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埃塞俄比亚东北部2型糖尿病患者的血小板指标及其与微血管并发症的关联:一项横断面研究

Platelet Indices and Its Association with Microvascular Complications Among Type 2 Diabetes Mellitus Patients in Northeast Ethiopia: A Cross-Sectional Study.

作者信息

Taderegew Mitku Mammo, Woldeamanuel Gashaw Garedew, Emeria Mamo Solomon, Tilahun Melkamu, Yitbarek Getachew Yideg, Zegeye Betregiorgis

机构信息

Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.

Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.

出版信息

Diabetes Metab Syndr Obes. 2021 Feb 25;14:865-874. doi: 10.2147/DMSO.S300460. eCollection 2021.

Abstract

PURPOSE

Platelet indices have been shown to be associated with complications of diabetes mellitus (DM). However, the clinical relevance of platelet indices for assessing the risk of being microvascular complications among patients with DM is largely overlooked. Hence this study aimed to determine the association of platelet indices with microvascular complications among type 2 DM patients.

PATIENTS AND METHODS

A hospital-based cross-sectional study was conducted among 352 type 2 DM patients from April 1 to May 30/2019 at Debre Berhan Referral Hospital. Data were collected by interview, physical measurements, document review, and laboratory tests. Then the data were entered into Epi-data manager-4.4.1.0 and exported into SPSS-25 for analysis. Platelet indices were compared between participants with and without microvascular complications using an independent -test. A logistic regression model was used to assess the association between microvascular complications and platelet indices. All inferences were considered statistically significant at P<0.05.

RESULTS

One hundred seventeen (33.2%) of participants were suffering from at least one microvascular complications. The mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) were significantly increased in DM patients with complications as compared to without complications (13.57±2.17fl vs. 11.76±1.93fl), (16.57±2.49fl vs. 14.97±2.41fl) and (28.09±7.58% vs. 24.19±6.46%), respectively (all are P˂0.001). In multivariate logistic regression analysis, MPV (AOR=1.68, 95% CI: 1.37-2.05), PDW (AOR=1.37, 95% CI: 1.15-1.63), P-LCR (AOR=1.07, 95% CI: 1.01-1.14), age (AOR=1.07, 95% CI: 1.01-1.12), and duration of DM (AOR=1.31, 95% CI: 1.18-1.46) were significantly associated with the presence of microvascular complications.

CONCLUSION

MPV, PDW, and P-LCR were significantly higher among type 2 DM patients with microvascular complications. This indicates that platelet indices can be used as prognostic markers of vascular complications and can be used as simple and cost-effective parameters to predict microvascular complications particularly in patients with old age and long duration of DM.

摘要

目的

血小板指标已被证明与糖尿病(DM)并发症相关。然而,血小板指标在评估DM患者微血管并发症风险方面的临床相关性在很大程度上被忽视了。因此,本研究旨在确定2型DM患者血小板指标与微血管并发症之间的关联。

患者与方法

2019年4月1日至5月30日,在德布雷伯汉转诊医院对352例2型DM患者进行了一项基于医院的横断面研究。通过访谈、体格检查、文件审查和实验室检查收集数据。然后将数据录入Epi - data manager - 4.4.1.0,并导出到SPSS - 25进行分析。使用独立样本t检验比较有和无微血管并发症的参与者之间的血小板指标。采用逻辑回归模型评估微血管并发症与血小板指标之间的关联。所有推断在P<0.05时被认为具有统计学意义。

结果

117名(33.2%)参与者患有至少一种微血管并发症。与无并发症的DM患者相比,有并发症的DM患者的平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板大细胞比率(P - LCR)显著升高,分别为(13.57±2.17fl对11.76±1.93fl)、(16.57±2.49fl对14.97±2.41fl)和(28.09±7.58%对24.19±6.46%)(均P˂0.001)。在多因素逻辑回归分析中,MPV(比值比[AOR]=1.68,95%置信区间[CI]:1.37 - 2.05)、PDW(AOR=1.37,95%CI:1.15 - 1.63)、P - LCR(AOR=1.07,95%CI:1.01 - 1.14)、年龄(AOR=1.07,95%CI:1.01 - 1.12)和DM病程(AOR=1.31,95%CI:1.18 - 1.46)与微血管并发症的存在显著相关。

结论

有微血管并发症的2型DM患者的MPV、PDW和P - LCR显著更高。这表明血小板指标可作为血管并发症的预后标志物,并且可作为预测微血管并发症的简单且经济有效的参数,特别是在老年和DM病程长的患者中。

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