The relationship of mean platelet volume with retinopathy in type 2 diabetes mellitus

Abstract

IntroductionDiabetes mellitus (DM), a major global health problem, is commonly associated with increased risk of developing micro-and macrovascular disease. Despite its clinical importance, the pathophysiology of diabetic complications is not completely understood. Platelets have been thought to be involved in these complications. Diabetic retinopathy (DR) is one of those important complications and leads to a considerable increase in morbidity.Platelet volume is a marker of platelet activation and function that can be measured easily as mean platelet volume (MPV) by clinical analyzers. It is now known that larger platelets are more reactive and produce more prothrombotic factors (1,2). Increased MPV has been demonstrated in diabetes (3-9). There are conflicting results about the relation of MPV with diabetic nephropathy/microalbuminuria (MA) (10-17), diabetic neuropathy (18-20), coronary artery disease (4,13,18,(21)(22)(23)(24)(25), and cerebrovascular disease (3-5,26) in diabetic patients. Large platelets may play a role in the development of vascular damage in DR by being more active, forcing the production of more prothrombotic factors, or causing endothelium-dependent vasomotor dysfunction.Keeping in mind these complex relations between MPV, diabetes, and its complications, in the present study we aimed to: 1) compare the MPV in diabetic patients with that in healthy controls; 2) determine if there is a difference in MPV between diabetic patients with and without DR, and also with and without proliferative retinopathy; 3) compare MPV levels of diabetic patients with or without hypertension (HTA), hyperlipemia (HL), and HTA with HL, and 4) see if there is a correlation of MPV with HbA1c and body mass index (BMI) in diabetic patients. Material and methods PatientsA total of 102 type 2 DM (T2DM) patients [65 female (63.7%), 35 male (36.3%)], 50 of them without retinopathy [31 female (62.0%), 19 male (38.0%)] and 52 with retinopathy [34 female (65.4%), 18 male (34.6%)], aged 22-90 years, were recruited from the Clinic of Ankara Education and Research Hospital from June 2009 to June Background/aim: Patients with diabetes mellitus have an increased risk of developing micro-and macrovascular complications. Retinopathy is one of the most important complications of diabetes whose pathophysiological cause has not yet been determined. One candidate may be platelet volume. In this study we aimed to investigate the association between mean platelet volume and diabetic retinopathy.Materials and methods: Mean platelet volume levels were investigated in type 2 diabetic patients with and without retinopathy, and in healthy participants. After reclassifying our diabetics in terms of the presence or absence of hypertension and hyperlipidemia, we compared their mean platelet volumes. We then checked to see if the mean platelet volume correlated with hemoglobin A1c and body mass index. Results:The mean platelet volume levels were higher in all diabetic patients, and they were highest in diabetics with retinopathy. The mean plate...

Association of mean platelet volume and platelet distribution width with diabetic retinopathy in patients with diabetes mellitus

“…Our study suggests that increased MPV is associated with poor glycemic control. This coincides with the results of Kodiatte et al, 4 Rajesh Kanna, 5 Jindal et al, 10 Buch et al, 11 Hasan et al, 17 Zaccardi et al, 18 Vernekar et al, 19 Shah b et al, 20 Zuberi et al, 21 Ozder et al, 24 Dindar et al, 26 Papanas et al, 27 Gungor et al, 28 Hekimsoy et al 30 Demirtunc et al 33 and Coban et al 35 but contradicts the results of Dayal et al, 2 Cakir et al, 31 Unübol et al 36 and Alhadas et al 22 found a positive correlation between both MPV and PDW and blood glucose levels.…”

“…In our study no correlation was found between MPV and PDW, and duration of diabetes similar to Papanas et al, 27 Madhavan et al, 23 Cakir et al 31 and Hasan et al 37 However Kodiette et al, 4 Akinsegun et al 13 and Gungor et al 28 found significant correlation between MPV and duration of diabetes.…”

“…Ates et al 15 found an increase in MPV with the stage of retinopathy. But Kodiette et al, 4 Citirik et al, 9 Gungor et al 28 found no correlation between MPV values and stages of retinopathy. Similar to our study Tetikoğlu et al 7 and Citirik et al 9 also found no association between PDW and stages of retinopathy.…”

“…We found higher MPV and PDW values in diabetics with retinopathy. Jindal et al, 10 Buch et al, 11 Alhadas et al, 22 Yilmaz et al, 25 also found that both MPV and PDW were associated with DR. Kodiatte et al, 4 Rajesh kanna, 5 Tetikoğlu et al, 7 Citirik et al, 9 Gungor et al, 28 Ates¸ et al, 15 Dindar et al, 26 Papanas et al 27 Tuzcu et al, 29 Hekimsoy et al, 30 Madhavan et al, 31 found significant correlation between MPV and DR. By contrast, Aydinli et al 32 and Demirtunc et al 33 advocated that there was no association between MPV and DR. Citirik et al, 9 Tetikoğlu et al 7 found no significant correlation between PDW and DR.…”

Mean Platelet Volume as a Predictive Biomarker for Retinopathy in Patients With Type 2 Diabetes

“…A sample size of 146 was calculated using frequency of MPV in patients with type 2 diabetes with WHO sample size calculator considering 5% level of significance, and 95% confidence interval. Sampling technique used was non-probability consecutive sampling 10 . All adult patients who were diagnosed cases of diabetes as per American Diabetic Association (ADA) irrespective of their gender, socio-economic status, duration of the disease and age above 25 years were included in this study.…”