Increased mean platelet volume in type 2 diabetes mellitus

Yıl 2014, , 17 - 22, 01.03.2014

Ezgi Çoşkun Yenigün Gülay Ulusal Okyay Atakan Pirpir Ahmet Hondur İsmail Safa Yıldırım

https://doi.org/10.5798/diclemedj.0921.2014.01.0366

Cited By: 10

Öz

Objective: Platelet functions have important roles in the development of vascular complications in diabetic patients. Platelets with increased volume have increased activity compared to smaller ones; therefore, mean platelet volume (MPV) is used as a marker for platelet activity. In the present study, we evaluated MPV in patients with type II diabetes mellitus (DM) and its associations with diabetic microvascular and macrovascular complications. Methods: Consecutive type II diabetic patients were screened from outpatient clinic of Internal Medicine Department of Diskapı Yıldırım Beyazıt Education and Researsch Hospital, Ankara, Turkey. A total of 48 patients with type II DM and 30 age and gender matched healthy subjects constituted the study population. For all subjects a complete blood count including MPV, fasting blood glucose level and lipid parameters were studied. In diabetic patients, duration of diabetes and HbA1C level, presence of microvascular and macrovascular complications were noted additively. Mean platelet volume was compared between diabetic patients and healthy counterparents. Then, among diabetic patients, MPV was compared between the ones with and without microvascular and macrovascular complications. Results: Mean platelet volume was found significantly higher in diabetic patients compared to non-diabetic healthy subjects. Diabetic patients with at least one of the microvascular complications had significantly higher MPV than those without microvascular damage.Higher MPV levels have also been shown in diabetics with macrovascular complications compared to the ones without macrovascular disease. Conclusion: Mean platelet volume was found to be higher in type II diabetics and those having any of microvascular or macrovascular diabetic complications.

Anahtar Kelimeler

Diabetes mellitus, diabetic complications, mean platelet volume.

Increased mean platelet volume in type 2 diabetes mellitus

Öz

Amaç: Diyabetik hastalarda vasküler komplikasyonların gelişiminde trombositler önemli rol oynamaktadır. Büyük trombositler küçüklere oranla daha aktif olup, ortalama trombosit hacmi (MPV) trombosit aktivitesini göstermede kullanılan bir belirteçdir. Biz bu çalışmamızda MPV\'nin tip 2 diyabetes mellituslu hastalarda ve diyabetin mikrovasküler ve makrovasküler komplikasyonlardaki ilişkisi araştırmayı amaçladık. Yöntemler: Çalışmaya Dışkapı Eğitim ve Araştırma Hastanesi Dahiliye polikliniğinde takipli olan 48 tip 2 diyabetli ve 30 sağlıklı hasta dahil edilmiştir. Tüm hastalarda tam kan sayımı, açlık kan şekeri ve lipid parametreleri çalışıldı. Diyabetik hastalarda diyabet süresi, HbA1c düzeyi, mikrovasküler ve makrovasküler komplikasyon varlığı araştırıldı. Ortalama trombosit hacmi diyabetik ve sağlıklı kontrol grubu arasında ve diyabetik kolda komplikasyon olan olmayan grup arasında karşılaştırıldı. Bulgular: Diyabetik hastalarda MPV, non-diyabetik sağlıklılarla karşılaştırıldığında anlamlı yüksek saptandı. En az bir mikrovasküler komplikasyonu olan hastalarda olmayanlara göre MPV belirgin yüksek saptandı. Makrovasküler komplikasyonu olan hastalarda MPV olmayan hastalara göre yüksek bulundu. Sonuç: Hem diyabetiklerde hem de mikro-makrovasküler komplikasyonları olan diyabetik hastalarda MPV yüksek bulunmuştur.

Anahtar Kelimeler

Diyabetes mellitus; diyabetik komplikasyon; ortalama trombosit hacmi

Kaynakça

• Alessandrini P, McRae J, Feman S, FitzGerald GA. Throm- boxane biosynthesis and platelet function in type 1 diabetes mellitus. N Engl J Med 1988;319:208-212.
• Keskin A, Özgen AG, Sermez Y, et al. Tip II diabetes mellitu- sta trombosit fonksiyonları ve glisemi kontrolü ile ilişkisi. Ulusal Endokrinoloji Dergisi 1995;5:179-185.
• Mathur A, Robinson MS, Cotton J, et al. Platelet reactivity in acute coronary syndromes: evidence for differences in platelet behaviour between unstable angina and myocardial infarction. Thromb Haemost 2001;85:989-994.
• Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haema- tol 2002;117:399-404.
• American Diabetes Association. Diabetes Care 2005;28.
• Colwell JA, Winocour PD, Halushka PV. Do platelets have anything to do with diabetic microvascular disease? Diabe- tes 1983;32:14-19.
• Jindal S, Gupta S, Gupta R, et al. Platelet indices in diabetes mellitus: indicators of diabetic microvascular complica- tions. Hematology 2011;16:86-89.
• Unubol M, Ayhan M, Güney E. The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus. Platelets 23:475-480.
• Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest 2005;115:3378-384.
• Coppinger JA, Cagney G, Toomey S, et al. Characteriza- tion of the proteins released from activated platelets leads to localization of novel platelet proteins in human athero- sclerotic lesions. Blood 2004;103:2096-2104.
• Senaran H, Ileri M, Altinbas A, et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Car- diol 2001;24:405-408.
• Trowbridge EA, Martin JF. The platelet volume distribu- tion: a signature of the prethrombotic state in coronary heart disease? Thromb Haemost 1987;58:714-717.
• Erne P, Wardle J, Sanders K, et al. Mean platelet volume and size distribution and their sensitivity to agonist in pa- tients with coronary artery disease and congestive heart failure. Thromb Haemostas 1988;59:259-263.
• Valkila EH, Salenius JP, Koivula TA. Platelet indices in patients with occlusive carotid artery disease. Angiology 1994;45:361-365.
• Coban E, Ozdogan M, Yazicioglu G, Akcit F. The mean platelet volume in patients with obesity. Int J Clin Pract 2005;59:981-982.
• Nadar SK, Blann AD, Kamath S, et al. Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol 2004;44:415- 422.
• Nadar S, Blann AD, Lip GY. Platelet morphology and plas- ma indices of platelet activation in essential hypertension: effects of amlodipinebased antihypertensive therapy. Ann Med 2004;36:552-557.
• Yang A, Pizzulli L, Luderitz B. Mean platelet volume as marker of restenosis after percutaneous transluminal coro- nary angioplasty in patients with stable and unstable angina pectoris. Thromb Res 2006;117:371-377.
• Henning BF, Zidek W, Linder B, Tepel M. Mean Platelet Volume and Coronary Heart Disease in Hemodialysis Pa- tients. Kidney & Blood Pressure Research 2002;25:103- 108.
• Sharpe PC, Trinic T. Mean platelet volume in diabetes mel- litus. Quarterly Journal of Medicine 1993;86: 739-742.
• Hekimsoy Z, Payzin B, Örnek T, Kandogan G. Mean plate- let volume in Type 2 diabetic patients. Journal of Diabetes and Complications 2004;18:173-176.
• Saigo K, Yasunaga M, Ryo R, Yamaguchi N. Mean platelet volume in diabetics. Rinsho Byori 1992;40:215-217.
• Tschoepe D, Roesen P, Schwipper B, Gries FA. Platelets in diabetes: the role in the hemostatic regulation in atheroscle- rosis. Semin Thromb haemost 1993;19:122-128.
• Papanas N, Symeonidis G, Maltezos E, et al. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 2004;15:475-478.
• Huczek Z, Kochman J, Filipiak KJ, et al. Mean platelet vol- ume on admission predicts impaired reperfusion and long- term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol 2005;46: 284-90.
• Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost 2010;8:148-156.
• Jones R L, Paradise C, Peterson C M. Platelet survival in patients with diabetes mellitus. Diabetes 1981;30:486-489.
• Tschöpe D, Langer E, Schauseil S. Increased platelet vol- ume- sign of impaired thrombopoiesis in diabetes mellitus. Klin Wochenschr 1989;67:253-259.