Sawai Man Singh Medical College, Jaipur.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Diabetes mellitus is a major global health problem, increasingly affecting the population across the world. Diabetic patients have an increased risk of developing micro and macro vascular diseases, and platelets may be involved as a causative agent with respect to altered platelet morphology and function. There are studies evaluating the association between Mean Platelet Volume (MPV) and HbA1c and its role in predicting glycaemic control with conflicting results. Thus the present study was conducted to assess the relationship between HbA1c levels and platelet activity (MPV), determine the association among MPV, glycemic control, and diabetic vascular complications and to evaluate the influence of improved glycemic control on MPV in type 2 diabetic patients.
This was a hospital based observational comparative study on 100 cases of diabetes mellitus divided in 2 groups i.e Group A (HbA1c <7) and Group B (HbA1c >7) and 50 healthy controls in Group C in hospital wards and OPD of SMS Medical College, Jaipur.
Age more than 18 years, and newly diagnosed or old cases of diabetes mellitus using the definition given by American Diabetes Association.
Abnormal platelet count (<100 and >450×103/μL), Acute febrile illness, Use of drugs affecting platelet function, Male patients with Hb<12.5mg/dl and females with Hb<11.5 mg/dl and Pregnant females.
It was observed that mean MPV(fl) was maximum in Group B (13.35±1.27), followed by Group A (10.77±.77) and Group C (9.09±.85) and a significant (p-value<0.05) relation was found statistically. We also observed that mean HbA1c (%) was maximum in Group B (8.82±1.41), followed by Group A (6.66±.004) and Group C (5.67±.45) and a significant (p-value<0.05) relation was found statistically in these 3 groups. In group B, at baseline MPV(fl) levels were more (13.35±1.26) than at follow up after glycemic control of 3mths (12.13±1.20) and this was found to be statistically significant.
We found that Mean platelet volume in diabetic mellitus type 2 patients was significantly higher than non-diabetic group. We also found that the mean platelet volume in uncontrolled diabetic group (HbA1c more than 7 percent) was significantly higher than controlled diabetic group (HbA1c less than 7 percent). Our study showed that in diabetes mellitus, platelets become more reactive and aggregable and their mean volume (MPV) is increased. We also found that increase in HbA1c concentration was directly proportional to increased MPV.
评估糖化血红蛋白（HbA1c）水平与血小板活性（MPV）之间的关系，确定 MPV、血糖控制与糖尿病血管并发症之间的相关性，并评估改善血糖控制对 2 型糖尿病患者 MPV 的影响。
这是一项基于医院的观察性对比研究，纳入了 100 例糖尿病患者，分为 2 组：A 组（HbA1c＜7）和 B 组（HbA1c＞7），以及 50 名健康对照组（C 组）。纳入标准为年龄大于 18 岁，根据美国糖尿病协会的定义，新诊断或患有糖尿病。排除标准为血小板计数异常（＜100 或＞450×103/μL）、急性发热性疾病、使用影响血小板功能的药物、男性患者 Hb＜12.5mg/dl，女性患者 Hb＜11.5mg/dl 和孕妇。
B 组的平均 MPV（fl）最高（13.35±1.27），其次是 A 组（10.77±.77）和 C 组（9.09±.85），统计学上有显著差异（p 值＜0.05）。我们还观察到 B 组的平均 HbA1c（%）最高（8.82±1.41），其次是 A 组（6.66±.004）和 C 组（5.67±.45），这 3 组的差异具有统计学意义（p 值＜0.05）。在 B 组中，基线时的 MPV（fl）水平（13.35±1.26）高于血糖控制 3 个月后的水平（12.13±1.20），这具有统计学意义。
我们发现 2 型糖尿病患者的平均血小板体积明显高于非糖尿病组。我们还发现，未控制的糖尿病组（HbA1c 大于 7%）的平均血小板体积明显高于控制的糖尿病组（HbA1c 小于 7%）。我们的研究表明，在糖尿病中，血小板变得更活跃和易聚集，其平均体积（MPV）增加。我们还发现，HbA1c 浓度的增加与 MPV 的增加成正比。
