Study of Impact of Glycemic Status (HbA1c) on Platelet Activity measured by Mean Platelet Volume & Vascular Complications in Diabetics.

INTRODUCTION:Diabetes mellitus is a global pandemic. The increased platelet activity may play a role in the development of vascular complications of this metabolic disorder. The mean platelet volume (MPV) is an indicator of the average size and activity of platelets. Larger platelets are younger and exhibit more activity. AIMS AND OBJECTIVES:To determine the MPV in diabetics with different glycemic control (HbA1C), to see if there is a difference in MPV between diabetics with and without vascular complications, and to determine the correlation of MPV with fasting blood glucose, glycosylated hemoglobin (HbA1c), body-mass index, and duration of diabetes in the diabetic patients. METHODOLOGY:Platelet counts and MPV were measured in 160 Type 2 diabetic patients using an automated blood cell counter. The blood glucose levels and HbA1c levels were also measured. All patients were divided in 2 groups, group A, which includes patients with HbA1C≤8 % and group B, which includes patients with HbA1C>8 %. Statistical evaluation was performed using Student's t test and Pearson correlation tests. RESULTS:The mean platelet counts and MPV were higher in diabetics with higher HbA1C (group B) compared to the diabetics with lower HbA1C (group A) [288.30 ± 103.96 X 109/l vs. 265.83 ± 66.97 X 109/l (P= 0.16)], 13.77 ± 0.08 fl versus 11.86 ± 0.66 fl (P= 0.0001), respectively. MPV showed a positive correlation with fasting blood glucose (regression (r) = 0.18) and HbA1C levels (P=0.0001). HbA1C and MPV increases with increase in duration of DM, which were 8.62±0.96 and 8.51±1.09 % (p=0.49) and 13.24±1.27 and 13.10±1.37 (p=0.50) respectively in both group with duration >5 years and ≤5 years. On the basis of vascular complications, HbA1C, MPV and Duration of DM were (in both group with and without complications respectively), 8.58±0.01 % and 8.56±0.09 % (p=0.03), 13.12±1.40 fl and 12.80±1.21fl (p=0.13), 9.11±3.22 years and 2.5±2.2 years (p<0.0001). CONCLUSION:Our results showed significantly higher MPV in diabetic patients with higher HbA1C (poor glycemic control). This indicates that elevated MPV could be either the cause for or due to the effect of the vascular complications. Hence, platelets may play a role and MPV can be used as a simple parameter to assess the vascular events in diabetes.