Regassa Dereje Abebe, Berihun Gebeyaw Arega, Habtu Bisrat Fikadu, Haile Woyesa Beyene, Nagaash Rahel Shumi, Kiya Girum Tesfaye
Department of Medical Laboratory Sciences, Wolkite University, Wolkite 11330, Ethiopia.
School of Medical Laboratory Sciences, Jimma University, Jimma 47, Ethiopia.
World J Diabetes. 2024 Sep 15;15(9):1889-1902. doi: 10.4239/wjd.v15.i9.1889.
Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality. It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices. However, the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context, and evidence for their role as predictors of poor glycemic status in diabetic patients is limited.
To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia, from June 15 to August 12, 2022.
A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus (T2DM) and 87 non-diabetic controls. The systematic random sampling technique was used to select par-ticipants. Data were collected using structured questionnaires, physical measurements, checklists, and laboratory tests. Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers, respectively. The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear. Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. The test, Mann-Whitney test, Kruskal-Wallis test, test, Spearman correlation, and receiver operating characteristic curve were used for analysis. A value < 0.05 was considered statistically significant.
The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (PLCR), and plateletcrit (PCT) compared to healthy individuals ( < 0.001). Furthermore, these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls. We also observed significant correlations between these indices and various anthropometric and clinical variables. Our findings suggest that PDW, with a cut-off value of 15.75 fL and an area under the curve (AUC) of 0.803, MPV, with a cut-off value of 12.25 fL and an AUC of 0.774, PLCR, with a cut-off value of 36.3% and an AUC of 0.775, and PCT, with a cut-off value of 0.24% and an AUC of 0.761, can serve as predictors of poor glycemic control in patients with diabetes mellitus.
The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes. Therefore, regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.
糖尿病是一种慢性代谢综合征,已成为一个具有重大发病率和死亡率的全球公共卫生问题。它是一种促炎和促血栓形成的病症,其特征是血小板活化增加和血小板指标改变。然而,在这种情况下,使用血小板指标作为血糖调节不佳的预测指标尚未得到充分评估,并且它们作为糖尿病患者血糖状态不佳预测指标的证据有限。
评估血小板指标,并确定其在2022年6月15日至8月12日于埃塞俄比亚比绍夫图综合医院被诊断为2型糖尿病的个体中与血糖调节不足相关的预后意义。
对261名参与者进行了一项比较横断面研究,其中包括174名2型糖尿病(T2DM)患者和87名非糖尿病对照者。采用系统随机抽样技术选择参与者。使用结构化问卷、体格测量、检查表和实验室检查收集数据。分别使用Sysmex-XN550和CobasC311分析仪从血样中测定血小板参数和空腹血糖水平。检查血液分析仪输出结果,并使用制备的血涂片对参与者进行疟原虫筛查。收集的数据录入Epi-data 3.1版本并导出到SPSS 25版本进行分析。使用t检验、曼-惠特尼U检验、克鲁斯卡尔-沃利斯检验、卡方检验、斯皮尔曼相关性分析和受试者工作特征曲线进行分析。P值<0.05被认为具有统计学意义。
我们的研究结果表明,与健康个体相比,糖尿病患者的血小板分布宽度(PDW)、平均血小板体积(MPV)、血小板大细胞比率(PLCR)和血小板压积(PCT)水平显著更高(P<0.001)。此外,与血糖控制良好的个体和健康对照相比,这些指标在T2DM中血糖控制不佳的个体中显著升高。我们还观察到这些指标与各种人体测量和临床变量之间存在显著相关性。我们的研究结果表明,PDW的截断值为15.75 fL,曲线下面积(AUC)为o.803;MPV的截断值为12.25 fL,AUC为0.774;PLCR的截断值为36.3%,AUC为0.775;PCT的截断值为0.24%,AUC为0.761,可作为糖尿病患者血糖控制不佳的预测指标。
观察到糖尿病患者与血小板指标显著增加之间的相关性,突出了它们作为糖尿病患者血糖控制不佳预测指标的潜力。因此,建议将血小板指标的定期筛查和分析作为糖尿病患者随访过程的一部分。