Platelet Volume Indices Research Articles

Mean Platelet Volume and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus

ABSTRACT Aims The objective of the study was to determine the mean platelet volume (MPV) and platelet distribution width (PDW) in subjects with type 2 diabetes mellitus (type 2 DM) compared to subjects without type 2 DM and their correlation with fasting blood glucose, glycosylated hemoglobin (HbA1c), and duration of type 2 DM respectively. Materials and methods A prospective analytical case—control study was conducted involving 50 subjects with type 2 DM and 50 subjects without type 2 DM. The mean and standard deviation were estimated for both the groups separately and independent Student's “t”-test was used for evaluating the significant difference. The statistical evaluation was carried out at 95% confidence level. Results Mean MPV and PDW in case group was significantly higher compared to control group (p < 0.005). Fasting blood glucose, HbA1c, and duration of type 2 DM did not significantly alter MPV or PDW. Conclusion The study concludes that MPV and PDW are significantly increased in patients with type 2 DM compared to patients without type 2 DM. Platelet volume indices are an important, simple, and cost-effective tool that should be used and explored extensively, especially in countries, such as India, for predicting the possibility of impending acute vascular events in patients with type 2 DM. Clinical significance This analytical method helps us to use MPV and PDW as early markers of vascular thrombosis. How to cite this article Bhanukumar M, Ramaswamy PKH, Peddi NK, Menon VB. Mean Platelet Volume and Platelet Distribution Width as Markers of Vascular Thrombosis in Type 2 Diabetes Mellitus. J Postgrad Med Edu Res 2016;50(3):127-131.

Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Platelet volume indices (PVI), an easy and inexpensive surrogate measure of platelet function, have been associated with cardiovascular diseases (CVD) and their risk factors. However, results are conflicting because of the lack of standardized procedures. The purpose of this study is to investigate the relationship of PVI with the Framingham risk score (FRS). Baseline data (2008-2010) of 3115 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were used. PVI measurements were strictly controlled. The cohort was distributed according to risk factors and the general FRS was estimated. Multiple linear regression analysis was used to estimate the association between PVI and FRS. Mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) independently correlated (p≤0.01) with FRS after adjustment for confounding variables. One unit increase in MPV, PDW, or P-LCR increased the FRS by 0.59%, 0.40%, and 0.08%, respectively. Diabetics had higher (p≤0.004) MPV, PDW, and P-LCR, and hypertensive individuals had higher (p≤0.045) PDW and P-LCR. Increased PVI was independently correlated with higher CVD risk based on the FRS, diabetes, and systolic hypertension. Prospective follow up of this cohort is warranted to confirm that PVI is associated with the development of CVD.

Platelet volume indices are associated with systolic and diastolic cardiac dysfunction, and left ventricular hypertrophy

BackgroundMean platelet volume (MPV) and platelet distribution width (PDW) are indices that reflect platelet activity. We investigated the association between these platelet indices and left ventricular hypertrophy and cardiac function.MethodsWe analyzed the data of 1241 patients who were admitted to the Cardiology Department.ResultsBoth MPV and PDW were selected as independent factors associated with left ventricular systolic and diastolic dysfunction, and left ventricular hypertrophy. The highest tertile of MPV and PDW was associated with left ventricular systolic dysfunction (left ventricular ejection fraction of <50 %) with an odds ratio of 1.53 and 2.03, respectively, when the respective lowest tertile was used as reference. The highest PDW tertile was associated with left ventricular hypertrophy with an odds ratio of 1.56 (95 % CI, 1.13–2.15) and with dysfunction with an odds ratio of 3.34 (95 % CI, 1.54–7.25).ConclusionsIndices of platelet activation (MPV and/or PDW) were independently associated positively with left ventricular hypertrophy and left ventricular systolic and diastolic dysfunction. Whether these platelet indices represent useful markers for identifying individuals at higher risk for thromboembolic disease and organ damage among cardiac patients awaits further investigation.

Platelet function and indices in Lithuanian men with dyslipidemia: associations with inflammatory biomarkers

Introduction. Platelet function, platelet volume indices, traditional markers of lipid metabolism, inflammatory markers and a novel biomarker, cyclophilin A (CyPA), are related as far as they have implications in pathogenesis of atherosclerosis. The purpose of this study was to evaluate interrelations among these factors, correlation between platelet function and inflammatory factors, also a function of CyPA. Materials and methods. 160 male patients with high risk of atherosclerosis and metabolic syndrome were included in the study. Inclusion criteria were as follows: disturbances in lipids profile, increased weight, smoking, acute or chronic stress, no previous or current acute cardiovascular disease (CVD), high risk and presence of stress confirmed by physician. CRP, vWF, fibrinogen, CyPA levels were measured. Platelet function was assessed by aggregation and flow cytometry. Results. Increasing number of risk factors gave statistically significant elevation in fibrinogen, thrombin receptors activating peptide, CRP, glucose, mean platelet volume (MPV), platelet large cell ratio, lipids and their ratios with extremely significant linearity. MPV correlated positively with CD42a (r = 0.605; p

Increased mean platelet volume in patients with infective endocarditis and embolic events

Platelet activation appears to play an important role in thromboembolic complications of infective endocarditis (IE). Mean platelet volume (MPV) is a potentially useful marker of platelet activity and a quick and easy determinant of thrombotic risk. Hence the aim of this study was to investigate the baseline platelet volume indices (MPV and platelet distribution width [PDW]) in IE patients who developed embolic events in the follow-up period and who did not. The study group consisted of 76 consecutive patients (female: 55, male: 21, mean age: 26 years old, ranged: 8-64 years) with definite IE according to Duke Criteria. Thirty four healthy subjects, who were age and gender adjusted, served as the control group. The mean duration of hospital stay was 44 days. Among the IE patients, 13 (13/76, 17.1%) had major embolic events. Significantly larger vegetations were observed in patients with embolic events as compared to non-embolic group (1.4 vs. 1.0 cm, p = 0.03). MPV at hospital admission was higher in patients who had embolic events in the follow-up period compared to both those who did not and the control subjects (10.62 ± 1.13 vs. 9.25 ± 0.97 and 8.93 ± 0.82 fL, p < 0.001, respectively). Similarly, the patients with embolic events had increased PDW compared to the non-embolic ones and the control group (16.31 ± 2.42 vs. 14.35 ± 1.97 and 14.04 ± 1.82%, p < 0.001, respectively). The present study demonstrated that IE patients with embolic events had increased MPV and PDW values, compared to non-embolics. Future prospective studies with standardized measurements may clarify the clinical role of platelet volume indices in thrombo-embolic complications of IE.

Platelet indices in Philadelphia-negative chronic myeloproliferative neoplasms / Indicii plachetari de volum în neoplasmele mieloproliferative cronice Philadelphia-negative

AbstractIntroduction: Philadelphia-negative chronic myeloproliferative neoplasms (Ph-MPN): polycythemia vera (PV), essential thrombocythaemia (ET), and primary myelofibrosis (PMF) are characterized by an increased rate of thrombosis complications partly due to platelets activation. Large platelets are more active, have an enhanced procoagulant function and have a pathogenic role in arterial and venous thrombosis. In our study we tried to establish if platelet volume indices (MPV, PDW, P-LCR) issued from automated complete blood count determination are significantly different in Ph-MPN patients in comparison to healthy subjects. Materials and methods: Blood cell counts including platelet volume indices were assessed for 102 Ph-MPN and 102 healthy subjects using the impedance method on Sysmex XS 1000i and glucose and lipid profile, were assessed on Architect c 8000. Assessement of JAK2V617 positivity was conducted with amplification refractory mutation system polymerase chain reaction (ARMS-PCR), in whole peripheral blood. Results: Platelet volume indices (PVI) measured with the impedance based method, did not show significant differences in Ph-MPN patients in comparison to healthy controls. We noticed a moderate correlation between these indices and the presence of JAK2V617F mutation. PVI were increased in the small subgroup of patients treated with anagrelide and decreased in patients treated with simvastatin, comparatively with untreated patients. Conclusion: In our study we did not find a significant difference between platelet volume indices from Ph-MPN patients and healthy subjects. Further studies are required to demonstrate correlations between platelet volume indices and JAK2 V617F mutation, treatment with anagrelide and statins, respectively

The relationship of fibroblast growth factors 21 and 23 and α-Klotho with platelet activity measured by platelet volume indices.

Subjects with high fibroblast growth factor 21(FGF21) and 23 (FGF23), endocrine hormones that regulate insulin sensitivity and phosphate metabolism, respectively, are reported to have a higher risk for adverse cardiovascular outcome. Therefore, the relationship of FGF21, FGF23, and α-Klotho (co-receptor for FGF23 signaling) with mean platelet volume (MPV) and platelet distribution width (PDW), two platelet volume indices that reflect platelet activity, was investigated. Data from 156 patients admitted to the cardiology department were analyzed. MPV and PDW were measured by an automatic blood counter, and serum FGF21, FGF23, and α-Klotho concentrations were measured by an enzyme-linked immunoassay. Log(FGF21) was significantly correlated with serum triglycerides but did not differ according to the use of non-use of antidiabetic or lipid-lowering drugs. MPV and PDW were significantly correlated (R=0.475, p<0.001). MPV was significantly correlated with log(FGF21) (R=-0.167, p<0.05) and log(FGF23) (R=0.351, p<0.001) but not with log(α-Klotho). Linear regression analysis showed a negative and positive association of log(FGF21) and log(FGF23), respectively, with MPV that was independent of possible confounders including sex, age, renal function, and antithrombotic drug use. In addition, log(FGF23) was found to have a significant independent positive association with PDW. Among cardiac patients, FGF21 had a negative association with MPV, whereas FGF23 had a positive association. Future studies of serum FGF23/FGF21 concentrations and the incidence of thromboembolic disorders are warranted.

Diagnostic Value of HbA1c Level in Behcet’s Disease and Evaluation of Neutrophil-Lymphocyte Ratio, Mean Platelet Volume and Body Mass Index

Background: Behcet’s disease (BD) is a chronic systemic inflammatory disorder. T cells, neutrophils, inflammatory vasculitis and endothelial injury were implicated in the pathogenesis of BD. Hemoglobin A1c (HbA1c) is a minor component of hemoglobin to which glucose is bound, and it was reported to be associated with intima-media thickness, endothelial dysfunction and atherosclerosis in non-diabetic patients. In this study, we aimed to investigate the relationship between markers of glucose metabolism and BD in non-diabetic individuals. To the best of our knowledge, this planned study was the first evaluating the glucose metabolism with HbA1c levels and correlating it with body mass index (BMI), lipid profiles and the other inflammatory markers (mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR) and sedimentation) in BD. Methods: Sixty-four patients and 64 controls were enrolled in this study. Clinical manifestations of the disease were recorded. Laboratory analysis including HbA1c, hemogram, hematocrit, platelet count, liver function tests, complete blood count, urine analysis, erythrocyte sedimentation rate, MPV, lipid testes including low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides and total cholesterol levels were measured. Height, weight and BMI of patients were recorded. Results: Glucose levels were statistically higher in BD (P < 0.01). HbA1c level was evaluated, and statistically significant difference was not obtained (P = 0.9). Hemoglobin, hematocrit, platelet level and liver-urine analysis tests did not show any significant difference. Cholesterol, triglyceride, and LDL levels were statistically higher in BD group than control group (P = 0.00, P = 0.003, and P = 0.001). BMI was evaluated, and there was a significant difference in BD group (P = 0.016). NLR and sedimentation were higher in BD (P < 0.01). However, the other inflammatory marker MPV had no significant elevation. Conclusions: There was no significant association observed between BD patients and HbA1c levels, and this was the first study investigating HbA1c levels and correlating it with other parameters. J Hematol. 2015;4(4):219-222 doi: http://dx.doi.org/10.14740/jh230e

Evaluation of platelet count and platelet indices in patients with coronary artery disease

Background: Ischemic heart disease is mainly caused by atherosclerosis and its complications. Platelets and their activity have an important role in initiation of atherosclerotic lesions and coronary thrombus formation. Larger platelets are enzymatically and metabolically more active and have a higher potential thrombotic ability as compared with smaller platelets. Aims: To study the changes in platelet volume indices and platelet count in ischaemic heart disease and assess their usefulness in predicting coronary events. Methods: This was a comparative study of 180 patients (60 patients with stable angina, 60 with acute coronary syndrome and 60 with non-cardiac chest pain). Blood venous sample were drawn from all subjects after admission and collected in EDTA tubes. Platelet count and volume indices were assayed within 30 min of blood collection, using Nihon Kohden autoanalyzer. Results : All platelet volume indicesmean platelet volume (MPV), platelet distribution width (PDW), and platelet concentrate (PCT)were significantly raised in patients with AMI and UA. In patients with myocardial infarction, the mean values of MPV, PDW, platelet count and PCT were 11.02fL, 17.85%, 2.61 lac/cumm and 0.34% respectively. In patients with unstable angina were 10.31fL, 16.75%, 2.3 lac/cumm and 0.36% respectively while in normal healthy control the mean values of these indices were 7.98 fL, 10.70%, 2.66 lac/cumm and 0.24% respectively. Conclusions: Patients with acute coronary syndrome had higher platelet volume indices and lower platelet counts compared with those with stable angina and the normal population. Measurements of platelet volume indices and platelet count may be of some benefit in detecting those patients at higher risk for acute coronary events.

Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome

ObjectiveAcute coronary syndrome (ACS) is a challenging issue in cardiovascular medicine. Given platelet role in atherothrombosis, we sought to determine whether platelet indices can be used as diagnostic tests for patients who suffered from an acute chest discomfort. MethodsWe prospectively enrolled 862 patients with an acute chest pain and 184 healthy matched controls. They were divided into four groups: 184 controls, 249 of non-ACS, 421 of unstable angina (UA), and 192 of myocardial infarction (MI) cases. Blood samples were collected at admission to the emergency department for routine hematologic tests. ResultsThe mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) were significantly greater in patients with MI compared with those of non-ACS or control subjects. Negative and significant correlations existed between MPV, PDW, and P-LCR values and platelet count (P < 0.001). Receiver operating characteristic (ROC) curves showed that the MPV, PDW, and P-LCR with cut-off values of 9.15 fL, 11.35 fL, and 20.25% and with area under the curves of 0.563, 0.557, and 0.560, respectively, detected MI patients among those who had chest discomfort. The sensitivities and specificities were found to be 72% and 40%, 73% and 37%, and 68% and 44% for MPV, PDW, and P-LCR, respectively. ConclusionAn elevated admission MPV, PDW, and P-LCR may be of benefit to detect chest pain resulting in MI from that of non-cardiac one, and also for risk stratification of patients who suffered from an acute chest discomfort.

Platelet Volume Indices in Peripheral Artery Disease

Platelet Volume Indices in Peripheral Artery Disease

Atrial Fibrillation Is Associated With Increased Mean Platelet Volume and Apnea Hypopnea Index in Patients With Obstructive Sleep Apnea.

This study investigated whether there is a relationship between atrial fibrillation (AF), mean platelet volume (MPV), and apnea hypopnea index (AHI) in patients who have obstructive sleep apnea syndrome (OSAS). We enrolled patients who had OSAS with either AF or normal sinus rhythm (NSR). We divided 90 patients (aged 50-80 years) into 2 groups: group 1 consisted of 40 patients with OSAS having AF and group 2 of 50 patients with OSAS having NSR. Mean platelet volume was higher in patients with AF than in those with NSR (9.8 ± 0.6 vs 8.4 ± 0.6 fL; P < .001). The MPV and AHI were substantial variables associated with AF (odds ratio [OR] = 2.41; 95% confidence interval [CI], 1.36-5.26; P < .004 and OR = 1.91; 95% CI, 1.26-3.32; P = .02). Elevated MPV value of ≥9.4 fL is associated with AF (70% sensitivity and 63% specificity). More research is needed to establish the clinical relevance of this association.

Standardization and reference intervals of platelet volume indices: Insight from the Brazilian longitudinal study of adult health (ELSA-BRASIL)

Platelet volume indices (PVI) are associated with hematological and non-hematological diseases, notably cardiovascular and cerebrovascular diseases. The establishment of PVI reference intervals (RIs) are essential to evaluate whether these indices are useful in clinical practice. Healthy-associated RIs have not yet been established for the Brazilian population. Here, we determined RIs of PVI for a health adult population, participants of the Brazilian Longitudinal Study of Adult Health ELSA-Brasil. A total of 580 individuals out of an initial sample of 3115 subjects constituted the healthy reference sample. To be part of the study, individuals had to fulfill the following criteria: blood count within 2 hours of collection, no use of continuous medication, self-rated health as good or very good, no reported diagnosis of diabetes and/or arterial hypertension, not smoking, lack of metabolic syndrome, body mass index (BMI) <30 kg/m2, and platelet, hemoglobin, and creatinine beyond reference values. The RIs are mean platelet volume (MPV): 8.9–11.8 fL, platelet distribution width (PDW): 9.6–15.3 fL, platelet large cell ratio (P-LCR): 15.6–39.5%. These parameters were not significantly affected by age, gender, smoking, obesity, and alcohol abuse. However, significant differences were found among self-rated race/color groups. Standardization of measurement procedures and the establishment of healthy-associated PVI RIs are essential to be able to support clinical decision-making from laboratorial test results. This study at the baseline of the ELSA Brasil reported herein may contribute to future efforts aiming to evaluate whether PVI values are associated with clinical conditions in the Brazilian population.

AB0577 Mean Platelet Volume is Associated with Behcet's Disease Activity

BackgroundMean platelet volume (MPV) has been known to be a marker of platelet activity and influenced by inflammation.The correlations of MPV with disease activities were reported in several rheumatic diseases...

OP-259 Predictive Value of Admission Platelet Volume Indices for In-hospital Major Adverse Cardiovascular Events in Acute ST-Segment Elevation Myocardial Infarction

Although mean platelet volume (MPV) is an independent correlate of impaired angiographic reperfusion and 6-month mortality in ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), there is less data regarding the association between platelet distribution width (PDW) and in-hospital major adverse cardiovascular events (MACEs). A total of 306 patients with STEMI pPCI were evaluated. No reflow was defined as a post-PCI thrombolysis in myocardial infarction (TIMI) flow grade of 0, 1, or 2 (group 1).

Platelet Volume Indices are Associated with High Residual Platelet Reactivity after Antiplatelet Therapy in Patients Undergoing Percutaneous Coronary Intervention

It is well known that platelet volume indices are associated with adverse outcomes following percutaneous coronary intervention(PCI). In this study, we investigated the hypothesis whether the association between platelet size and clinical outcomes is the result of high residual platelet reactivity after antiplatelet therapy in patients with large platelets. Between February 2010 and December 2011, a total of 462 consecutive patients with coronary artery disease who were scheduled to undergo planned PCI were enrolled in this study. The degree of platelet aggregation induced by arachidonic acid(AA) and adenosine diphosphate(ADP) was assessed using the Multiple Electrode Platelet Aggregometry(Multiplate(®), Dynabyte, Munich, Germany)(MEA) test. We simultaneously measured the mean platelet volume(MPV) in the same period(Sysmex XE-2100, Mundelein, IL). The study population consisted of 462 consecutive patients, including 371 stable angina patients and 91 acute coronary syndrome patients. The patients with large platelets(upper quintile of MPV ≥10.6 fL) had significantly high residual platelet reactivity after both aspirin(MEA ASP 9 [5-14] Units vs. 13 [8-18.5] Units, p < 0.001) and clopidogrel(MEA ADP 21 [15-30] Units vs. 24 [18.5-40] Units, p=0.003) treatment. According to a multivariate analysis, having large platelets was independently associated with high residual platelet reactivity after both aspirin (OR 2.52, 95% CI 1.50-4.24, p < 0.001) and clopidogrel(OR 2.86, 95% CI 1.59-5.15, p < 0.001) treatment. Platelet volume indices were not associated with any differences in the incidence of major adverse cardiac events during follow-up. Platelets with a higher volume are associated with high residual platelet reactivity after conventional dual antiplatelet therapy.

Slow coronary flow phenomenon and increased platelet volume indices.

Background and ObjectivesWe sought to determine the relationship between mean platelet volume (MPV), platelet distribution width (PDW), and platelet larger cell ratio (P-LCR) with slow coronary flow (SCF).Subjects and MethodsEighty participants who underwent coronary angiography were divided into two groups, 50 participants with SCF as case group, and 30 with normal coronary flow (NCF) as control group. Baseline characteristics and laboratory data were collected before angiography.ResultsPlatelet volume indices MPV (10.8±1.2 fL), PDW (14.5±2.2 fL), and P-LCR (30.5±8.1%) in the SCF group were significantly (p<0.05) higher than those (10.1±0.9 fL, 13.2±1.8 fL, and 26.8±6.8%, respectively) in the NCF group. The patients with three SCF arteries had significantly higher platelet volume indices compared to those with NCF arteries; however, the patients with one SCF artery did not. Based on linear regression model, MPV, PDW, and P-LCR were independent predictors of mean infarction frame counting (TFC). In multivariate analysis, MPV {odds ratio (OR)=32.393, 95% confidence interval (CI)=1.189-882.606, p=0.039} and P-LCR (OR=0.566, 95% CI=0.330-0.937, p=0.028) were independent predictors of SCF.ConclusionPlatelet volume indices MPV, PDW, and P-LCR were associated with both the presence and extent of SCF.

Platelet volume indices in patients with varicocele

ObjectiveThis study sought to evaluate platelet volume indices (mean platelet volume [MPV], platelet distribution width [PDW], and platelet large cell ratio [P-LCR]) in varicocele patients, and compare it with platelet volume parameters in healthy controls.MethodsThis cross-sectional study involved 2 groups: group 1 included 51 varicocele subjects and group 2 consisted of 50 healthy control subjects of similar ages. Peripheral venous blood samples were collected with ethylenediaminetetraacetic acid-K2 anticoagulant between 8:30 AM and 10 AM following an overnight fast. Platelet volume parameters (MPV, PDW, and P-LCR) were measured in both groups within 2 hours of sampling.ResultsThe mean PDW, MPV, and P-LCR were 13.9±2.5%, 10.1±1.3 fL, and 27.3±7.8% in varicocele patients, respectively, and were 12.6±2.4%, 9.3±1.1 fL, and 21.9±6.4% in the control group, respectively. The mean PDW, MPV, and P-LCR were significantly higher in the varicocele group than the control group.ConclusionThe results of the present study suggest that vascular components may play an important role in the pathophysiology of varicocele; therefore, there is a great need for prospective studies to confirm this relationship.

Letter: clinical marker of platelet hyperreactivity in diabetes mellitus (diabetes metab j 2013;37:423-8).

Corresponding author: Cengiz Beyan Department of Hematology, Gulhane Military Medical Academy, Etlik, Ankara 06018, Turkey E-mail: cbeyan@gata.edu.tr Dear Editor, We read with great interest the review article by Kim et al. [1] entitled with “Clinical marker of platelet hyperreactivity in diabetes mellitus.” In this review, the authors described the mean platelet volume (MPV) as a clinical marker of platelet function abnormalities in patients with diabetes mellitus. We would like to comment on this topic. Turbidimetric platelet aggregometry developed in the 1960s revolutionized the ability to identify and diagnose alterations in platelet function and soon became the gold standard test for platelet function testing. The measurement of MPV or other platelet indices are not used as platelet function tests [2]. Beyan et al. [3] aimed to investigate whether platelet indices have a correlation with platelet aggregation responses using optical method in healthy adults and to evaluate the predictive significance of platelet indices over platelet aggregation responses. They found no correlation between any of platelet indices including platelet count, MPV, platelet mass, platelet distribution width, and plateletcrit and platelet aggregation responses induced with adenosine diphosphate, collagen and epinephrine. Recently, De Luca et al. [4] reported a study to investigate whether MPV was associated with platelet reactivity and the extent of coronary artery disease among diabetic patients. They performed a cohort study including 1,016 consecutive diabetic patients undergoing coronary angiography. Platelet aggregation was evaluated by light transmission aggregometry after stimulation with collagen. They found MPV was not related to platelet reactivity and concluded that MPV may not be considered a risk factor for coronary artery disease among diabetic patients. Therefore, it does not seem possible to use mean platelet volume or other platelet indices as a direct indicator of platelet activation or function. On the other hand, the correct measurement of MPV is dependent on a number of variables, including time of analysis after venipuncture, method of analysis, anticoagulant used and specimen storage temperature [5]. The MPV varies with time in ethylenediaminetetraacetic acid (EDTA) anticoagulated samples. EDTA induced platelet size changes result in a progressive increase in MPV with impedance technology. The MPV increases up to 30% within 5 minutes of exposure, and increases further by 10% to 15% over the next 2 hours [6]. Also, the reference range of MPV is specific to the individual technologies. Different technologies for measuring the MPV give different results. Studies comparing results from these instruments have shown MPV differences of up to 40% [7]. As a result, MPV may not be a suitable indicator of platelet function abnormalities in diabetic patients.

Relationship between platelet volume indices with macrovascular and peripheral neuropathy complications in type 2 diabetic patients (2型糖尿病患者血小板容积参数与大血管及外周神经并发症的相关性研究)

AbstractBackgroundThe relationship of platelet volume indices including mean platelet volume (MPV) and platelet distribution width (PDW) with carotid intima‐media thickness (IMT) as well as vibration perception threshold (VPT) was investigated in type 2 diabetic patients.MethodsA total of 500 type 2 diabetic patients (298 male, 202 female) were enrolled. Clinical and laboratory data were collected from hospital records.ResultsBoth MPV and PDW were significantly associated with carotid IMT, after adjustment for confounding factors including age, systolic blood pressure, total cholesterol and creatinine (0.833 ± 0.029 mm vs 0.955 ± 0.030 mm; 0.839 ± 0.029 mm vs 0.955 ± 0.030 mm; P = 0.0015 and P = 0.022, respectively). Agreed with carotid IMT analysis results, significant association was found between PDW and VPT as tertiles (15.760 ± 1.091V vs 20.187 ± 1.094V, P = 0.016). In multivariable analysis, both MPV and PDW were significantly associated with VPT (P = 0.021 and P = 0.007, respectively). However, only PDW, but not MPV, was significantly associated with carotid IMT (P = 0.002).ConclusionsThese findings implied the predictive value of platelets volume indices in vascular and peripheral neuropathy complications in type 2 diabetes.