Effects of Doxazosin and Amlodipine on Mean Platelet Volume and Serum??Serotonin Level in Patients with??Metabolic Syndrome

Alterations in platelet activity and endothelial glycocalyx biomarkers by treatment with an angiotensin converting enzyme inhibitor or an alpha-1 adrenoceptor antagonist in patients with hypertension: results from the DoRa study

Drugs blocking the renin-angiotensin-aldosterone system may offer benefit on endothelial function, inflammation, and hemostasis in addition to the effects of reducing blood pressure. We have shown antithrombin effects by treatment with the angiotensin converting enzyme (ACE) inhibitor ramipril. As thrombin is a key inducer of platelet aggregation, we hypothesized that treatment with ramipril could modulate platelet reactivity and endothelial glycocalyx (eGCX) function. This study assessed platelet activity (CD40 ligand and P-selectin) and eGCX markers (E-selectin, hyaluronan, syndecan-1, and thrombomodulin) in 59 individuals with mild-to-moderate hypertension, randomized double-blind to ramipril 10 mg or doxazosin 8 mg od for 12 weeks. Ramipril and doxazosin similarly reduced blood pressure. Antihypertensive treatment reduced CD40 ligand (p < .001) with no interaction (p = .405) by treatment group (reductions by ramipril and doxazosin were 8.7 ± 30.8 ng/L, p = .044, and 13.4 ± 25.5 ng/L, p = .002, respectively). There were no changes in P-selectin by treatment within (p = .556) or between (p = .256) treatment groups. No changes were observed in E-selectin, hyaluronan, syndecan-1, or thrombomodulin by antihypertensive treatment (p = .091-.991), or between ramipril and doxazosin (p = .223-.999). Our results show a potential reduction of platelet activity by ACE inhibitor treatment. Also, the alpha 1-adrenoceptor antagonist doxazosin may reduce platelet activation. Neither drug influenced eGCX markers.

Association of Red Blood Cell and Platelet Parameters with Metabolic Syndrome: A Systematic Review and Meta-Analysis of 170,000 Patients

This systematic review and meta-analysis aim to establish associations between metabolic syndrome (MetS) and erythrocyte and platelet markers, contributing to improved diagnostic tests for identifying individuals at risk. Observational studies and Randomized Controlled Trials (RCTs) were included. The standardized mean difference (SMD) and 95% confidence intervals (CI) of erythrocyte and platelet markers between individuals with and without MetS were used as effect size (inverse variance model). Methodological quality assessment was conducted using the Newcastle-Ottawa scale (NOS) for observational studies and the Cochrane Risk of Bias tool 2.0 for RCTs. The analysis included 51 articles. Compared to controls, individuals with MetS exhibited significantly higher concentrations of mean red blood cell count [Standardized Mean Difference (95% CI): 0.15 (0.13-0.18); p<0.00001], hemoglobin [0.24 (0.18-0.31); p<0.00001], blood platelet count [5.49 (2.78-8.20); p<0.0001], and red blood cell distribution width [(0.55 (0.05-1.04); p=0.03]. Regarding mean platelet volume [0.16 (- 0.03 to 0.35); p=0.10] and platelet-to-lymphocyte ratio (PLR) [7.48 (-2.85-17.81); p=0.16], a non-significant difference was observed in patients with MetS. There was no statistically significant difference in hematocrit counts between the two groups [0.47 (-0.40 to -1.34); p=0.29]. Biomarkers such as mean red blood cell count, hemoglobin, blood platelet count, and RDW are associated with higher levels in patients in MetS, whereas mean platelet volume and PLR tend to be lower. These markers can potentially provide new avenues for early diagnosis of MetS.

Amlodipine downregulates gene expression that involved in the signaling pathways of coagulation process in COVID-19 patients: An observational clinical study

The SARS-CoV-2 virus has the property of activating the coagulation process, which is responsible for producing thrombotic events which is considered as one of the most serious COVID-19 complications. Hypertension is a hazard factor for COVID-19 complications, and people who are treated with calcium entry blockers may halt the occurrence of thrombotic events. to evaluate the effect of amlodipine on some genes involved in the activation of the coagulation procedure in COVID-19 patients with hypertensive. observational, cross-sectional study. This study was carried out in the Department of Pharmacy at Al-Kut University College in Wasit, Iraq, in conjunction with Al Zahraa Hospital from June 2021 to March 2022. A total of 45 COVID-19 patients participated in this study who were grouped into as follows: Group I (n = 23) who had no previous history of hypertension and Group II (n = 22) who had previous hypertension and were treated with amlodipine. Expression of the calcium-sensing receptor (CaSR), coagulation factor V (F5), and methylenetetrahydrofolate dehydrogenase (NADP+ dependent) 1 Like (MTHFD1L) genes was determined. P values were calculated by Chi-square test for categorized facts and the Mann-Whitney test for incessant data. P ≤ 0.05 was considered statistically significant. Group II patients had significantly lower levels of CaSR, F5, and MTHFD1L gene expression compared with the corresponding levels in Group I patients. The expression level of MTHFD1L was elevated significantly in patients who had currently high blood pressure compared with normotensive patients in both the groups. Amlodipine is preferred in hypertensive patients who have COVID-19 because it attenuates the levels of gene expression that have an impact on the coagulation process.

Associations of platelet indices with proteinuria and chronic kidney disease

OBJECTIVES

Platelet (PLT) indices are predictive in many diseases and conditions. The relationships of these indices with proteinuria and progression of renal disease are not well known. This study aimed to assess PLT indices in patients with primary glomerular nephrotic range proteinuria (PGNRP), with and without chronic kidney disease (CKD), and to compare these indices with those of healthy individuals (His).

METHODS

This cross-sectional study was performed from January 2015 to May 2015. HIs (n = 57) and patients with PGNRP (n = 41) were enrolled. PLT indices and blood biochemistry parameters were compared between HIs and patients with PGNRP, as well as between subgroups of patients with PGNRP who had CKD (n = 23) and those who did not have CKD (n = 18).

RESULTS

There were no statistically significant differences in any PLT indices (i.e., platelet number, mean platelet volume, plateletcrit, and platelet distribution width) between HIs and patients with PGNRP, or between the subgroups of patients with PGNRP. However, patients with PGNRP who had CKD exhibited higher median C-reactive protein and mean albumin levels, compared with patients who did not have CKD.

CONCLUSIONS

Pathological processes in proteinuria and CKD are not associated with PLT indices.

Potential Protective Role of Blood Pressure-Lowering Drugs on the Balance between Hemostasis and Fibrinolysis in Hypertensive Patients at Rest and During Exercise

In patients with hypertension, the triad represented by endothelial dysfunction, platelet hyperactivity, and altered fibrinolytic function disturbs the equilibrium between hemostasis and fibrinolysis and translates into a hypercoagulable state, which underlies the risk of thrombotic complications. This article reviews the scientific evidence regarding some biological effects of antihypertensive drugs, which can protect patients from the adverse consequences of hypertensive disease, improving endothelial function, enhancing antioxidant activity, and restoring equilibrium between hemostatic and fibrinolytic factors. These protective effects appear not to be mediated through blood pressure reduction and are not shared by all molecules of the same pharmacological class.

Can Platelet Indices Reduce Negative Appendectomy Rates?

Introduction

The role of whole blood count parameters in the diagnosis of diseases in which inflammatory processes play a role is one of the more frequently mentioned topics in the literature in recent years. Studies of acute appendicitis have also been carried out in this regard, but studies focused on platelet parameters are few and contradictory. We aimed to investigate the role of mean platelet volume (MPV) and platelet distribution width (PDW) in the diagnosis of acute appendicitis.

Materials and methods

We retrospectively screened the medical records of patients older than 15 years who had an appendectomy from January 2012 to January 2015 at a training hospital in Kocaeli, Turkey. Patients were divided into three groups according to their pathology results: non-appendicitis (Group 1), uncomplicated appendicitis (Group 2), and complicated appendicitis (Group 3). We calculated the sensitivity, specificity, positive and negative predictive values, the likelihood ratios in the diagnosis of appendicitis for white blood cell (WBC), neutrophil count, c-reactive protein (CRP), MPV, and PDW values were calculated.

Results

There were no significant differences in the MPV between Group 1 (n = 39; 7.89 ± 1.32 fL), Group 2 (n = 119; 7.80 ± 1.19 fL), and Group 3 (n = 89; 7.70 ± 0.80 fL; p = 0.141). Also, we found no significant differences in PDW between Group 1 (117.38% ± 1.17), Group 2 (17.17% ± 1.04), and Group 3 (17.12% ± 0.64; p = 0.228).

Conclusions

Only nine of the 208 patients whose pathology reports confirmed appendicitis had healthy values for both CRP and WBC. Many factors affect MPV and PDW. Therefore, platelet indices are not useful markers in diagnosing acute appendicitis.

Relationship between mean platelet volume and metabolic syndrome in Chinese patients

Mean platelet volume (MPV) is a determinant of activation and variability of platelets (PLT). The focus of this study was to to investigate MPV values in patients with and without metabolic syndrome (MS). It also evaluates the association between them. There are close connections among MPV, MS, and cardiometabolic risk. We compiled age, body mass index, blood cell counts, MPV, and other data of 59976 self-reported healthy volunteers (28428 male, 31548 female), 24.65% of who have MS. The mean age of the group was 48.21 years old. The data was grouped by sex and values of data between men and women groups were analyzed by independent sample’s t-test. The relationship between sex and MS was evaluated by chi-square tests. Crude odd ratios of MS between MPV quartiles and 95% confidence intervals were analyzed by binary logistic regression in this study. We found women had higher levels of MPV (10.09 vs. 9.98, P < 0.01) and PLT (228.68 vs. 212.11, P < 0.01) than men. In females, the prevalence of MS was higher in low MPV group than in high MPV groups. The odds of having MS were significantly lower in higher MPV quartiles compared with MPV Quartile 1 in women (Adjusted OR < 1, P < 0.01). This study indicated that MS was inversely associated with MPV in females only.

Clinical use of Serial Mean Platelet Volume Measurement for Diagnosis of Non-ST Segment Elevation Myocardial Infarction in Patients Visiting Emergency Department with Acute Chest Pain

Objective

We aim to demonstrate diagnostic accuracy of serial MPV measuring and to assess its correlation with cardiac troponin I (cTnI) levels.

Design

Cross-sectional study.

Methods

Consecutive patients presenting to emergency department with new onset chest pain started in the last four hours without electrocardiographic ST segment and T wave changes, pathological q waves were included in study. Complete blood count and cTnI levels were studied on admission and six hours after presentation. Patients with cTnI levels higher than 0.06 ng/ml were diagnosed as non-ST elevation myocardial infarction (NSTEMI) and other patients were matched as the control group.

Results

NSTEMI group had significantly higher levels of MPV on admission and at the sixth hour. The increase in MPV was corraleted with elevation of cTnI levels. At six hours follow up, the increase in MPV levels predicted myocardial ischaemia (corrected r2=0.36; p=0.001) in linear regression analysis. The corresponding area under the receiver operating characteristic curve (ROC) for admission MPV, sixth hour MPV and increase in MPV levels in predicting myocardial ischaemia in patients with increased cTnI were 0.652, 0.727 and 0.896 respectively. If MPV threshold was selected as ≥0.10 fL during follow up, myocardial ischaemia was predicted with a sensitivity of 75% and specificity of 88%.

Conclusions

Elevation of MPV levels in patients with acute chest pain may be an indicator of myocardial ischaemia. Serial MPV measurement can be used to complement serial cTnI measurements to diagnose NSTEMI.

No associations exist between mean platelet volume or platelet distribution width and thyroid function in Chinese

Mean platelet volume (MPV) and platelet distribution width (PDW) are morphometric indices of size distribution and variability of platelet. We aimed to explore the associations between MPV or PDW and thyroid function in a large Chinese cohort.This was a cross-sectional study with a recruitment of 13,622 self-reported healthy Chinese (8424 males, 5198 females). Clinical data of the participants comprised of anthropometric measurements, hepatic function, renal function, serum levels of lipid, glucose, C-reactive protein, erythrocyte sedimentation rate, platelet, MPV, PDW, and thyroid hormones. Database was sorted by sex, and the associations between MPV or PDW and thyroid function were analyzed by quartiles of MPV or PDW. Levels of MPV and PDW were compared in different thyroid function subgroups by 1-way analysis of variance and independent sample's t test. Receiver-operating characteristic (ROC) curve was adopted to determine diagnostic values of MPV and PDW for thyroid dysfunction. Crude and adjusted odds ratios of MPV and PDW for thyroid dysfunction with 95% confidence intervals were analyzed by binary logistic regression models.MPV, PDW, and thyroid stimulation hormone were significantly higher in females than in males. Females showed significantly higher incidence of hypothyroidism and hyperthyroidism than males. However, there were no significant differences of MPV and PDW among different thyroid function subgroups in both sexes, and no obvious correlations were revealed between MPV or PDW and thyroid function. From ROC analysis, we demonstrated no diagnostic values of MPV and PDW for thyroid dysfunction. From binary logistic regression models, no risks of different MPV and PDW quartiles were identified for thyroid dysfunction in both sexes.We could not show any association between MPV or PDW and thyroid function. Prospective studies with better defined risk groups should be performed in the future for further verification and validation.

Diagnostic Value of Mean Platelet Volume Combined With Troponin I for Acute Coronary Syndrome

OBJECTIVE

To explore diagnostic performance of mean platelet volume (MPV) for acute myocardial infarction (AMI) of patients with acute coronary syndrome (ACS).

METHODS

We compared MPV and other indicators of 1,524 patients with ACS. Among them, 880 patients were diagnosed with AMI, 344 were diagnosed with unstable angina pectoris and 350 were the control group.

RESULTS

The level of MPV in ACS group was significantly higher than the control group (9.5 ± 1.34fL versus 7.9 ± 1.03fL, P < 0.001). Additionally, MPV of AMI group was higher than unstable angina pectoris (9.4 ± 1.30fL versus 9.2 ± 1.42fL, P < 0.001). Increased MPV could be identified as an early independent predictor of AMI (odds ratio = 1.957, 95% CI: 1.389-2.758, P < 0.001). The area under the receiver operating characteristic curves curve for MPV combined with troponin I (TnI) was 0.816, the sensitivity (68.81%) and the specificity (97.98%) at the best cut-off value were higher than using MPV or TnI alone respectively.

CONCLUSIONS

MPV has been shown as an independent risk factor for early onset of AMI and can be applied to assist AMI diagnosis of ACS patients. Additionally, measuring MPV in conjunction with TnI levels can improve the diagnostic performance of TnI with higher sensitivity and specificity.

The relationship of mean platelet volume with microalbuminuriain type 2 diabetic patients

BACKGROUND/AIM

Activation and size of platelets have been suggested to be involved in the pathogenesis of vascular complications in diabetes mellitus. The purpose of the present study was to investigate the association of mean platelet volume with microalbuminuria in type 2 diabetic patients.

MATERIALS AND METHODS

Mean platelet volume levels were investigated in healthy participants and type 2 diabetic patients with and without microalbuminuria. After their mean platelet volume values were compared, correlation of mean platelet volume with sex, duration of diabetes, microalbuminuria, fasting blood glucose, hemoglobin A1c, creatinine clearance, and body mass index was examined.

RESULTS

Mean platelet volume levels were higher in all diabetic patients than those in controls. Mean platelet volume levels were highest in diabetics with microalbuminuria. The mean platelet volume levels had a positive correlation with microalbuminuria.

CONCLUSION

Mean platelet volume values of diabetic patients were higher than those of nondiabetics, the highest levels being in diabetics with microalbuminuria. Our results suggest that microalbuminuria might be related with mean platelet volume in diabetic patients.

Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: a meta-analysis

BACKGROUND

Platelet activation contributes to cardiovascular disease (CVD), the main complication of type 2 diabetes mellitus (T2DM) and pre-diabetic conditions. Mean platelet volume is an easy-to-measure platelet parameter that has been associated with CVD. We sought to assess mean platelet volume, platelet distribution width, and platelet count in T2DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and metabolic syndrome.

METHODS

Web-based literature search (PubMed, EMBASE, and Web of Science) of studies published in English through June 2014 was performed to select case-control and cross-sectional studies that reported data on mean platelet volume, platelet distribution width, or platelet count in cases (subjects with T2DM, IFG, IGT, or metabolic syndrome) and noncases. Descriptive and quantitative information was extracted, and within-study standardized mean difference was estimated from means and standard deviations. Standardized mean differences across studies were synthesized using a random random-effects model, and subgroup analyses were performed on pre-specified study-level characteristics.

RESULTS

Thirty-nine studies were included. Compared with controls, mean platelet volume was significantly higher in T2DM (standardized mean difference, 95% confidence interval: 0.70, 0.50-0.91; N = 24,245), IFG (0.14, 0.02-0.26; N = 17,389) but not in metabolic syndrome (0.15, -0.24 to 0.55; N = 14,990). Platelet distribution width was wider in T2DM (0.93, 0.09-1.76; N = 471). Platelet count resulted higher in IFG (0.18, 0.12-0.24; N = 3960) and metabolic syndrome (0.39, 0.01-0.78; N = 4070). Only two studies included IGT.

CONCLUSIONS

Available data suggest that T2DM subjects tend to have higher mean platelet volume and platelet distribution width values, but nondifferent platelet count as compared with subjects without T2DM. Whether and how these morphometric changes contribute to CVD of T2DM or can be used as CVD biomarker awaits further investigation.

Is there any relationship between mean platelet volume and varicocele?

Mean platelet volume (MPV) is a parameter that is obtained from an automatic haemogram device during routine blood count and measures platelet reactivity. Increased platelet volume has been considered to be a risk factor for vascular diseases. The aim of this study was to evaluate the relationship between the presence of varicocele and the MPV, platelet count (PLT) and platelet distribution width (PDW) values. We included 264 patients with a diagnosis of varicocele in Group 1, and 220 patients with no varicocele in Group 2. The varicocele diagnosis was performed both with physical examination findings and colour Doppler ultrasonography (CDU). Mean platelet volume values were statistically significantly high (P < 0.001) whereas PLT and PDW values were statistically significantly low (P = 0.011), (P = 0.008) in the varicocele group compared with the control group respectively. However, no significant correlation was found between MPV and PDW in patients diagnosed with varicocele and the varicocele grade on examination and spermatic vein diameter on CDU. Mean platelet volume, which is used widely to measure the size of platelets and indicates platelet reactivity, can provide guidance in the investigation of varicocele pathophysiology and the relevant vascular pathologies.

Relationship between mean platelet volume and retinopathy in patients with type 2 diabetes mellitus

OBJECTIVES

To evaluate the effect of mean platelet volume (MPV) on diabetic retinopathy in patients with type 2 diabetes mellitus.

MATERIALS AND METHODS

In this study, ocular findings and MPV values were retrospectively reviewed in 192 patients with type 2 diabetes mellitus. The patients were classified into four groups according to ocular findings, as follows: group 1, diabetic patients without diabetic retinopathy (n = 70); group 2, diabetic patients with non-proliferative diabetic retinopathy (n = 64); group 3, diabetic patients with proliferative diabetic retinopathy (n = 58); and group 4, healthy controls (n = 100).

RESULTS

A significant difference was found in MPV values between groups 2 and 4 (P = 0.001), between groups 3 and 4 (P = 0.001), and between groups 1 and 4 (P = 0.004). No significant difference was found in MPV values between groups 1 and 2 (P = 0.241) and between groups 2 and 3 (P = 0.460); whereas there was a statistically significant difference between groups 1 and 3 (P = 0.015). The three diabetic groups (groups 1, 2, and 3) were compared with each other. While there was a statistically significant difference between groups 1 and 3 (P = 0.015), there was no significance between groups 2 and 3 (P = 0.46), and between group 1 and 2 (P = 0.241). Logistic regression analysis found a 1.40-fold increase in the risk of retinopathy development (OR: 1.404; P = 0.002) and a 1.46-fold increase in the risk of proliferative diabetic retinopathy (OR: 1.466; P = 0.002) as the MPV value increased.

CONCLUSIONS

In diabetic patients, the risk of retinopathy development increases with higher MPV values.

Mean platelet volume and other platelet volume indices in patients with stable coronary artery disease and acute myocardial infarction: A case control study

Background:

Coronary artery disease is mainly caused by atherosclerosis and its complications. Platelets and their activity have an important role in initiation of atherosclerotic lesions and coronary thrombus formation. Larger platelets are enzymatically and metabolically more active and have a higher potential thrombotic ability as compared with smaller platelets.

Aims:

To study the changes in platelet volume indices and platelet count in acute myocardial infarction, stable coronary artery disease and compare them with controls to assess their usefulness in predicting coronary events.

Materials and Methods:

This was a comparative study of 128 subjects; 39 patients with acute myocardial infarction (AMI), 24 patients with stable coronary artery disease (SCAD) and 65 controls. Venous sample were drawn from AMI subjects on admission (within 4 hours of chest pain) and collected in standardized EDTA sample tubes. Platelet count and volume indices were assayed within 30 minutes of blood collection, using Sysmex KX21-N autoanalyzer. Venous samples were also drawn from SCAD on who were admitted for angiography and subject attending routine checkups.

Results:

The mean platelet volume was significantly higher in patients with AMI (9.65 ± 0.96) as compared to SCAD (9.37 ± 0.88) and controls (9.21 ± 0.58). The best cut-off values for MPV when predicting AMI and SCAD in patients were 9.25 fl (sensitivity 56.4%; specificity 45.9%) and 9.15 fl (sensitivity 54.2%; specificity 42.23%), respectively.

Conclusions:

Measurements of MPV may be of some benefit in detecting those patients at higher risk for an AMI and CAD.

Are platelet volume indices of clinical use? A multidisciplinary review

Platelet size correlates with platelet activity and can be assessed by platelet volume indices (PVI). The PVI, mean platelet volume (MPV), is universally available with routine blood counts by automated hemograms and therefore is an attractive index to study in clinical scenarios. PVI are useful in assessing the etiology of thrombocytopenia. In addition, a normal platelet distribution width in the setting of thrombocytosis is highly suggestive of a reactive etiology. Higher MPV is also associated with the presence of cardiovascular risk factors, chest pain due to acute coronary syndrome, and adverse outcome after acute coronary syndrome. Results from studies evaluating MPV in patients with peripheral artery disease, unprovoked deep vein thrombosis, and pulmonary embolism further advocate a potential role for MPV in identifying patients at high risk of thrombosis. Nevertheless, most of these data come from retrospective studies some of which have small study populations and confounding factors influencing platelet volume. Moreover, the cut-off values derived from these retrospective studies have not been validated prospectively. Despite the potential for clinical utility evident from these studies, the above-mentioned flaws together with technical problems in measuring MPV currently limit its clinical usefulness. Our review provides a perspective on PVI's potential clinical use.

Mean Platelet Volume and Related Factors in Patients at Different Stages of Diabetic Nephropathy

Introduction:

Mean platelet volume (MPV) is an independent cardiovascular disease predictor, and characteristics of MPV in patients with diabetic nephropathy (DN) are not well known.

Aim:

To determine the MPV levels in patients at different stages of DN.

Patients and Methods:

The MPV levels were investigated in healthy participants (group 1, n = 157), patients with type 2 diabetes mellitus without complication (group 2, n = 160), diabetic patients with clinical proteinuria (group 3, n = 144), and in patients with chronic kidney disease due to DN (group 4, n = 160).

Findings:

The MPV level was higher in all diabetic patients than that in normal participants ( P < .05). The MPV values had a positive correlation with the serum creatinine and proteinuria, and a negative correlation with the glomerular filtration rate ([GFR] P < .001 for all, r values; .72, and .82, and −.92, respectively).

Conclusion:

The MPV values were higher in diabetic groups than that in normal participants. Both GFR and proteinuria were the most powerful determinants of MPV.

Mean platelet volume in obese adolescents with nonalcoholic fatty liver disease

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is the accumulation of excess fat in the liver in the absence of alcohol consumption, which commonly coexists with obesity. NAFLD is associated with increased risk of atherosclerosis and insulin resistance. Mean platelet volume (MPV) is a marker of platelet activation, which is a determinant of atherosclerosis.

AIMS

The first aim of the present study was to investigate the MPV levels in obese adolescents and compare the MPV levels in patients with and without NAFLD and also with healthy controls. The second aim of this study was to evaluate the relationship between IR and MPV.

PATIENTS AND METHODS

Case records of 128 exogenous obese adolescents were retrospectively evaluated. Laboratory parameters were collected by using a computerized patient database. Insulin resistance was calculated by a homeostasis model assessment (HOMA-IR) index. Patients were divided into two groups: patients with NAFLD (Group 1) and patients without NAFLD (Group 2). Forty-seven healthy children constituted the control group.

RESULTS

MPV was significantly higher in obese adolescents than their healthy peers. Group 1 had significantly higher MPV than group 2. HOMA-IR was significantly higher in group 1 than group 2. MPV was significantly higher in patients with IR than patients without IR. There was a positive correlation between MPV and HOMA-IR. MPV was inversely correlated with HDL cholesterol and platelet count.

CONCLUSION

MPV may be used as a follow-up marker in patients with NAFLD at the point of atherosclerosis.

The relationship between glycemic control and platelet activity in type 2 diabetes mellitus

AIMS

Platelet activity and aggregation potential, which are essential components of thrombogenesis and atherosclerosis, can be conveniently estimated by measuring mean platelet volume (MPV) as part of whole blood count. It has been shown that MPV was significantly higher in diabetes mellitus (DM); however, the effect of glycemic control on MPV has not been studied. The aim of this study was to investigate the relationship among MPV, glycemic control, and micro- and macrovascular complications in type 2 DM.

METHODS

Seventy patients with type 2 DM and 40 age- and sex-matched healthy individuals were enrolled. Diabetic patients were grouped into those with glycated hemoglobin (HbA1c) levels <or=7% (Group A, n=35 patients) and those with HbA1c >7% (Group B, n=35 patients). Initially, both groups were compared with regard to MPV, HbA1c, serum lipid levels, coronary artery disease, retinopathy, neuropathy, and nephropathy. Thereafter, Group B was called to monthly visits to obtain improved control glycemic control, which was defined as achievement of HbA1c <or=7%. At the end of 3 months of follow-up, Group B was reevaluated.

RESULTS

MPV was significantly higher in patients with DM than in controls (8.7+/-0.8 fl vs. 8.2+/-0.7 fl, P=.002). In diabetic patients, there was a significant positive correlation between MPV and HbA1c levels (r=.39, P=.001) but not diabetic vascular complications. When we compared the two diabetic groups, Group B patients had significantly higher MPV than Group A (9.0+/-0.7 fl vs. 8.4+/-0.8 fl, P=.01). Thirty patients (86%) of Group B achieved improved glycemic control at the end of the 3 months. MPV of the patients with improved glycemic control were significantly decreased compared to baseline MPV (8.4+/-0.8 fl vs. 9.0+/-0.7 fl, P=.003).

CONCLUSIONS

Our results suggested a close relationship between poor glycemic control and increased platelet activity in patients with type 2 DM. Furthermore, platelet activity recovered through improved glycemic control, which may prevent the possible role of platelets in cardiovascular events in these patients.

Doxazosin in metabolically complicated hypertension

Metabolic syndrome, a cluster of metabolic abnormalities with visceral obesity and insulin resistance as its central component, is highly prevalent among hypertensive patients. Hypertension complicated by metabolic syndrome is associated with an increased risk of cardiovascular disease and new-onset Type II diabetes mellitus that further aggravates the prognostic outlook. Such a complex condition requires a multifactorial intervention including blood pressure lowering, improvement of the adverse metabolic profile and delayed onset of new diabetes. In this respect, doxazosin and other alpha-1 adrenoceptor blocking agents are of interest given their effect on the lipid profile in dyslipidemic, obese hypertensive patients, either diabetic or not. Doxazosin improves insulin sensitivity, apparently by accelerating insulin and glucose disposal through vasodilatation of skeletal muscle vascular beds. Whether long-term treatment with the drug might delay, or possibly prevent, incident Type II diabetes in hypertension complicated by metabolic syndrome is an intriguing possibility to be tested in appropriately designed clinical trials.