Vinholt P J, Hvas A M, Frederiksen H, Bathum L, Jørgensen M K, Nybo M
Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark.
Department of Clinical Biochemistry, Aarhus University Hospital, Denmark.
Thromb Res. 2016 Dec;148:136-142. doi: 10.1016/j.thromres.2016.08.012. Epub 2016 Aug 20.
Platelet count is used to determine bleeding risk and monitoring thrombopoiesis. While abnormal platelet counts are associated with mortality and morbidity, it is unclear whether it also apply to platelet counts within reference range. We investigated the relationship between platelet count (100-450×10/L) and mortality, development of future cardiovascular disease (myocardial infarction, ischaemic stroke, or peripheral vascular disease), venous thromboembolism, bleeding or cancer in the general population.
We conducted a register-based cohort study of 21,252 adults (≥20years) from the Danish General Suburban Population Study (GESUS). Laboratory results from GESUS were linked to information from national registers regarding morbidity and death. Cox proportional hazard regression was conducted with adjustment for age, sex, smoking status, haemoglobin, leukocyte count, C-reactive protein and Charlson comorbidity index.
We found a U-shaped relationship between mortality and platelet count. Mortality was significantly increased for platelet count <175×10/L or >300×10/L. When categorizing platelet count using the interval 201-250×10/L as reference group, platelet count 301-450×10/L was associated with mortality, adjusted hazard ratio (HR)=1.42(95% CI 1.06-1.90) and cardiovascular disease, adjusted HR=1.32 (95% CI 1.03-1.69). Platelet count 100-200×10/L was associated with future cancer, adjusted HR=1.28(95% CI 1.05-1.57), but not with future bleeding or venous thromboembolism.
Platelet count is associated with mortality, future cardiovascular disease, and future cancer.
血小板计数用于确定出血风险和监测血小板生成。虽然异常血小板计数与死亡率和发病率相关，但尚不清楚其是否也适用于参考范围内的血小板计数。我们调查了普通人群中血小板计数（100 - 450×10⁹/L）与死亡率、未来心血管疾病（心肌梗死、缺血性中风或外周血管疾病）、静脉血栓栓塞、出血或癌症之间的关系。
我们对丹麦普通郊区人群研究（GESUS）中的21252名成年人（≥20岁）进行了基于登记的队列研究。GESUS的实验室结果与国家登记处关于发病率和死亡的信息相关联。进行了Cox比例风险回归，并对年龄、性别、吸烟状况、血红蛋白、白细胞计数、C反应蛋白和Charlson合并症指数进行了调整。
我们发现死亡率与血小板计数呈U形关系。血小板计数<175×10⁹/L或>300×10⁹/L时，死亡率显著增加。以201 - 250×10⁹/L区间作为参考组对血小板计数进行分类时，血小板计数301 - 450×10⁹/L与死亡率相关，调整后的风险比（HR）=1.42（95%CI 1.06 - 1.90），与心血管疾病相关，调整后的HR = 1.32（95%CI 1.03 - 1.69）。血小板计数100 - 200×10⁹/L与未来癌症相关，调整后的HR = 1.28（95%CI 1.05 - 1.57），但与未来出血或静脉血栓栓塞无关。
血小板计数与死亡率、未来心血管疾病和未来癌症相关。
