Onișor Danusia, Roiban Andrada Larisa, Cernea Simona
Department ME2, Internal Medicine VII, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureş, 540142 Târgu Mureş, Romania.
Gastroenterology Clinic, Mureș County Clinical Hospital, 540103 Târgu Mureş, Romania.
Medicina (Kaunas). 2024 Dec 21;60(12):2091. doi: 10.3390/medicina60122091.
: Metabolic dysfunction-associated steatotic liver disease (MASLD) is an important chronic liver disease with major health risks, especially in the presence of T2DM, but the pathophysiology of this condition is not fully understood. This study aimed to investigate the platelet hematometric indices in patients with T2DM and MASLD. : Demographic and medical (including anthropometric) data were collected from 271 participants, from whom blood samples were also drawn in fasting conditions for complete blood count, liver and metabolic panel, ferritin, haptoglobin, creatinine, and fibrosis markers. The correlations of main platelet parameters with clinical and laboratory data were investigated by bivariate and multiple regression analyses. : The median platelets number was 235·10/μL, and thus, the study population was divided into two subgroups: with higher and lower numbers (group 1 (mean): 286.38 ± 43.29·10/μL and group 2 (mean): 188.12 ± 39.77·10/μL). Despite similar BMIs, group 2 had higher fatty liver index (FLI) (84.44 ± 18.04 vs. 79.85 ± 17.98; = 0.0088) and insulin resistance (HOMA-IR: 3.16 ± 1.50 vs. 2.63 ± 1.31; 0.0008), higher direct bilirubin, transaminases, uric acid, and ferritin concentrations. Higher percentages of males and subjects with HOMA-IR values >2.5 were accounted for in this group. In the multiple regression analyses, the platelet count and plateletcrit (PTC) correlated independently with sex, leucocyte count, HOMA-IR, and bilirubin concentrations ( < 0.0001). The platelet distribution width (PDW) was positively correlated with insulin resistance in two separate analyses (β = 0.060; = 0.0004, and β = 0.052; = 0.0025), and with GGT, while the mean platelet volume presented a weak but significant positive association with FLI. Patients with higher HOMA-IR had higher PDW and a lower platelet count and PTC. : Male patients with T2DM and MASLD had lower platelet count and PTC and larger PDW. Higher insulin resistance was associated with lower platelet count and PTC and higher PDW.
代谢功能障碍相关脂肪性肝病(MASLD)是一种重要的慢性肝病,存在重大健康风险,尤其是在2型糖尿病(T2DM)患者中,但这种疾病的病理生理学尚未完全明确。本研究旨在调查T2DM和MASLD患者的血小板血液学指标。:收集了271名参与者的人口统计学和医学(包括人体测量学)数据,还在空腹状态下采集了他们的血样,用于全血细胞计数、肝脏和代谢指标检测、铁蛋白、触珠蛋白、肌酐及纤维化标志物检测。通过双变量和多元回归分析研究主要血小板参数与临床及实验室数据之间的相关性。:血小板中位数为235×10⁹/μL,因此,研究人群被分为两个亚组:血小板数量较高和较低的亚组(第1组(均值):286.38±43.29×10⁹/μL,第2组(均值):188.12±39.77×10⁹/μL)。尽管两组体重指数相似,但第2组的脂肪肝指数(FLI)更高(84.44±18.04对79.85±17.98;P = 0.0088)、胰岛素抵抗更严重(稳态模型评估胰岛素抵抗指数(HOMA-IR):3.16±1.50对2.63±1.31;P = 0.0008),直接胆红素、转氨酶、尿酸和铁蛋白浓度更高。该组男性及HOMA-IR值>2.5的受试者所占百分比更高。在多元回归分析中,血小板计数和血小板压积(PTC)与性别、白细胞计数、HOMA-IR及胆红素浓度独立相关(P<0.0001)。在两项独立分析中,血小板分布宽度(PDW)与胰岛素抵抗呈正相关(β = 0.060;P = 0.0004,β = 0.052;P = 0.0025),并与γ-谷氨酰转移酶(GGT)相关,而平均血小板体积与FLI呈微弱但显著的正相关。HOMA-IR较高的患者PDW较高,血小板计数和PTC较低。:患有T2DM和MASLD的男性患者血小板计数和PTC较低,PDW较大。较高的胰岛素抵抗与较低的血小板计数和PTC以及较高的PDW相关。