Diyabetik Hastalarda Trombosit Dağılım Genişliği (PDW), Ortalama Trombosit Hacmi (MPV) ve Vitamin D Düzeyi Arasındaki İlişkinin İncelenmesi

Öz

Amaç: Bu çalışmanın amacı, Tip 2 diabetes mellitus hastalarında vitamin D düzeyleri ile tam kan sayımı parametrelerinden ortalama trombosit hacmi (MPV) ve trombosit dağılım genişliği (PDW) düzeyleri arasındaki potansiyel ilişkinin varlığını araştırmaktır. Yöntem: Bu çalışmaya Atlas Üniversitesi Medicine Hastanesi’ne 2013-2016 yıllarında check-up taraması yapılan 1581 hasta dahil edilmiştir. Hastalarda açlık glukoz düzeylerine bakılarak kontrol grubu, bozulmuş açlık glukoz grubu ve diabetes mellitus grubu şeklinde üç gruba ayırarak retrospektif olarak inceleme yapılmıştır. İstatistiksel analizler için Shapiro-Wilks, Oneway ANOVA, Tukey HDS, Kruskal Wallis, Mann Whitney U ve Ki-Kare testleri yapılmıştır. Ayrıca, değişkenler arasındaki doğrusal ilişkinin şiddeti ve yönünün belirlenmesinde korelasyon analizine (Pearson, Spearman’ın Rho testi) başvurulmuştur. Bulgular: Yapılan istatiksel analizlerde diabetes mellitus grubunda, bozulmuş açlık glukoz grubunda ve kontrol grubunda ortalama trombosit hacmi ve trombosit dağılım genişliği ile 25(OH)D3 vitamini düzeyi açısından istatistiksel olarak anlamlı düzeyde bir korelasyon tespit edilmemiştir (p>0,05). Sonuç: Bu çalışmanın sonucunda ortaya çıkan bulgular ışığında; 25(OH)D3 vitamin eksikliğinin, diabetes mellitus gelişiminde rol oynayabileceği düşünülmüştür. Yine benzer şekilde bu çalışmada ortaya çıkan bulgular ışığında hemogramın birer parametresi olan PDW ve MPV’nin, diabetes mellitusun komplikasyonlarında risk artışına neden olan gösterge şeklinde kullanımı söz konusu olabilir.

Anahtar Kelimeler

• Vitamin D
• MPV
• PDW
• tip 2 diyabet
• hemogram

Investigation of the Relationship between Platelet Distribution Width (PDW), Mean Platelet Volume (MPV) and Vitamin D Levels in Diabetic Patients

Öz

Aim: This study aims to investigate the potential relationship between vitamin D levels and mean platelet volume and platelet distribution width levels of complete blood count parameters in Type 2 diabetes mellitus patients. Method: A total of 1581 patients who underwent check-up screening at Atlas University Medicine Hospital between 2013 and 2016 were included in this study. The fasting glucose levels of the patients were retrospectively examined by dividing them into three groups: the control group, the impaired fasting glucose group, and the diabetes mellitus group. Shapiro-Wilks, Oneway ANOVA, Tukey HDS, Kruskal-Wallis, Mann Whitney U, and Chi-Square tests were used for statistical analysis. In addition, correlation analysis (Pearson, Spearman's Rho test) was used to determine the intensity and direction of the linear relationship between the variables. Results: The statistical analyses did not reveal a statistically significant correlation between mean platelet volume and platelet distribution width and 25(OH)D3 vitamin levels in the diabetes mellitus group, the impaired fasting glucose group, and the control group (p>0.05). Conclusion: In light of the findings of this study, it was thought that 25(OH)D3 vitamin deficiency may play a role in the development of diabetes mellitus. Similarly, PDW and MPV, as hemogram parameters, could potentially serve as indicators of an increased risk for diabetes mellitus complications.

Anahtar Kelimeler

• Vitamin D
• MPV
• PDW
• type 2 diabetes
• hemogram

Kaynakça

1. 1. American Diabetes Association. Standards of medical care in diabetes-2016: Classification and diagnosis of diabetes. Diabetes Care. 2016;39(Supplement 1):S13-S22.
2. 2. Lakso M. Epidemiology and diagnosis of type 2 diabetes. In: Goldstein BJ, Müller-Wieland D, eds. Textbook of Type 2 Diabetes. New York: Martin Dunitz Taylor&Francis Group; 2003:1-12.
3. 3. Larsen CM, Faulenbach M, Vaag A, et al. Sustained effects of interleukin-1 receptor antagonist treatment in type-2 diabetes. Diabetes Care. 2009;32(9):1663-1668.
4. 4. Chiu KC, Chu A, Go VL, Saad MF. Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. The American Journal of Clinical Nutrition. 2004;79(5):820-825.
5. 5. Boucher BJ, Mannan N, Noonan K, Hales CN, Evans SJ. Glucose intolerance and impairment of insulin secretion in relation to vitamin D deficiency in east London Asians. Diabetologia. 1995;38(10):1239-1245.
6. 6. Dow RB. The Clinical and laboratory utility of trombosit volume parameters. Jnl Medical Science. 1994;15:1-15.
7. 7. Bath PM, Butterworth RJ. Trombosit size: Measurement, physiology and vascular disease. Blood Coagulation and Fibrinolysis. 1996;7:157-161.
8. 8. Graham SS, Traub B, Mink IB. Automated trombosit sizing parameters on a normal population. American Journal of Clinical Pathology. 1987;87(3):365-369.

9. 9. Sharp PC, Trinick T. Mean trombosit volume in diabetes mellitus. Quarterly Journal of Medicine. 1993;86:739-742.
10. 10. Dow R. The clinical and laboratory utility of platelet volume parameters. Aust J Med Sci. 1994;15:118-125.
11. 11. DeFronzo RA, Ferrannini E, Groop L, et al. Type 2 diabetes mellitus. Nature Reviews Disease Primers. 2015;1:150-19.
12. 12. American Diabetes Association. diagnosis and classification of Diabetes Mellitus. Diabetes Care. 2014;37: 81-90.
13. 13. Schaefer C, Biermann T, Schroeder M, et al. Early microvascular complications of prediabetes in mice with impaired glucose tolerance and dyslipidemia. Acta Diabetol. .2010;47:19-27.
14. 14. Centers for Disease Control and Prevention. National Diabetes Fact Sheet: National estimates and general information on diabetes and pre-diabetes in the United States, 2005. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2005.
15. 15. Pratley RE, Matfin G. Review: Pre-diabetes: Clinical relevance and therapeutic approach. British Journal of Diabetes & Vascular Disease. 2007;7:120-129.
16. 16. Tominaga M, Eguchi H, Manaka H, et al. Impaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes Study. Diabetes Care. 1999;22(6):920-924.
17. 17. DeVegt F, Dekker JM, Ruhé HG, et al. Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population: The Hoorn Study. Diabetologia. 1999;42(8):926-931.
18. 18. Despres JP. Dyslipidaemia and obesity. Baillieres Clin Endocrinol Metab. 1994;8:629-660.
19. 19. Heinecke JW. Mechanisms of oxidative damage of low density lipoprotein in human atherosclerosis. Current Opinion in Lipidol. 1997;8(5):268-274.
20. 20. McNeilly AM, Davison GW, Murphy MH, et al. Effect of α-lipoic acid and exercise training on cardiovascular disease risk in obesity with impaired glucose tolerance. Lipids Health Disease. 2011;10(1):217-226.
21. 21. Heath H, Lambert PW, Service FJ, Arnaud SB. Calcium homeostasis in diabetes mellitus. J Clin Endocrinol Metab. 1979;31:892-895.
22. 22. Suzuki A, Kotake M, Ono Y, et al. Hypovitaminosis D in type 2 diabetes mellitus: Association with microvascular complications and type of treatment. Endocr J. 2006;53(August (4)):503-510.
23. 23. Anderson JL, May HT, Horne BD, et al. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am J Cardiol. 2010;106:963-968.
24. 24. Dalgard C, Peterson MS, Weihe P, Grandjean P. Vitamin D status in relation to glucose metabolism in septuagenarians. Diabetes Care. 2011;34(6):1284-1288.
25. 25. Gagnon C, Lu ZX, Magliano DJ, et al. Serum 25-hydroxyvitamin D, calcium intake, and risk of type 2 diabetes after 5 years: Results from a national, population-91 based prospective study (the Australian Diabetes, Obesity and Lifestyle study). Diabetes Care. 2011;34(5):1133-1138.
26. 26. 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 Haematol. 2002;117(2):399-404.
27. 27. Martyn CN, Matthews DM, Popp-Snijders C, Tucker J, Ewing DJ, Clarke BF. Effects of sorbinil treatment on erythrocytes and trombosits of persons with diabetes. Diabetes Care. 1986;9(1):36-39.
28. 28. Tschope D, Langer E, Schauseil S, et al. Increased trombosit volume sign of impaired thrombopoiesis in diabetes mellitus. Klinische Wochenschrift. 1989;15(7):253-259.
29. 29. Hekimsoy Z, Payzin B, Örnek T, Kandoğan G. Mean trombosit volume in Type 2 diabetic patients. Journal of Diabetes and its Complications. 2004;18(3):173-176.