Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital,Ethiopia

BACKGROUND Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality.It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices.However,the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context,and evidence for their role as predictors of poor glycemic status in diabetic patients is limited.AIM To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia,from June 15 to August 12,2022.METHODS A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus(T2DM)and 87 non-diabetic controls.The systematic random sampling technique was used to select participants.Data were collected using structured questionnaires,physical measurements,checklists,and laboratory tests.Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers,respectively.The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear.Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis.Theχ^(2) test,Mann-Whitney U test,Kruskal-Wallis test,post hoc test,Spearman correlation,and receiver operating characteristic curve were used for analysis.A P value<0.05 was considered statistically significant.RESULTS The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width(PDW),mean platelet volume(MPV),platelet large cell ratio(PLCR),and plateletcrit(PCT)compared to healthy individuals(P<0.001).Furthermore,these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls.We also observed significant correlations between these indices and various anthropometric and clinical variables.Our findings suggest that PDW,with a cut-off value of 15.75 fL and an area under the curve(AUC)of 0.803,MPV,with a cut-off value of 12.25 fL and an AUC of 0.774,PLCR,with a cut-off value of 36.3%and an AUC of 0.775,and PCT,with a cut-off value of 0.24%and an AUC of 0.761,can serve as predictors of poor glycemic control in patients with diabetes mellitus.CONCLUSION The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes.Therefore,regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.

Is Any Correlation between Platelet Indices with Extent of Coronary Artery Involvement in Ischemic Heart Diseases?

Ischemic heart disease (IHD) is the most common cause of death around the world. Nowadays Platelet counts (PC) and volumetric platelet indices are available routinely in most laboratories and reflect the level of mobility and production of platelets. It seems that the excessive flexibility and size of the platelets and their local activation have correlation with extent of ischemic heart disease. So our objective is the study of platelet indices in ischemic heart disease. This non-randomized prospective study was performed on 245 patients with ischemic heart disease, who underwent the coronary angiography. The patients were divided into four groups: stable angina, unstable angina, acute myocardial infarction and control group;and then platelet indices, including the platelet counts (PC), the average platelet volume (MPV), the Platelet Distribution Width (PDW) and plateletcrit (PCT) in each group with the extent of coronary disease were compared based on an Syntax Score system and observational methods. The average ages of the patients were 57 years and 65% of them were male and the rest were female. A significant difference is exists between indices in all three groups compared to the control that this difference was related to gender and the type of the coronary artery involvement. However, only in infarction group, PDW in different disease intensities was significantly different. In this study, unlike many of the previous studies no relationship was found between the MPV with the extent of coronary disease.

Evaluation of Red Cell Distribution Width and Platelet Indices in Children with Chronic Heart Disease

Background: Platelets play a key role in the development and progression of cardiovascular diseases. Also red cell distribution width (RDW%) & platelet indices are a good predictor of clinical outcomes. Purpose: Study the relationship between RDW%, platelets count, mean platelet volume (MPVfl) and platelet distribution width (PDWfl) in children with congenital heart disease (CHD) or rheumatic heart diseases (RHD). Subjects and Methods: The study was carried on 151 children diagnosed as CHD or RHD selected from pediatric department of Al-Zahraa University Hospital and National Heart Institute. They were aged from 6 months to 12 years. Another 80 apparently healthy children were taken as controls. Complete blood count and echocardiography examination were evaluated for all participants. Results: The mean value of RDW% was increased in CHD and RHD than controls, RDW% higher in cyanotic CHD (CCHD) (either decompensated or compensated) than acyanotic CHD, and in decompensated RHD than compensated RHD with more than one valve affection. The mean platelets count were decreased in cyanotic than acyanotic CHD, platelets count were increased in decompensated than compensated RHD either with one valve or more than one valve affection. The mean values of MPV and PDW were increased in decompensated CHD, but it decreased in decompensated RHD. Conclusion: The RDW%, MPV and PDW considered as simple markers in the follow up of patients with CHD or RHD for early detection of serious complication.

The Assessment of Platelet Indices Levels in Patients with Generalized Anxiety Disorder

Background: The prevalence of anxiety disorders is increasing in the world. Studies revealed that generalized anxiety disorder may lead to change in platelet size, volume and functions. Thus, the changes in platelet indices may increase the future risk of thrombotic diseases in patients with Generalized Anxiety Disorder (GAD). Aim: To evaluate platelet indices (total count of platelet, mean platelet volume, platelet distribution width, plateletcrit) levels in patients with generalized anxiety disorder. Material and Methods: A cross-sectional study was performed in the Department of Physiology, Dhaka Medical College, Dhaka from July 2019 to June 2020. After obtaining ethical clearance, a total of 144 individuals were selected based on inclusion and exclusion criteria with ages ranging from 18 - 50 years. Group A was the study group selected from Out Patient Department of Psychiatry of Dhaka Medical College Hospital, Dhaka, diagnosed by an experienced psychiatrist. Group B was the control group who were apparently healthy adults selected from different areas of Dhaka city. The subjects were interviewed and detailed history regarding personal, family, medical and drug history were taken. Prior to sample collection, informed written consent was taken from the participants. Platelet indices (total count of platelet, mean platelet volume, platelet distribution width, plateletcrit) were measured in the Department of Laboratory Medicine, Dhaka Medical College Hospital, Dhaka. Statistical Analysis: For statistical analysis, the Unpaired Student’s “t” test was considered using SPSS 25.0 version. Results: Mean platelet volume of generalized anxiety disorder patients was significantly higher (p < 0.001) than the control group. Platelet distribution width and plateletcrit were higher in the study group than the control group. Conclusion: It can be concluded that generalized anxiety disorder patients may have more chance of thrombotic diseases due to significantly higher mean platelet volume and higher platelet distribution width, plateletcrit than healthy adults.

Use of Platelet Indices for Determining Illness Severity and Predicting Prognosis in Critically III Patients

Background：Decreased platelet （PLT） count is one of the independent risk factors for mortality in intensive care unit （ICU） patients.This study was to investigate the relationship between PLT indices and illness severity and their performances in predicting hospital mortality.Methods：Adult patients who admitted to ICU of Changzheng Hospital from January 2011 to September 2012 and met inclusion criteria were included in this study.Univariate analysis was used to identify potential independent risk factors for mortality.Multiple logistic regression analysis was used to calculate adjusted odds ratio for mortality in patients with normal or abnormal PLT indices.The relationship between PLT indices and illness severity were assessed by the Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） scores or sequential organ failure assessment （SOFA） scores in patients with normal and abnormal PLT indices.The performances of PLT indices in predicting mortality were assessed by receiver operating curves and diagnostic parameters.The survival curves between patients with normal and abnormal PLT indices were compared using Kaplan-Meier method.Results：From January 2011 to September 2012,261 of 361 patients （204 survivors and 57 nonsurvivors） met the inclusion criteria.After adjustment for clinical variables,PLT count 〈 100 × 10^12/L （P =0.011）,plateletcrit （PCT） 〈0.108 （P =0.002）,mean platelet volume （MPV） 〉11.3 fL （P =0.023） and platelet distribution width （PDW） percentage 〉17% （P =0.009） were identified as independent risk factors for mortality.The APACHE Ⅱ and SOFA scores were 14.0 （9.0-20.0） and 7.0 （5.0-10.5） in the ＂low PLT＂ tertile,13.0 （8.0-16.0） and 7.0 （4.0-11.0） in the ＂low PCT＂ tertile,14.0 （9.3-19.0） and 7.0 （4.0-9.8） in the ＂high MPV＂ tertile,14.0 （10.5-20.0） and 7.0 （5.0-11.0） in the ＂high PDW＂ tertile,all of which were higher than those in patients with normal indices.Patients with decreased PLT and PCT values （all P 〈 0.001）,or increased MPV and PDW values （P =0.007 and 0.003,respectively） had shortened length of survival than those with normal PLT indices.Conclusions：Patients with abnormally low PLT count,high MPV value,and high PDW value were associated with more severe illness and had higher risk of death as compared to patients with normal PLT indices.

Factors affecting the quantity and quality of platelet-rich plasma and platelet-derived growth factor-BB:an observational study

Objective:Platelet-rich plasma(PRP)releases growth factors upon activation,which in turn accelerates healing and regeneration of the target tissue.However,PRP composition may vary according to the patient’s demographics,and wider applications of PRP warrant product standardization.The current study aimed to examine variables influencing the platelet-derived growth factor BB(PDGF-BB)concentration in PRP.Methods:This observational study was conducted in the Department of Pathology and Dentistry at Swami Rama Himalayan University,a tertiary care hospital in northern India from December 2016 to November 2017.PRP was prepared from 40mL of whole blood from 35 individuals(22 women,13 men).Platelet counts,platelet indices(platelet distribution width,mean platelet volume)and PDGF-BB levels were measured,and platelet yield,platelet dose,and growth factor dose in PRP were also calculated.All parameters were analyzed using Pearson’s correlation coefficient.The association between PDGF-BB and PRP platelet count was evaluated using logistic regression.This study was approved by the Ethics Committee of Swami Rama Himalayan University(SRHU/HIMS/ETHICS/2016/103)on September 7,2016.Results:The mean platelet count,PDGF-BB concentration,platelet yield,platelet dose,and growth factor dose in PRP were 1317×10^(9)/L,30±9.89ng/mL,71.62±28.34%,6.5±3.5×10^(9),and 159.62±52.39ng/mL,respectively.Linear regression analysis indicated that PRP platelet counts were a good predictor for PGDF-BB(P<0.05;adjusted R^(2)=0.96.PRP platelet count was significantly positively correlated with PDGF-BB concentration(r=0.74,P<0.001),platelet yield(r=0.80,P<0.001),platelet dose(r=1,P<0.001),and growth factor dose(r=0.74,P<0.001).Conclusions:PRP has wide clinical applications associated with its healing and regenerative properties,and both the quality and quantity of PRP thus need to be standardized as per the requirements.Evaluating variables affecting PRP will thus aid pathologists and clinical practitioners.