Evaluation of platelet volume indices as predictive biomarkers of microvascular complications in patients with type 2 diabetes

Abstract

Introduction: Patients with type 2 diabetes are known to have a higher risk of developing micro- and macrovascular complications which enhance the risk of morbidity and mortality. Increased platelet activity is postulated to be a vital mechanism in the development of vascular complications. Platelet volume indices (PVI), including mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) are indicators of enhanced platelet activity and these may be useful markers of complications. Materials and methods: We conducted a case-control study across 130 T2DM patients that were matched for age and gender with 130 people who did not have T2DM. Detailed demographic profile and clinical history including duration of diabetes along with complete physical examination was conducted. Fundus examination was conducted for direct ophthalmoscopy for retinopathy and Neuropathy Disability Score (NDS) was calculated to assess the severity of neuropathy. The biochemical investigations included were the platelet indices, fasting blood glucose (FPG), postprandial blood glucose, HbA1c, serum creatinine, and urine albumin. Results: We observed that platelet indices, such as MPV, PDW, and PCT were significantly higher in diabetic individuals than in matched controls. Higher MPV, PDW, and PCT were observed in diabetic patients with microvascular complications compared with those without microvascular complications. We observed that patients with neuropathy with NDS > 6 had higher value of MPV, PDW, and PCT than compared with those with NDS < 6. There was significant difference for MPV between diabetics with and without complications and non-diabetics (p < 0.05). PDW and MPV were positively correlated with duration of diabetes. Conclusions: The association between MPV, PDW, and PCT and diabetic retinopathy revealed that platelet indices were significantly higher than control group in both NPDR and PDR. However, we did not observe any difference in platelet indices in NPDR and patients without diabetic retinopathy. MPV, PDW, and PCT were higher in individuals with higher HbA1clevel and the correlation was found to be statistically significant.