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

Yıl 2018, Cilt: 9 Sayı: 1, 31 - 35, 01.09.2018

Kenan Çadırcı , Osman Okan Olcaysu , Derman Yiğit Ayşe Çarlıoğlu , Şenay Arıkan

https://doi.org/10.18663/tjcl.315153

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

• 1. Endler G, Klımesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for mycardial infarction but not for coronary artery disease. British Journal of Haematology. 2002; 117: 399-404
• 2. Biadgo B, Melku M, Abebe SM, Abebe M. Hematological indices ad their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 2016; 9: 91-99
• 3. Valencia WM, Florez H. How to prevent the microvascular complications of type 2 diabetes beyond glucose control. BMJ 2017; 356: 6505
• 4. Çay S, Bıyıkoğlu F, Cihan G, Korkmaz Ş. Mean platelet volume in the patients with cardiac syndrome X. Journal of Thrombosis and Thrombolysis 2005; 20: 175-78
• 5. Sewell R, Ibbotson RM, Phillips R, Carson P. High mean platelet volume after myocardial infarction: is it due to consumption of small platelets? Br Med J (Clin Res Ed) 1984; 289: 1567-68
• 6. Hekimsoy Z, Payzin B, Örnek T, Kandoğan G. Mean platelet volume in type 2 diabetic patients. J Diabetes Complications 2004; 18: 173-76
• 7. Papanas N, Symeonidis G, Maltezos E, et al. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 2004; 15: 475-78
• 8. Yenigün EC, Okyay UG, Pirpir A, Hondur A, Yıldırım İS. Increased mean platelet volume in type 2 diabetes mellitus. Dicle Medical Journal 2014; 41: 17-22
• 9. Ünübol M, Ayhan M, Güney E. The relationship between mean platelet volume with microalbuminuria and glycemic control in patents with type 2 diabetes mellitus. Platelets, September 2012; 23: 475-80
• 10. Jindal S, Gupta S, Gupta R, et al. Platelet indices in diabetes mellitus:indicators of diabetic microvascular complications. Hematology. 2011; 16: 86-89
• 11. Kebapçılar L, Bilgir O, Demirel H, ve ark. Tip2 diyabetik hastalarda ortalama trombosit volümü karşılaştırılması ve mikrovasküler komplikasyonlarla ilişkisinin değerlendirilmesi. Medical Journal of Izmir Hospital 2009; 15: 1-4