.

The role of platelet large cell ratio in determining mortality in COVID-19 patients.

Inflammatory mechanisms have been implicated and have been subject to research in the clinical course of COVID-19 patients. In this study, platelet large cell ratio (P-LCR) has been examined as a novel prognostic and inflammatory parameter. A total of 1992 COVID-19-positive patients admitted to COVID-19 unit of Infectious Diseases were included. In order to identify a potential relationship between P-LCR and mortality, surviving patients were compared with subjects who died as a result of the disease. Although P-LCR levels showed a steady increase in all COVID-19 patients after admission, they were significantly higher in those who eventually died (P < .001), indicating a positive correlation between mortality and P-LCR. The P-LCR levels of patients followed up in the intensive care unit were statistically significantly higher than those followed up in the ward (P < .001). P-LCR levels of patients intubated in intensive care unit were statistically significantly higher than those who were not intubated (P < .001). Also, P-LCR levels were subdivided into 3 categories as normal, low, and elevated. Elevated P-LCR was found to be positively correlated with leukocyte count, neutrophil count, D-dimer, troponin, ferritin, and C-Reactive Protein (CRP) and showed negative correlation with fibrinogen, lymphocyte count, and platelet count. As P-LCR was correlated with the severity of inflammation in all COVID-19 patients, it was significantly higher in those patients who died. Elevated P-LCR was considered to be associated with the risk of severe disease and death. This inexpensive, readily available test may be incorporated into our clinical practice as a novel marker of poor prognosis in addition to other valuable laboratory parameters.

Platelet indices as a predictive marker in neonates with respiratory distress

BackgroundThe neonatal intensive care unit (NICU) frequently gets admissions due to respiratory distress (RD). Platelet indices are a beneficial biomarker in order to gauge the severity of neonatal RD. We aimed to assess platelet indices as a potential predictor in neonates with RD.MethodsThis prospective research involved 120 neonates who had been admitted to the NICU with evidence of RD. On admission and after respiratory support was reduced; a complete blood count (CBC) was performed to determine platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT), platelet distribution width (PDW), platelet mass index (PMI), and platelet large cell ratio (PLCR).ResultsMPV and PDW were significantly higher after respiratory support reduction. PC and PMI were significantly higher in neonates exhibiting moderate and severe distress. PC of 276.5*109/L had the highest degree of predictability of RD severity (area under curve (AUC) 0.762, sensitivity 81.5%, specificity 64.3%), 95% confidence interval (0.7–0.9), while PMI of 2473.5 fL/nL was the best cut-off point to predict severity of RD (AUC 0.663, sensitivity 63%, specificity 57.1%) 95% confidence interval (0.6–0.8). There was a significant difference in the average PC between different oxygen modes.ConclusionHigher PMI and PC are associated with moderate and severe RD and can be used to predict the severity of neonatal RD.

Correlation between platelet indices and preeclampsia with severe features

Backgrounds: Pre-eclampsia is a pregnancy-related syndrome with a 2-8% prevalence worldwide. In Indonesia, its incidence was 128,273 (5.3%) cases that caused 30-40% of maternal deaths. In 2021, at Karawang General Public Hospital, there are 43% cases of pre-eclampsia with 3% of complication. The pathophysiology is related to the inflammatory and coagulation system that includes platelets. Thus, platelet indices as indicators for platelet changes could be potential laboratory markers for pre-eclampsia.Objective: To examine the relationship between the platelet indices and pre-eclampsia severe features at the Karawang General Public HospitalMethods: The six months cross-sectional study was conducted at the Karawang General Public Hospital for pre-eclampsia pregnant women with at least 28 weeks of gestational age. The pre-eclampsia criteria were blood pressure higher or equal to 140/90 mmHg and qualitative proteinuria dipstick +1. The subjects were divided into two groups: pre-eclampsia with severe features and without severe features. Severe features criteria were thrombocytopenia, impaired liver function, renal insufficiency, pulmonary edema, new onset headache, and visual disturbances. Pregnant women have their blood platelet indices checked in the form of platelet crit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR). Data were analyzed with descriptive analysis (percentage), cut-off analysis, ROC curve, AUC analysis, bivariate Chi-square analysis, and multivariate logistic regression analysis.Results: There was a significant difference (p &lt; 0.05) in the value of PCT, MPV, PDW, and P-LCR between pregnant pre-eclampsia women with severe features and pregnant pre-eclampsia women without severe features. P-LCR has the best sensitivity (52.9%) and specificity (98.9%).Conclusions: There was a significant change in the value of the platelet indices (PCT, MPV, PDW, P-LCR) in pregnant pre-eclampsia women with severe features at the Karawang General Public Hospital.

The unique association between the level of plateletcrit and the prevalence of diabetic kidney disease: a cross-sectional study.

The activation of platelets in individuals with type 2 diabetes mellitus (T2DM) triggers inflammation and hemodynamic abnormalities, contributing to the development of diabetic kidney disease (DKD). Despite this, research into the relationship between plateletcrit (PCT) levels and DKD is sparse, with inconsistent conclusions drawn regarding the connection between various platelet parameters and DKD. This highlights the necessity for comprehensive, large-scale population studies. Therefore, our objective is to explore the association between PCT levels and various platelet parameters in relation to DKD. In this cross-sectional study, hematological parameter data were collected from a cohort of 4,302 hospitalized Chinese patients. We analyzed the relationships between PCT, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and DKD, along with the urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic potential of these parameters. DKD patients exhibited significantly higher PCT levels compared to those without DKD. Multivariate regression analysis identified elevated PCT and PLT levels as potential independent risk factors for both DKD and UACR, while lower MPV levels might serve as independent protective factors for eGFR. The areas under the ROC curve for PCT in relation to DKD and UACR (≥30 mg/g) were 0.523 and 0.526, respectively. The area under the ROC curve for PLT in relation to UACR (≥30 mg/g) was 0.523. PCT demonstrates a weak diagnostic value for T2DM patients at risk of developing DKD and experiencing proteinuria, and PLT shows a similarly modest diagnostic utility for detecting proteinuria. These insights contribute to a deeper understanding of the complex dynamics involved in DKD. Additionally, incorporating these markers into routine clinical assessments could enhance risk stratification, facilitating early interventions and personalized management strategies.

Differences in platelet indices between type-2 diabetes mellitus patients with and without microvascular complications at Teaching Hospital, Karapitiya

Type-2 Diabetes Mellitus (T2DM) is associated with a greater amount of morbidity and mortality due to microvascular and macrovascular complications. Involvement of platelets in vascular complications of diabetes is well known and changes in platelet indices have been identified as predictors of these vascular complications. This study was carried out to determine the changes in platelet indices in patients with T2DM. This was a comparative cross sectional study conducted at Teaching Hospital, Karapitiya. Study subjects included T2DM patients with microvascular complications as study group and T2DM patients without any vascular compli-cations as comparison group. For each group age and sex matched 52 subjects were recruited. Subjects with microvascular complications had mean platelet volume (MPV) of 10.62±0.49fL, platelet distribution width (PDW) of 12.23±1.12fL, plateletcrit (PCT) of 0.28±0.05% and platelet large cell ratio (PLCR) of 29.44±4. Subjects without any vascular complications had MPV of 9.38±0.40fL, PDW of 9.9±1.14fL, PCT of 0.26±0.05% and PLCR of 19.67±3.1. Values of MPV, PDW and PLCR were significantly higher in patients with diabetic microvascular complications (p&lt;.001). There was no significant difference in PCT between the two groups. In comparison of platelet indices according to glycemic control, a significantly higher MPV, PDW and PLCR values were observed in patients with HbA1c of &gt;7% (p&lt;.001). A significant association was present among the MPV, PDW and PLCR values when fasting plasma glucose (FPG) was &gt; 130mg/dL (p&lt;.001). There was a direct relation-ship with abnormal platelet indices and microvas-cular complications of T2DM. Further studies are recommended to ascertain causative relationship of changes in platelet indices and diabetic microvascular complications.

Risk factors for ischemic stroke in China: a case-control study

Background Stroke is a primary cause of disability and death in adults worldwide. This study aimed to determine whether uric acid (UA), total bilirubin (TBIL), serum creatinine (Scr), homocysteine (Hcy), platelet large cell ratio (P-LCR), mean platelet volume (MPV), red blood cell volume distribution width (RDW), and common carotid artery intima-media thickness (CCA-IMT) were risk factors for ischemic stroke and whether there were sex differences in their associations. Methods This was a case-control study, and all data were collected from the medical records at Fuzhou First People’s Hospital of Jiangxi Province, China. The case group consisted of 400 patients treated for ischemic stroke at the Neurology Department, Fuzhou First People’s Hospital from January 2017 to June 2023. The control group included 200 patients with non-ischemic stroke in the same period and at the same hospital. In this study, clinical history, physical examination, and biochemical indices such as UA, TBIL, Scr, Hcy, P-LCR, MPV, and RDW were obtained from the patients’ medical records. Craniocerebral imaging was performed using magnetic resonance imaging (MRI) or computerized tomography (CT). CCA-IMT was measured using ultrasonography of the carotid arteries. Results In the multivariate binary logistic regression analysis, Hcy, FBS, right CCA-IMT and Hypertension were associated with ischemic stroke (p&lt;0.001). The odds of ischemic stroke increased with Hcy (adjusted OR=1.217, 95% CI=1.129-1.311, p&lt;0.001), fasting blood sugar (FBS) (adjusted OR=1.313, 95%CI=1.169-1.475, p&lt;0.001), and right CCA-IMT (adjusted OR=45.273, 95%CI=6.693-306.232, p&lt;0.001). Hypertensive persons had a higher possibility of ischemic stroke than persons without hypertension (adjusted OR=3.161, 95%CI=2.086-4.790, p&lt;0.001). Conclusions Hcy, FBS, right CCA-IMT, and hypertension are independent risk factors for ischemic stroke in China. There was no association between TBIL, Scr, P-LCR, MPV, RDW, and the incidence of ischemic stroke. There was no sex difference in the association between Hcy, TBIL, Scr, P-LCR, and the incidence of ischemic stroke.

Reliability of the DI-60 Digital Image Analyzer for Detecting Platelet Clumping and Obtaining Accurate Platelet Counts.

Pseudothrombocytopenia caused by platelet clumping (PC) can lead to unnecessary platelet transfusions or underdiagnosis of hematologic neoplasms. To overcome these limitations, we assessed the capacity of the Sysmex DI-60 digital morphology analyzer (Sysmex, Kobe, Japan) for detecting PC and determining an accurate platelet count in the presence of PC. For this purpose, 135 samples with or without PC (groups Y and N, respectively) were processed by an examiner (a hematologic specialist) using both the Sysmex XN-9000 and DI-60 analyzers. Although the platelet aggregate (PA) and giant platelet (GP) counts reported by the DI-60 and the examiner exhibited strong correlations, they proved inadequate as effective indicators for screening samples containing PC. Between the PA and GP counts and four platelet indices (the platelet distribution width [PDW], mean platelet volume [MPV], platelet large cell ratio [P_LCR], and plateletcrit [PCT]) reported by the XN-9000, we observed statistically significant correlations (both overall and with group Y), but they were relatively weak. The platelet counts determined using the DI-60 and light microscopy in group Y showed substantial variations. Although the performance of the DI-60 was reliable for detecting PA and GP in smear images, such fixed areas are not representative of whole samples. Further, in the presence of PC, the resulting platelet counts determined using the DI-60 were not sufficiently accurate to be accepted as the final count.

Role of Platelet Indices for Cardiovascular Risk Assessment in Premenopausal Females with Metabolic Syndrome

Objectives: The study aimed to estimate platelet indices in premenopausal females with metabolic syndrome (MetS) and the prevalence of individual risk factors of MetS and their association with platelet indices. Materials and Methods: It was a hospital-based, cross-sectional, and observational study conducted for a period of 3 months with the 130 premenopausal females with MetS. The collected data comprised clinical profile, hematological parameters, fasting blood glucose (FBG), serum creatinine, and lipid profile and were subjected to statistical analysis with P &lt; 0.05 as level of significance. Results: The mean age of the participants was 39.95 ± 3.44 years. Substance abuse of tobacco and alcohol was present in 9.23% and 5.37% of participants. Salt intake more than 5 g/day was confirmed by majority (86.15%). Waist circumference &gt;80 centimeters (cm) was noted in 64.61% of participants. Body mass index in range of 25–29.9 kilograms (kg)/m2 and 30–40 kg/m2 was observed in 36.92% and 60.77%, respectively. Diabetes mellitus (DM) and hypertension (HTN) had prevalence of 86.92% and 30% of participants, respectively. FBG ≥100 mg/dL was observed in 43.84% participants. The participants with DM, HTN, and hyperlipidemia showed the highest mean platelet volume (MPV) value. Patients with glycosylated hemoglobin (HbA1C) &gt;6.5% exhibited statistically significantly higher values of platelet distribution width, MPV, and platelet–large cell ratio. Platelet indices exhibited significant positive correlation with HbA1C, FBG, total cholesterol, triglyceride, and negative correlation with high-density lipoprotein. Conclusion: The present study highlighted the high prevalence of components associated with MetS, notably hyperglycemia, HTN, and obesity. The study also elucidated the substantial impact of DM, HTN, and hyperlipidemia on platelet indices.