TİP 2 DİYABETİK HASTALARDA ORTALAMA TROMBOSİT VOLÜMÜ KARŞILAŞTIRILMASI VE MİKROVASKULER KOMPLİKASYONLARLA İLİŞKİSİNİN DEĞERLENDİRİLMESİ

Year 2009, Volume: 15 Issue: 1, 1 - 4, 01.03.2009

Pınar Öner Arif Yüksel

Abstract

Bu çalışmada; Tip2 diyabetik olguların ortalama trombosit hacmi ile glisemik kontrol ve mikrovasküler komplikasyonlarla ilişkisinin incelenmesi amaçlandı. 48 tip 2 diyabetik hasta 21 oral antidiyabetik ve 27 insülin kulanan birey çalışmaya alındı. 12 saat açlık sonrası MPV, lipid düzeyleri, HbA1c ve mikrovasküler komplikasyonlar açısından bireyler incelendi. Spearman korelasyonu ile MPV ve diğer çalışılan parametreler arasındaki ilişkiler değerlendirildi. Diyabetik hastalarda hem MPV ile HbA1c hem de MPV ve diyabetik komplikasyonlar açısından anlamlı bir ilişki bulunamadı. İnsülin kullanan bireylerde ortalama MPV düzeyi 8.9 ve oral antidiyabetik kullanan olgularda ise 8.1 olarak tespit edildi. MPV insülin kullananlarda oral antidiyabetik kullananlara göre daha yüksek olarak bulundu p=0.034 . Diyabetik komplikasyonları olan olgularda her ne kadar MPV düzeyleri komplikasyonu olmıyan bireylere göre daha yüksek bulunsa da bu istatiksel olarak anlamlı değildi. Diyabetik microvasküler komplikasyon gelişimi ile HbA1c ve hastalık süresinin ilişkisi mevcuttu p < 0.05 . Albuminüri retinopati ve nöropati gelişimi açısından aralarında bir korelasyonu mevcuttu p < 0.05 . Biz bu çalışmamızda, diyabetik komplikasyonlar ile ortalama trombosit volümü arasında bir ilişki tespit edemedik. MPV her ne kadar diyabetik komplikasyonu gelişimi açısından bir risk faktörü olduğunu tespit edemesekte patogenezinde rol alabileceğini düşünmekteyiz. Gelişen bir mikrovasküler komplikasyonun diğer komplikasyonların gelişimi açısından bir risk faktörü olduğunu gözlemlenmiştir

Keywords

İmmunglobulin, ortalama trombosit volümü, diyabetik komplikasyonlar

COMPARISON OF MEAN PLATELET VOLUME IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND THE RELATIONSHİP BETWEEN MICROVASCULAR COMPLICATIONS

Abstract

The aim of this study was to investigate the relationship among mean platelet volume MPV , glycemic control, and microvascular complications in type 2 DM. Forty eight patients with type 2 DM 21 oral antidiabetic and 27 insulin users individuals were enrolled in the study. After 12 hours of fasting, we examined their MPV, lipid profile, HbA1c and also evaluated microvascular complications. We applied Spearman correlation test on the data for defining the relation between MPV and other parametres. In diabetic patients, there was no significant positive correlation between both MPV and HbA1c levels or MPV and diabetic vascular complications. Mean MPV in the insulin users group was 8.9 fl, and in the oral antidiabetic group 8.1 fl. MPV was significantly higher in patients with insulin users than in oral antidiabetic group p=0.034 . However mean MPV was higher in diabetic microvascular complications; this was not reach statically significant. Diabetic microvascular complications were positively correlated with HbA1c and disease duration p < 0.05 . Albuminuria was significantly correlated with retinopathy and neuropathy development p < 0.05 . We could not determine a correlation between diabetic complications and platelet volumes. We suggest that MPV may be not a risk factor for development diabetic complications; however it may have a role in the pathogenesis. One diabetic complication may be influences the risk of developing other microvascular complications

Keywords

Immunoglobulin, mean platelet volume, diabetic complications

References

• Kim DK, Escalante DA, Garber AJ. Prevention of atherosclerosis in diabetes: emphasis on treatment for the abnormal lipoprotein metabolism of diabetes. Clin Ther. 1993 Sep-Oct;15(5): 766-78
• Laakso M, Lehto S. Epidemiology of risk factors for cardiovascular disease in diabetes and impaired glucose tolerance. Atherosclerosis. 1998 Apr;137 Suppl: S65-73
• Tavil Y, Sen N, Yazici HU, et al. Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease. Thromb Res 2007; 120: 245-50.
• Khandekar MM, Khurana AS, Deshmukh SD, et al. Platelet volume indices in patients with coronary artery disease and acute myocardial infarction: an Indian scenario. J Clin Pathol 2006; 59: 146-9.
• O’Malley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke 1995; 26: 995-9.
• Sharpe P. C, Trinick T. Mean platelet volume in diabetes mellitus. Quarterly Journal of Medicine 1993; 86(11): 739−742.
• Winocour, P. Platelets, vascular disease, and diabetes mellitus. Canadian Journal of Physiology and Pharmacology 1994; 72: 295−303.
• Hekimsoy Z, Payzin B, Ornek T, Kandoğan G. Mean platelet volume in Type 2 diabetic patients. J Diabetes Complications. 2004 May-Jun;18(3): 173-6.
• Hendra TJ, Oswald GA, Yudkin JS. Increased mean platelet volume after acute myocardial infarction relates to diabetes and to cardiac failure. Diabetes Res Clin Pract. 1988 May 19; 5(1): 63-9.
• Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications. 2008 Mar 19. [Epub ahead of print].
• Bath P. M, Butterworth R. J. Platelet size: Measurement, physiology and vascular disease. Blood Coagulation & Fibrinolysis 1996; 7: 157−161.
• Tschöpe D, Schwippert B, Schettler B, Kiesel U, Rothe H, Roesen P, Gries FA. Increased GPIIB/IIIA expression and altered DNA-ploidy pattern in megakaryocytes of diabetic BB-rats. Eur J Clin Invest 1992 Sep; 22(9): 591-8
• Blandini F, Martignoni E, Sances E, Bono G, Nappi G. Combined response of plasma and platelet catecholamines to different types of short-term stress. Life Sci. 1995 Feb 17; 56(13): 1113-20
• Abdul-Ghani M, Nawaf G, Nawaf F, Itzhak B, Minuchin O, Vardi P. Increased prevalence of microvascular complications in type 2 diabetes patients with the metabolic syndrome. Isr Med Assoc J 2006 Jun;8(6):378-82.
• Girach A, Vignati L. Diabetic microvascular complications--can the presence of one predict the development of another? J Diabetes Complications 2006 Jul-Aug;20(4): 228-37