The study of Mean Platelet Volume (MPV) as a Potential Risk Factor for Macrovascular Complications (Ischemic Heart Disease and Cerebrovascular Stroke) in Type 2 Diabetes Mellitus

Abstract

Background Type 2 diabetes mellitus (T2DM) has reached global epidemic proportions, with more than 382 million people affected according to 2013 estimate. By 2035, its prevalence is expected to reach 471 million, meaning that 10% of the world’s population will have diabetes. Patients with diabetes often suffer from metabolic abnormalities, poor glycemic control, oxidative stress, insulin resistance, and low-grade inflammation. These conditions trigger vascular dysfunction, which predisposes them to atherothrombosis Objective The present study aimed to study the mean platelet volume (MPV) as a potential risk factor for ischemic heart disease and cerebrovascular stroke in type 2 diabetes. Methods The study was conducted on 150 subjects there ages ranged from 40 to 60 years old. They were divided into 4 groups: Group 1: included30 type 2 diabetic overweight or obese patients without previous history of myocardial infarction or cerebrovascular stroke. Then, they were subdivided into 2 subgroups: 1a) 15 diabetic non hypertensive patients. 1b) 15 diabetic hypertensive patients. Group 2: included A) 30 type 2 diabetic overweight or obese patients with recent cerebrovascular stroke. Then, they were subdivided into 2 subgroups: 2Aa) 15 diabetic non hypertensive patients. 2Ab) 15 diabetic hypertensive patients. B) 30 type 2 diabetic overweight or obese patients with acute myocardial infarction. Then, they were subdivided into 2 subgroups: 2Ba) 15 diabetic non hypertensive patients. 2Bb) 15 diabetic hypertensive patients. Group 3: 30 overweight or obese non-diabetic patients with acute myocardial infarction or recent cerebrovascular stroke. Then, they were subdivided into 3a) 15 patients with acute myocardial infarction. 3b) 15 patients with recent cerebrovascular stroke. Group 4: 30 Healthy control with matching age and sex and were subdivided into 2 subgroups: Control a) 15 lean subjects. Control b) 15 overweight or obese subjects. All subjects in this study were subjected to Full medical history taking. Thorough clinical examination (including weight, height, BMI, blood pressure). The following laboratory investigations were done: Fasting blood glucose, Two hour post prandial, HbA1c, Fasting insulin (for HOMA IR), Lipid profile (Total cholesterol-LDL-HDL-Triglycerides), Mean platelet volume and Liver and kidney function test. The following radiological investigation were done: Carotid ultrasonography for estimation of intima-media thickness and abdominal ultrasonography. Results As regards MPV, there was a high statistical significant difference between the studied groups (p-value<0.01), being the highest in group II (mean 11.93 ± 0.37 fl) followed by group III (10.77±1.69 fl), group I (10.67±1.98 fl) and group IV (8.83±0.98 fl). On comparing between every other groups there was a high statistical significant difference between group (I) & (II) being higher in group II, (I) & (IV) being higher in group I, (II) & (III) being higher in group II, (II) & (IV) being higher in group II and (III) & (IV) being higher in group III (P value<0.01). However, there was a non-statistical significant difference between group (I) & (III) regarding the MPV (P value>0.05). On comparing between hypertensive and non-hypertensive patients in each group as regard MPV, there were non-significant statistical difference. Conclusion MPV was higher in type 2 diabetic patients than healthy control. Moreover, MPV was significantly higher in type 2 diabetic patients with macrovascular complications. There was no significant difference between hypertensive and non hypertensive patients as regard MPV. There was no significant difference between obese and lean subjects as regard MPV. There was a positive significant correlation between MPV and markers of glycemic control in T2DM.

Association of Mean Platelet Volume With Vascular Complications in the Patients With Type 2 Diabetes Mellitus

“…A meta-analysis of MPV levels in diabetic retinopathy revealed that MPV levels were significantly higher in patients with diabetic retinopathy as compared to those without diabetic retinopathy [25]. Our study found that higher values of MPV were associated with a higher prevalence of microvascular and macrovascular complications, which is similar to other studies [26,27]. But, on stratification of MPV with high HbA1c (>10), the significant association with vascular complications was lost.…”