Radha Rajesh Kanna Nandagopal, Selvam Diwakar
Associate Professor, Department of Pathology, Chettinad Hospital and Research Institute , India .
Dental Student, Chettinad Hospital and Research Institute , India .
J Clin Diagn Res. 2016 Aug;10(8):EC22-6. doi: 10.7860/JCDR/2016/21499.8353. Epub 2016 Aug 1.
Platelets are tiny, disc-shaped, non-nucleated structures derived from megakaryocytes. The morphological differences in measuring Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) of platelets have important implications for assessing the functional expressions of platelets. Electron microscopy reveals the presence of glycogen as prominent masses in platelets. MPV values have been generally reported to be very high in individuals with uncontrolled diabetes mellitus (DM).
This study aimed to determine and compare the MPV values in uncontrolled and controlled group of Type-2 Diabetics along with healthy non-diabetic people and to correlate MPV values with age, sex and glycosylated haemoglobin (HbA1c) levels in diabetic groups. This study also aimed to determine the prevalence of retinopathy in uncontrolled and controlled group of diabetic patients.
This case control study was carried out in our institution for 1 year. The patients were grouped as uncontrolled group of diabetic patients and controlled group of diabetic patients based on their HbA1c levels. 106 uncontrolled diabetic patients and 100 controlled diabetic patients were included, with 100 non-diabetic subjects as controls. Patient's profile which included all demographic particulars and medical history was obtained. Fundus examination and other ophthalmic findings of 50 uncontrolled and 50 controlled diabetic cases were recorded. The findings were analysed statistically using IBM SPSS software.
In uncontrolled group of 106 diabetic patients, 54 patients were males and 52 patients were females and the mean age was 51.63±11.04, mean HbA1c was 9.86±1.91% and mean MPV was 8.93±0.90fl. In controlled group of 100 diabetic patients, 49 patients were males and 51 patients were females and the mean age was 47.88±15.17, mean HbA1c was 6.08±0.49% and mean MPV was 8.106 ± 0.72fl. In 100 non-diabetic controls 77 patients were males and 23 patients were females and the mean age was 37.97±9.69 and mean MPV was 8.02±0.86fl. Among 50 cases of uncontrolled DM, 14 uncontrolled DM patients had diabetic retinopathy with an average MPV of about 9.2±0.61fl and mean HbA1c of 10.6±1.98% whereas, 30 uncontrolled patients with no evidence of retinopathy with an average MPV of about 8.39±0.676 fl and mean HbA1C of 9.18±1.91%.
MPV values are higher in uncontrolled DM patients when compared with controlled DM patients and a higher percentage of them develop microvascular complications like Diabetic Retinopathy suggesting that mean platelet volume could indicate and play a more important role in the detection of vascular complications of Diabetes.
血小板是源自巨核细胞的微小、盘状、无核结构。测量血小板平均体积(MPV)和血小板分布宽度(PDW)的形态学差异对评估血小板的功能表达具有重要意义。电子显微镜显示血小板中糖原以突出的团块形式存在。一般报道称,未控制的糖尿病(DM)患者的MPV值非常高。
本研究旨在确定并比较2型糖尿病未控制组和控制组以及健康非糖尿病人群的MPV值,并将糖尿病组的MPV值与年龄、性别和糖化血红蛋白(HbA1c)水平相关联。本研究还旨在确定糖尿病未控制组和控制组患者视网膜病变的患病率。
本病例对照研究在我们机构进行了1年。根据HbA1c水平,将患者分为糖尿病未控制组和糖尿病控制组。纳入106例未控制的糖尿病患者和100例控制的糖尿病患者,以100名非糖尿病受试者作为对照。获取患者的个人资料,包括所有人口统计学细节和病史。记录了50例未控制和50例控制的糖尿病病例的眼底检查及其他眼科检查结果。使用IBM SPSS软件对结果进行统计学分析。
在106例未控制的糖尿病患者组中,男性54例,女性52例,平均年龄为51.63±11.04岁,平均HbA1c为9.86±1.91%,平均MPV为8.93±0.90fl。在100例控制的糖尿病患者组中,男性49例,女性51例,平均年龄为47.88±15.17岁,平均HbA1c为6.08±0.49%,平均MPV为8.106±0.72fl。在100名非糖尿病对照组中,男性77例,女性23例,平均年龄为37.97±9.69岁,平均MPV为8.02±0.86fl。在50例未控制的糖尿病病例中,14例未控制的糖尿病患者患有糖尿病视网膜病变,平均MPV约为9.2±0.61fl,平均HbA1c为10.6±1.98%;而30例未发现视网膜病变的未控制患者,平均MPV约为8.39±0.676fl,平均HbA1C为9.18±1.91%。
与控制的糖尿病患者相比,未控制的糖尿病患者的MPV值更高,且他们中更高比例的人会发生糖尿病视网膜病变等微血管并发症,这表明平均血小板体积在糖尿病血管并发症的检测中可能具有指示作用并发挥更重要的作用。