Immature Platelet Fraction and Other Platelet Indices in Type 2 Diabetes Mellitus

Abstract

BACKGROUND Diabetes mellitus (DM) has become a significant global health concern, with its associated complications imposing a substantial burden on healthcare systems worldwide. While it is widely recognized as a complex metabolic disorder, the understanding of its pathophysiology continues to evolve, leading to the identification of various diabetes subtypes and their diverse clinical presentations. Despite extensive research, the impact of diabetes on platelet function remains a lesser explored domain. METHODS We conducted a case-control study to investigate the variation of platelet indices in individuals with type 2 diabetes mellitus (T2DM) compared to healthy controls. Our study, conducted at a tertiary care facility in the national capital region, aimed to identify potential prognostic markers and explore the utility of platelet indices in predicting diabetic complications. A total of 230 participants, including 115 T2DM cases and 115 age and sex-matched healthy controls, were enrolled in the study. Baseline investigations, including hemogram and platelet indices, were performed and statistical analyses were conducted to compare the results between the two groups. RESULTS  Significant differences were found in platelet parameters between T2DM cases and controls, with elevated levels observed in individuals with T2DM. Immature platelet fraction (IPF), mean platelet volume, plateletcrit, platelet distribution width, platelet large cell count, and platelet large cell ratio were among the parameters that were significantly elevated in individuals with T2DM. Furthermore, IPF emerged as a promising biomarker, demonstrating excellent diagnostic performance with an area under the ROC curve of 0.941. A cutoff value of IPF (%) ≥9.6 showed high sensitivity (86%) and specificity (95%) in distinguishing T2DM cases from controls. CONCLUSION Our study provides novel insights into the relationship between platelet indices and T2DM, highlighting the potential utility of IPF as a prognostic marker in diabetic individuals. These findings warrant further investigation in larger cohorts and prospective studies to validate the proposed cutoff values and explore their clinical and therapeutic implications in the management of T2DM and delaying its complications.