Mean platelet volume in type 2 diabetic patient: is there a relationship between mean platelet volume and diabetic microvascular complications?

Öz

Aim: Most diabetic patients suffer from vascular thrombotic and atherosclerotic  complications. Alteration in platelet size are associated with atherosclerotic complications in patients with diabetes. The aim of present study is to determine the relationship between mean platelet volume (MPV) and microvascular diabetic complications in type 2 diabetic patients.

Material and Method: 115 type 2 diabetic patients [mean age 50.4±9.9 year and body mass index (BMI) 31.0±5.3 kg/m²], and 67 healthy control subjects without any systemic disease (mean age 48.8±12.0 year and BMI 30.3±7.3 kg/m²) were included in this study. Chronic diyabetic microvascular complications in diyabetic group were researched. Neurological evaluation, ocular fundus examination and EMG (electromyography) were performed. Our diabetic patients were initially divided into two groups with and without at least one microvascular complication. Subsequently, patients with microvascular complications were divided into subgroups according to nephropathy, neuropathy and retinopathy. MPV levels were re-analyzed in all subgroups.

Results: There were 79 patients in our diabetic patient group with at least one microvascular complication. In this group, 44 (34.7%) patient neuropathy, 33 (26.0%) patients diabetic nephropathy and 13 (10.2%) patients diabetic retinopathy were detected. There were 36 patients in the diabetic group without microvascular complications. This group was accepted as a diabetic control group.

We determined that mean MPV levels in diabetic microvascular group was significantly different from control group (8.6±0.8 fL and 7.9±0.8 fL, p<0.001). Again we determined that mean MPV levels in diabetic control group was significantly different from control group (8.3±0.5fL ve 7.9±0.8fL, p=0.005)

Despite the difference in MPV between the diabetic microvascular group and the diabetic control group, this difference was not statistically significant ( 8.6±0.8 fL, 8.3±0.5 fL, p=  0.06).

In subgroup analysis, we demonstrated that mean MPV levels in diabetic nephropathy (p=0.006) and in diabetic neuropathy groups (p=0.001) and diabetic retinopathy group (p=0.02) were higher than control subjects.  

Conclusions: In our study, we determined mean MPV levels in type 2 diabetic group was significantly highly from control group. Also, we detected MPV level in diabetic patients with nephropathy, neuropathy and retinopathy is more increase than healthy subjects. Although MPV is often used as the marker of platelet activity, elevated MPV levels in patients with type 2 diabetes mellitus may associate with increased microvascular complication risk. 

Anahtar Kelimeler

• Mean platelet volume,diabetic nephropathies,diabetic neuropathies,diabetic retinopathy

Tip 2 diyabetik hastalarda ortalama trombosit hacmi: mikrovasküler komplikasyonlar ile ortalama trombosit hacmi arasında bir ilişki var mı?

Öz

Amaç: Diabetik hastaların çoğunda vasküler trombotik  ve aterosklerotik  komplikasyonlar görülür. Diabetik hastalarda trombosit boyutundaki değişiklikler aterosklerotik komplikasyonlar ile ilişkilidir. Bu çalışmanın amacı, tip 2 diabetik hastalarda ortalama trombosit hacmi (Mean Platelet Volume, MPV) ile mikrovasküler komplikasyonlar arasındaki ilişkiyi saptamaktır.

Gereç ve Yöntemler: Bu çalışmaya 79 tip 2 DM tanılı hasta (ortalama yaş 51.0±10.8 yıl ve BMI 31.0± 5.5 kg/m²) ve tamamen sağlıklı ve sistemik hastalığı bulunmayan 67 kişide (ortalama yaş 48.8±12.0 yıl ve BMI 30.3±7.3 kg/ m²) kontrol grubu olarak dahil edildi. Kronik diabetik mikrovasküler komplikasyonlar araştırıldı. Nörolojik değerlendirme, fundus muayenesi ve EMG (Elektromyografi) tetkiki yapıldı. Hastalar nefropati, nöropati ve retinopatiye göre alt gruplara ayrıldı. Tüm alt gruplarda MPV düzeyi tekrar analiz edildi.

Bulgular: En az bir mikrovasküler komplikasyonu olan hasta grubumuzda, 44 (%34.7) hastada nöropati, 33 (%26.0) hastada diabetik nefropati ve 13 (%10.2) hastada ise diabetik retinopati tespit edildi.  Diabetik grupta MPV düzeyleri kontrol grubundan anlamlı olarak yüksekti (sirasıyla 8.6±0.8fL ve 7.9±0.8fL, p<0.001).

Subgrup analizlerinde MPV düzeyleri açısından diabetik nefropati ile kontrol grubu arasında (p=0.007) ve yine diabetik nöropati grubu ile kontrol grubu arasında (p=0.04) anlamlı istatistiki bir fark tespit edildi. Diabetik retinopatili hasta grubu ile kontrol grubu arasında MPV bakımından fark olmasına rağmen bu fark istatistiki açıdan anlamlı değildi ( p=0,07).

 Sonuç: Çalışmamızda, diabetik nefropati ve diabetik nöropatili hastalarda MPV düzeyinin sağlıklı bireylerden daha yüksek olduğunu tespit ettik. Sıklıkla trombosit aktivitesinin bir göstergesi olarak kulanılmakta olan MPV, tip 2 diabetli hastalarda mikrovasküler komplikasyon gelişmesi riski ile ilişkili olabilir. 

Anahtar Kelimeler

• Ortalama trombosit hacmi,diyabetik nefropati,diyabetik nöropati,diyabetik retinopati

Kaynakça

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