International Journal of Research in Medical Sciences | March 2016 | Vol 4 | Issue 3 Page 757
International Journal of Research in Medical Sciences
Sharma M et al. Int J Res Med Sci. 2016 Mar;4(3):757-761
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Research Article
Study of altered platelet morphology with changes in glycaemic status
Mitakshara Sharma
1
*, Sanjeev Narang
2
, S. K. Nema
2
INTRODUCTION
Diabetes mellitus (DM) is not a single disease entity but a
group of metabolic disorders which share the common
underlying features of hyperglycaemia resulting from
interactions between environmental factors and
polygenetic inheritance. It is characterised by metabolic
abnormalities, chronic hyperglycaemia and long term
macro vascular & micro vascular complications involving
blood vessels, nerves, eyes and kidneys.
1,2
Approximately
382 million people are suffering from diabetes worldwide
and this number is expected to increase to 592 million by
2035. India ranks first in the world in having the largest
number of absolute diabetics i.e. 19 million followed by
China and US.
3
The development of diabetic angiopathies is preceded by
activation platelets which play an important role in its
pathogenesis.
4
Both DM type I and type II have platelet
hyperactivity, dysfunction and altered morphology which
leads to thrombus formation, microvascular embolisation
and release of constrictive, oxidative and mitogenic
ABSTRACT
Background: Diabetes is a pandemic causing very high morbidity and mortality due to its complications which are a
result of micro and macro angiopathy. Platelets play a key role in the vascular complications. These complications are
attributed to platelet activation which can be recognised by an increase in platelet volume indices (PVI) including
mean platelet volume (MPV) and platelet distribution width (PDW). Platelet indices can be potentially useful
surrogate markers for the early diagnosis of thromboembolic and cardiovascular complications in diabetes.
Methods: This is a cross-sectional study conducted for 2 years with total 930 subjects. The patients were segregated
in 03 groups on basis of HbA1C as (a) Diabetic, (b) Non-Diabetic and (c) FG. Samples for HbA1C and platelet
indices were collected using EDTA (ethylene diamine tetracetic acid) as anticoagulant and were processed on
autoanalysers.
Results: The study revealed a stepwise increase in the PVI from non-diabetics to IFG to diabetics. MPV and PDW
were increased in the IFG cases as compared to the non-diabetic and were markedly increased in the diabetic patients.
MPV and PDW of diabetics, IFG and non-diabetics were 17.60±2.04, 11.76±0.73, 9.93±0.64 and 19.17±1.48,
15.49±0.67, 10.59±0.67 respectively with a significant p value 0.00. Significant positive correlation between PVI with
glycaemic levels and duration of diabetes across the groups (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875).
However, the total platelet count was found to decrease with the increasing glycaemic levels with a p value <0.001. A
significant negative correlation was found between glycaemic levels and total platelet count (PC- HbA1c r = -0.164).
Conclusions: This study showed that platelet morphology is altered with increasing glycaemic levels. These changes
can be known by measurements of PVI which is an important simple and effortless tool can be used more extensively
to predict the acute vascular events and thereby help curb morbidity and mortality.
Keywords: MPV, PDW, PVI, IFG, HbA1C, Diabetes
1
Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2
Department of Pathology, Index Medical College & Research Centre, Indore, MP, India
Received: 07 January 2016
Revised: 13 January 2016
Accepted: 03 February 2016
*Correspondence:
Dr. Mitakshara Sharma,
E-mail: mitakshara.sharma@yahoo.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20160513