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Khanna P, Salwan SK, Sharma A. Correlation of Platelet Indices in Patients With Type 2 Diabetes Mellitus and Associated Microvascular Complications: A Hospital-Based, Prospective, Case-Control Study. Cureus 2024; 16:e55959. [PMID: 38601371 PMCID: PMC11005942 DOI: 10.7759/cureus.55959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Background Diabetic patients exhibit increased platelet activity. Insulin inhibits the activation of platelets. Therefore, a relative or absolute deficiency of insulin would increase platelet reactivity. The younger (larger) platelets are also more metabolically and enzymatically active. If detected early, microvascular complications could alert us regarding the possible macrovascular complications. Thus, the aims and objectives of the present study were to determine platelet indices in patients with type 2 diabetes mellitus with controls (non-diabetics) and to find an association of platelet indices with microvascular complications. Material & methods In this prospective case-control study conducted from 2021 to 2022 (2 years), a total number of 200 subjects were taken and were divided into two groups of 100 each, cases (I) and controls (II). The cases included patients of diabetes mellitus (DM) of a duration of more than 5 years, which were further divided into two groups of 50 each, IA and IB. Group IA consisted of patients with diabetes mellitus of a duration of more than five years with at least one microvascular complication and group IB was diabetics of more than five years duration without any microvascular complications, which includes diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. An automated cell counter (Thermo Fisher Scientific, Waltham, MA, US) provided hemoglobin values along with the platelet count and platelet indices, i.e. mean platelet volume (MPV), platelet large cell ratio (P-LCR), and platelet distribution width (PDW). Results The present study consisted of 200 subjects divided into 2 groups of 100 each, cases (I) and controls (II). The average MPV (9.4-12.3 femtolitre) in diabetics was 12.089±1.450 fL as compared to the controls where it was 9.464±1.424 fL with a statistically significant p-value of 0.001. PDW among the cases was 16.868±2.352 fL while in controls, it was 12.753±10.559 fL (p=0.001). The mean P-LCR was 34.975±8.056% among the cases, in comparison to the mean P-LCR among the controls, which was 26.031±7.004 (p=0.001). In this study, the MPV, PDW, and P-LCR were significantly raised in individuals having diabetes with microvascular complications when compared with patients without complications. The mean MPV in diabetics with complications was 12.5960±0.95660 fL and in those without complications was 11.5820±1.67609 fL (with a p-value of P = 2×10-3)which is statistically significant. Similar results were obtained in cases of PDW and P-LCR. The mean PDW in diabetics with complications was 17.1140±2.58228 fL and without complications was 15.6220±2.10532 fL ((with a p-value of P = 2×10-3)). The mean P-LCR in diabetics with microvascular complications was 35.408±3.5490% and without complications was 33.542±4.8694% (with a p-value of P = 3.1×10-3). Conclusion Based on the findings of the present study, there is a statistical correlation between type 2 diabetes and variations in platelet indices, resulting in the associated microvascular complications. Higher MPV, PDW, and P-LCR values suggest that these parameters are more reliable predictors of early vascular complications in individuals with type 2 diabetes mellitus and can be utilized as an easy-to-use, low-cost method. They are a readily available, economical, practical, noninvasive, and simple-to-understand approach for assessing platelet dysfunction, which in turn helps anticipate the existence of microvascular complications.
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Affiliation(s)
- Parul Khanna
- Department of General Medicine, Sri Guru Ram Das University of Health Sciences, Amritsar, IND
| | - Surinder K Salwan
- Department of General Medicine, Sri Guru Ram Das University of Health Sciences, Amritsar, IND
| | - Aditya Sharma
- Department of General Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
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Szymańska P, Luzak B, Siarkiewicz P, Golański J. Platelets as Potential Non-Traditional Cardiovascular Risk Factor-Analysis Performed in Healthy Donors. Int J Mol Sci 2023; 24:14914. [PMID: 37834362 PMCID: PMC10573668 DOI: 10.3390/ijms241914914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/24/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
Abnormal lipid profile, increased glucose level, and elevated body weight are traditional cardiometabolic risk factors; however, the role of platelets in the development of cardiovascular disease (CVD) is increasingly being highlighted. The aim of this study was to select platelet-related parameters (non-genetic molecular and routine laboratory measurements) that may be associated with increased cardiovascular risk among healthy populations. We evaluated the level of platelet indices, platelet-based inflammatory markers, platelet reactivity parameters, and platelet reactive oxygen species (ROS) generation in relation to selected cardiometabolic risk factors. We noted the association between total cholesterol and LDL cholesterol with platelet aggregation and platelet ROS generation. We found the relationship between triglycerides, glucose, and body mass index with the relatively new multi-inflammatory indices (MII-1 and MII-3). Moreover, we noticed that the mean platelet volume-to-lymphocyte ratio in healthy subjects is not a good source of information about platelets and inflammation. We also highlighted that platelet-to-HDL-cholesterol ratio may be a promising prognostic cardiometabolic indicator. The association between platelet-related (especially molecular) and cardiometabolic parameters requires further research. However, the goal of this study was to shed light on the consideration of platelets as a non-traditional cardiovascular risk factor and a crucial element in identifying individuals at high-risk of developing CVD in the future.
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Affiliation(s)
- Patrycja Szymańska
- Department of Haemostasis and Haemostatic Disorders, Chair of Biomedical Sciences, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland; (P.S.); (B.L.)
| | - Bogusława Luzak
- Department of Haemostasis and Haemostatic Disorders, Chair of Biomedical Sciences, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland; (P.S.); (B.L.)
| | - Przemysław Siarkiewicz
- Institute of Polymer and Dye Technology, Faculty of Chemistry, Lodz University of Technology, Stefanowskiego 16, 90-537 Lodz, Poland;
| | - Jacek Golański
- Department of Haemostasis and Haemostatic Disorders, Chair of Biomedical Sciences, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland; (P.S.); (B.L.)
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Oshima S, Higuchi T, Okada S, Takahashi O. The Relationship Between Mean Platelet Volume and Fasting Plasma Glucose and HbA1c Levels in a Large Cohort of Unselected Health Check-Up Participants. J Clin Med Res 2018; 10:345-350. [PMID: 29511424 PMCID: PMC5827920 DOI: 10.14740/jocmr3361w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/06/2018] [Indexed: 11/19/2022] Open
Abstract
Background Larger platelets are more active and mean platelet volume (MPV) is an indicator of platelet activation and an independent risk factor of cardiovascular diseases. While MPV is reported to be higher in diabetic patients, the relationship between MPV and glycemic parameters in general population remains inconclusive. Methods In this cross-sectional study, we studied relationship between MPV and fasting plasma glucose (FPG) and HbA1c levels in 38,204 unselected participants of general health check-up aged 20 years or older in the year of 2014 who were considered to be representative of the general population. Individuals with known diabetes, coronary artery disease and/or cerebrovascular disease who were on drug therapy and those with platelet counts below 100 × 109/L or above 400 × 109/L were excluded. Results The mean age of the individuals was 52.3 ± 12.1 years and 46.1% were male. There were positive associations between MPV and both FPG (r = 0.066; P < 0.001) and HbA1c (r = 0.025; P < 0.001) levels when all individuals were analyzed as a whole. While the association was only marginal in individuals with HbA1c levels below 6.5% (r = 0.009; P = 0.068), it was significant in those with HbA1c ≥ 6.5% (r = 0.138; P < 0.001). When the individuals were categorized into four groups according to the HbA1c values: HbA1c < 5.5%, 5.5% ≤ HbA1c < 6.0%, 6.0% ≤ HbA1c < 6.5%, and HbA1c ≥ 6.5%, the mean MPV was virtually same among groups with HbA1c level < 6.5% and that of the individuals with HbA1c ≥ 6.5 was significantly higher than groups with lower HbA1c levels. Multivariate analyses adjusted with age and sex showed the same results. Conclusion FPG and HbA1c appeared to be associated with MPV in unselected health check-up participants; however, the association between glycemic state and MPV was apparent only in individuals with impaired glycemic control and only marginal in those with normal glycemic control. The clinical significance of the associations warrants further study.
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Affiliation(s)
- Shinichiro Oshima
- Department of Internal Medicine, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Takakazu Higuchi
- Division of Hematology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.,Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya 343-8555, Japan
| | - Sadamu Okada
- Division of Hematology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Osamu Takahashi
- Center for Clinical Epidemiology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
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Zaccardi F, Rocca B, Rizzi A, Ciminello A, Teofili L, Ghirlanda G, De Stefano V, Pitocco D. Platelet indices and glucose control in type 1 and type 2 diabetes mellitus: A case-control study. Nutr Metab Cardiovasc Dis 2017; 27:902-909. [PMID: 28838851 DOI: 10.1016/j.numecd.2017.06.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/23/2017] [Accepted: 06/27/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIMS The relationship between platelet indices and glucose control may differ in type 1 (T1DM) and type 2 (T2DM) diabetes. We aimed to investigate differences in mean platelet volume (MPV), platelet count, and platelet mass between patients with T1DM, T2DM, and healthy controls and to explore associations between these platelet indices and glucose control. METHODS AND RESULTS A total of 691 T1DM and 459 T2DM patients and 943 control subjects (blood donors) were included. HbA1c was measured in all subjects with diabetes and 36 T1DM patients further underwent 24 h-continuous glucose monitoring to estimate short-term glucose control (glucose mean and standard deviation). Adjusting for age and sex, platelet count was higher and MPV lower in both T1DM and T2DM patients vs control subjects, while platelet mass (MPV × platelet count) resulted higher only in T2DM. Upon further adjustment for HbA1c, differences in platelet count and mass were respectively 19.5 × 109/L (95%CI: 9.8-29.3; p < 0.001) and 101 fL/nL (12-191; p = 0.027) comparing T2DM vs T1DM patients. MPV and platelet count were significantly and differently related in T2DM patients vs both T1DM and control subjects; this difference was maintained also accounting for HbA1c, age, and sex. Platelet mass and the volume-count relationship were significantly related to HbA1c only in T1DM patients. No associations were found between platelet indices and short-term glucose control. CONCLUSION By accounting for confounders and glucose control, our data evidenced higher platelet mass and different volume-count kinetics in subjects with T2DM vs T1DM. Long-term glucose control seemed to influence platelet mass and the volume-count relationship only in T1DM subjects. These findings suggest different mechanisms behind platelet formation in T1DM and T2DM patients with long-term glycaemic control being more relevant in T1DM than T2DM.
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Affiliation(s)
- F Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester, UK; Diabetes Care Unit, Catholic University School of Medicine, Rome, Italy.
| | - B Rocca
- Institute of Pharmacology, Catholic University School of Medicine, Rome, Italy
| | - A Rizzi
- Diabetes Care Unit, Catholic University School of Medicine, Rome, Italy
| | - A Ciminello
- Institute of Haematology, Catholic University School of Medicine, Rome, Italy
| | - L Teofili
- Institute of Haematology, Catholic University School of Medicine, Rome, Italy
| | - G Ghirlanda
- Diabetes Care Unit, Catholic University School of Medicine, Rome, Italy
| | - V De Stefano
- Institute of Haematology, Catholic University School of Medicine, Rome, Italy
| | - D Pitocco
- Diabetes Care Unit, Catholic University School of Medicine, Rome, Italy
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Lippi G, Salvagno GL, Nouvenne A, Meschi T, Borghi L, Targher G. The mean platelet volume is significantly associated with higher glycated hemoglobin in a large population of unselected outpatients. Prim Care Diabetes 2015; 9:226-230. [PMID: 25249479 DOI: 10.1016/j.pcd.2014.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/29/2014] [Accepted: 08/31/2014] [Indexed: 01/27/2023]
Abstract
AIMS To examine the association between mean platelet volume (MPV) and glycated hemoglobin (HbA1c) in a large cohort of unselected outpatients. METHODS We retrospectively reviewed combined results of complete blood count (CBC) and hemoglobin A1c (HbA1c) performed in all outpatients aged 18 years or older, who were referred to the outpatient clinic of our hospital for routine health check-up during the year 2013. RESULTS Cumulative results of both CBC and HbA1c could be retrieved for 4072 male and female outpatients aged 18 years or older. There were significant associations between HbA1c and both MPV (r=0.10; p<0.001) and platelet count (r=0.05; p<0.001), that remained statistically significant after adjusting for age and sex. After stratifying the whole sample of patients for MPV quartiles, there was a significant, positive trend of HbA1c across quartiles of MPV (p<0.001). Similar findings were found when the whole sample was stratified by clinical thresholds of HbA1c (p<0.001), with values of MPV gradually increasing from subjects with normal glucose homeostasis, pre-diabetes and diabetes. CONCLUSIONS The results of our investigation, which is supposed to be the largest cohort study on unselected outpatients assessing the relationship between HbA1c and platelets number or size, indicate that elevated MPV is significantly associated with higher HbA1c levels and vice versa.
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Affiliation(s)
- Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, Academic Hospital of Parma, Parma, Italy.
| | - Gian Luca Salvagno
- Laboratory of Clinical Chemistry and Hematology, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Antonio Nouvenne
- Department of Clinical and Experimental Medicine, Academic Hospital of Parma, Parma, Italy
| | - Tiziana Meschi
- Department of Clinical and Experimental Medicine, Academic Hospital of Parma, Parma, Italy
| | - Loris Borghi
- Department of Clinical and Experimental Medicine, Academic Hospital of Parma, Parma, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
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Zaccardi F, Rocca B, Pitocco D, Tanese L, Rizzi A, Ghirlanda G. Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: a meta-analysis. Diabetes Metab Res Rev 2015; 31:402-10. [PMID: 25421610 DOI: 10.1002/dmrr.2625] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/09/2014] [Indexed: 11/06/2022]
Abstract
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.
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Affiliation(s)
- Francesco Zaccardi
- Internal Medicine and Diabetes Care Unit, Catholic University School of Medicine, Rome, Italy; Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Okan DH, Gökmen Z, Seyit B, Yuksel K, Cevdet Z, Deniz A. Mean platelet volume in brucellosis: correlation between brucella standard serum agglutination test results, platelet count, and C-reactive protein. Afr Health Sci 2014; 14:797-801. [PMID: 25834485 DOI: 10.4314/ahs.v14i4.4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Brucellosis, a zoonotic infection, was most widely diagnosed by the Brucella standard serum agglutination test (SAT). No previous publication has demonstrated a correlation between the degree of Brucella SAT agglutination positivity and the severity of brucellosis infection. OBJECTIVE To contribute to the clarification of the relationship between patelets and brucellosis. It is also aimed at evaluating the usefulness of the SAT titer as a measure of brucellosis severity. MATERIAL AND METHODS We compared the control (n=60) and patients (n=96) groups in terms of mean platelet volume (MPV), C-reactive protein (CRP) and platelet values. Patients were grouped according to their degree of agglutination positivity titers and compared by means of CRP, MPV and platelet values. We also investigated the relationship among logarithmic values of MPV, platelet and CRP parameters for each group. RESULTS Although statistically meaningful difference was observed between control and patients group in terms of MPV and platelet value, there were no statistically significant differences observed among patients groups. The physiological negative correlation between MPV and platelet count was not encountered in group 2 and 3. Logarithmic values of CRP were not correlated with logarithmic values of MPV and platelet counts. CONCLUSION The MPV could be a new parameter to evaluate hematologic abnormalities in patients with brucellosis. The SAT titer was not a useful measure for evaluation of the severity of brucellosis.
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Affiliation(s)
- Dogan Halef Okan
- Clinical Biochemistry, Ankara Numune Training and Research Hospital, 06100, Ankara, Turkey
| | - Zararsiz Gökmen
- Department of Biostatistics and Medical Informatics, Erciyes University, Faculty of Medicine, 38039, Kayseri -Turkey
| | - Bayik Seyit
- Clinical Microbiology, Ankara Numune Training and Research Hospital 06100, Ankara, Turkey
| | - Koca Yuksel
- Clinical Biochemistry, Ankara Numune Training and Research Hospital, 06100, Ankara, Turkey
| | - Zungun Cevdet
- Clinical Biochemistry, Ankara Numune Training and Research Hospital, 06100, Ankara, Turkey
| | - Akbulut Deniz
- Clinical Biochemistry, Ankara Numune Training and Research Hospital, 06100, Ankara, Turkey
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Stratmann B, Xu T, Meisinger C, Menart B, Roden M, Herder C, Grallert H, Peters A, Koenig W, Illig T, Wichmann HE, Wang-Sattler R, Rathmann W, Tschoepe D. PLA1A2 platelet polymorphism predicts mortality in prediabetic subjects of the population based KORA S4-Cohort. Cardiovasc Diabetol 2014; 13:90. [PMID: 24886443 PMCID: PMC4022397 DOI: 10.1186/1475-2840-13-90] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 04/28/2014] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The genetic polymorphism concerning the ß3-subunit of platelet integrin receptor glycoprotein IIIa is held responsible for enhanced binding of adhesive proteins resulting in increased thrombogenic potential. Whether it is associated with mortality, HbA1c or platelet volume is tested prospectively in an epidemiological cohort. RESEARCH DESIGN AND METHODS Population-based Cooperative Health Research in the Region of Augsburg (KORA) S4-Survey (N = 4,028) was investigated for prognostic value of PLA1A2-polymorphism regarding all-cause mortality, correlation with HbA1c, and mean platelet volume. Multivariate analysis was performed to investigate association between genotype and key variables. RESULTS Prevalence of thrombogenic allele variant PLA2 was 15.0%. Multivariate analysis revealed no association between PLA1A2 polymorphism and mortality in the KORA-cohort. HbA1c was a prognostic marker of mortality in non-diabetic persons resulting in J-shaped risk curve with dip at HbA1c = 5.5% (37 mmol/mol), confirming previous findings regarding aged KORA-S4 participants (55-75 years). PLA1A2 was significantly associated with elevated HbA1c levels in diabetic patients (N = 209) and reduced mean platelet volume in general population. In non-diabetic participants (N = 3,819), carriers of PLA2 allele variant presenting with HbA1c > 5.5% (37 mmol/mol) showed higher relative risk of mortality with increasing HbA1c. CONCLUSION PLA1A2 polymorphism is associated with mortality in participants with HbA1c ranging from 5.5% (37 mmol/mol) to 6.5% (48 mmol/mol). Maintenance of euglycemic control and antiplatelet therapy are therefore regarded as effective primary prevention in this group.
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Affiliation(s)
- Bernd Stratmann
- Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstr. 11, D-32545 Bad Oeynhausen, Germany
| | - Tao Xu
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Barbara Menart
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Harald Grallert
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Wolfgang Koenig
- Department Internal Medicine II, University Clinic Ulm, Ulm, Germany
| | - Thomas Illig
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Heinz-Erich Wichmann
- Institute of Epidemiology I, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Rui Wang-Sattler
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Diethelm Tschoepe
- Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstr. 11, D-32545 Bad Oeynhausen, Germany
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Kim JH, Bae HY, Kim SY. Response: clinical marker of platelet hyperreactivity in diabetes mellitus (diabetes metab j 2013;37:423-8). Diabetes Metab J 2014; 38:160-1. [PMID: 24851211 PMCID: PMC4021304 DOI: 10.4093/dmj.2014.38.2.160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Jin Hwa Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Hak Yeon Bae
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Sang Yong Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
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Abstract
Atherothrombotic complications are important causes of morbidity and mortality in diabetic patients. Diabetes has been considered to be a prothrombotic status. Several factors contribute to the prothrombotic condition, such as increasing coagulation, impaired fibrinolysis, endothelial dysfunction, and platelet hyperreactivity. Among the factors that contribute to the prothrombotic status in diabetes, altered platelet function plays a crucial role. Although understanding platelet function abnormalities in diabetes still remains as a challenge, more attention should be focused on platelet function for effective management and the prediction of atherothrombotic events in diabetic patients. This review will provide an overview on the current status of knowledge of platelet function abnormalities and clinical marker of platelet hyperreactivity in patients with diabetes.
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Affiliation(s)
- Jin Hwa Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Hak Yeon Bae
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Sang Yong Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
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Shimodaira M, Niwa T, Nakajima K, Kobayashi M, Hanyu N, Nakayama T. Correlation between mean platelet volume and fasting plasma glucose levels in prediabetic and normoglycemic individuals. Cardiovasc Diabetol 2013; 12:14. [PMID: 23311535 PMCID: PMC3558413 DOI: 10.1186/1475-2840-12-14] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 12/21/2012] [Indexed: 12/25/2022] Open
Abstract
Background Prediabetes is an independent risk factor for cardiovascular diseases. Mean platelet volume (MPV) can reflect platelet activity, and high MPV is associated with thrombogenic activation and an increased risk of cardiovascular disease. In diabetic patients, MPV is higher when compared with normal subjects. However, the relationship between MPV and prediabetes is poorly understood. The purpose of the present study was to compare MPV in prediabetic and normoglycemic subjects, and to evaluate the relationship between MPV and fasting plasma glucose (FPG) levels in these two groups. Methods We retrospectively studied 1876 Japanese subjects who had undergone health checks at Iida Municipal Hospital. Age, sex, body mass index (BMI), blood pressure, medical history, smoking habits, alcohol intake, lipid profiles, FPG levels, and MPV were evaluated. Subjects were categorized into four groups according to FPG: Q1 (70 mg/dL ≤ FPG < 90 mg/dL, n = 467), Q2 (90 mg/dL ≤ FPG < 95 mg/dl, n = 457), Q3 (95 mg/dL ≤ FPG < 100 mg/dL, n = 442), and Q4 (100 mg/dL ≤ FPG < 126 mg/dL, n = 512). Q1, Q2, and Q3 were defined as normal FPG groups and Q4 was defined as prediabetic group. Results The MPV increased with the increasing FPG levels, in the following order: Q1 (9.89 ± 0.68 fl), Q2 (9.97 ± 0.69 fl), Q3 (10.02 ± 0.72 fl), and Q4 (10.12 ± 0.69 fl). After adjusting for the confounding parameters, MPV of the prediabetic group was higher than that in other groups (P < 0.001 for Q4 vs. Q1 and Q2, and P < 0.05 for Q4 vs. Q3). MPV in the high-normal glucose group (Q3) was significantly higher than in the low-normal glucose group (Q1). MPV was independently and positively associated with FPG, not only in prediabetic subjects but also in normal FPG subjects (β = 0.020 and β = 0.006, respectively). Conclusions MPV in patients with prediabetes was higher than that in normal subjects, and was positively associated with FPG levels in prediabetic and normal subjects.
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