2型糖尿病患者平均血小板体积的临床分析

糖尿病及其并发症已经给人类健康和社会发展带来了严重的负担,其中合并血管病变是使糖尿病患者致残、致死的重原因之一。而平均血小板体积（MPV）代表循环池中单个血小板平均体积,血小板体积越大,其活性越强,导致动脉粥样硬化和血栓形成可能性越高,故常用来作为评估血小板功能和活性。本文通过观察2型糖尿病患者的平均血小板体积,以探讨其在2型糖尿病中的临床意义。     

2型糖尿病伴冠心病患者平均血小板体积的影响因素研究

目的:研究血糖和血脂等对合并2型糖尿病(DM)冠心病患者平均血小板体积(MPV)的影响。方法:冠状动脉造影等确诊的无糖代谢异常冠心病患者(非DM组)115例,合并DM的冠心病患者(DM组)183例,测定外周血MPV等血小板参数和其他常规实验室指标,分析合并DM冠心病患者MPV的变化及血糖和血脂等对MPV的影响。结果:MPV于DM组显著高于非DM组[(10.30±0.88)vs.(10.04±1.03)fL,P<0.05];DM组患者各亚组间比较,肥胖亚组显著高于非肥胖亚组[(10.51±0.77)vs.(10.21±0.91)fL,P<0.05],既往DM亚组显著高于新诊断DM亚组[(10.41±0.88)vs.(10.14±0.85)fL,P<0.05],HbA1c高值(HbA1c≥7%)亚组显著高于HbA1c低值(HbA1c<7%)亚组[(10.47±0.76)vs.(10.16±0.94)fL,P<0.05];MPV分别与体质量指数(BMI)(r=0.149,P=0.044)、空腹血糖(FBG)(r=0.191,P=0.009)、HbA1c(r=0.189,P=0.01)、hs-CRP(r=0.146,P=0.048)和白细胞计数(WBC)(r=0.169,P=0.022)显著正相关,与HDL-C显著负相关(r=-0.143,P=0.053);多元回归分析显示,对MPV有独立影响的因素是HDL-C、HbA1c、hs-CRP和FBG(均P<0.05)。结论:DM冠心病患者MPV进一步升高,MPV的升高与HDL-C、HbA1c、hs-CRP和FBG有密切关系。     

2型糖尿病患者平均血小板体积与血管病变的关系

目的 探讨2型糖尿病患者平均血小板体积(MPV)的变化及其与糖尿病血管病变的关系。方法 选取2型糖尿病患者255例(其中视网膜病变55例，冠心病68例)和健康人183例，测定血小板数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)。结果 2型糖尿病组PLT较正常对照组显著降低，但两组PLT都在正常范围内。糖尿病组MPV和PDW明显高于对照组，但MPV在糖尿病视网膜病变组与糖尿病非视网膜病变组无显著性差异，在糖尿病冠心病组与糖尿病非冠心病组亦无显著差异。多因素Logistic回归分析未发现在统计学上有意义的影响因子。结论 2型糖尿病患者MPV较对照组明显升高表明血小板参与了糖尿病的血管病变。     

平均血小板体积与冠心病的相关性

目的通过分析不同类型冠心病患者的平均血小板体积水平,研究平均血小板体积和冠心病的相关性。方法 237例接受冠脉造影的患者分为3组:急性冠脉综合征、稳定型心绞痛和非冠心病组。冠心病的诊断标准为至少1根血管狭窄50%,所有的冠脉造影图像是由两个医生(双盲情况下)完成。对所有入选患者测量其平均血小板体积。结果与非冠心病组相比,急性冠脉综合征组平均血小板体积显著增高(P0.05);平均血小板体积在稳定型心绞痛组与急性冠脉综合征及非冠心病组患者之间无显著差异(P0.05)。结论平均血小板体积与冠心病存在显著相关性,但与冠心病的程度无显著相关性。     

2型糖尿病患者血小板聚集、粘附、ATP释放及血小板平均体积变化的研究

目的　评价 2型糖尿病患者血小板功能变化。方法　用血小板功能分析仪测定血小板聚集、ATP释放 ,用胶原珠法测定血小板粘附。结果　糖尿病患者血小板聚集率、ATP释放均较健康人增高 (P<0 .0 5) ;糖尿病患者血小板体积明显增大 ,与健康人比较有明显差异 (P<0 .0 0 5) ;血小板粘附率两者之间无明显差异。结论　糖尿病患者血小板功能亢进表现为血小板聚集、ATP释放反应增强 ,平均体积变大 ,但没有见到血小板粘附功能的亢进。这些指标可作为糖尿病患者并发血栓性疾病的检测指标。     

2型糖尿病伴急性脑梗死患者平均血小板体积的变化及意义

选取50例2型糖尿病伴急性脑梗死患者作为A组,50例2型糖尿病非急性脑梗死患者作为B组,50例无糖尿病的急性脑梗死患者作为C组;对三组的MPV等指标进行测定,并分析其变化和影响因素。结果 A组和C组患者的PLT水平均明显低于B组,MPV、PDW、FIB水平明显上升高于B组,组间比较P<0.05,差异显著;PT、APTT等指标间比较无明显差异(P>0.05)。A组和C组的舒张压和收缩压显著高于B组,P<0.05,差异明显;A组患者的餐后2h血糖、空腹血糖、糖化血蛋白水平均高于B组和C组,C组患者血糖各项指标趋于正常,B组餐后2h血糖、空腹血糖、糖化血蛋白水平高于C组,P<0.05,统计学差异显著;A组总胆固醇、三酰甘油、低密度脂蛋白显著升高,高于B组和C组,C组高于B组,且A组高密度脂蛋白低于B组和C组,C组低于B组,P<0.05,统计学差异显著。多因素回归性分析显示:血糖、血压的急骤波动、MPV、FIB、总胆固醇、三酰甘油、低密度脂蛋白水平升高、高密度脂蛋白水平降低是急性脑梗塞的危险因素(OR=2.571、1.726、1.953、2.417、1.863、2.868、1.397、0.462),P均<0.05,统计学差异显著。结论 2型糖尿病伴急性脑梗死患者MPV明显升高,MPV对急性脑梗死预防和治疗的一定指导意义。     

平均血小板体积/血小板计数比值与冠心病的相关性

目的 分析平均血小板体积/血小板计数比值(MPV/PLT)与冠心病的相关性.方法 回顾性分析长春中医药大学附属医院住院部冠心病患者311例为观察组,其中包括稳定型心绞痛(SAP)组、不稳定型心绞痛(UAP)组和急性心肌梗死(AMI)组,并抽取同期健康体检者为对照组,测定观察组和对照组PLT、MPV,并计算MPV/PLT...     

平均血小板体积与冠心病的关系

血小板形态和功能的变化是心脑血管疾病发病机制中的重要独立危险因子之一。血小板在冠心病(CHD)的发生、发展过程中具有重要作用,但目前尚无明确反映血小板功能的指标,近年多项研究发现血小板参数中的平均血小板体积（MPV）是反映血小板活化的一个重要指标。检测MPV是评估血小板功能一种简单、快捷的方法,对预测CHD临床事件的发生具有一定的临床意义。     

2型糖尿病患者平均血小板容积与非瓣膜病心房颤动关系的研究

目的:探讨2型糖尿病(T2DM)患者平均血小板容积(MPV)与非瓣膜病心房颤动(AF)的关系及其临床意义。方法：连续选择2013年4月至2015年4月在武汉大学人民医院心内科住院诊断为T2DM患者222例,根据其是否合并心房颤动分为房颤组及对照组,并进一步根据房颤的类型将房颤患者分为阵发性房颤组及持续性/永久性房颤组。统计各组患者的一般临床资料,入院24小时内实验室检查结果以及超声心动图检查,并对结果进行统计学分析。结果： 年龄、高血压病史、冠心病病史、红细胞分布宽度、平均血小板容积、肌酐、天冬氨酸转氨酶、左心房内径、左室射血分数在房颤组和对照组间比较,差异具有统计学意义（P<0.05）。多变量Logistic回归分析显示,高血压史、高龄及平均血小板容积增高为2型糖尿病患者发生心房颤动的独立危险因素(P<0.05)。阵发性房颤组、持续性/永久性房颤组及对照组MPV分别为11.6±1.0、11.8±1.1、11.1±1.0fL。MPV在阵发性房颤组与对照组间,以及在持续性/永久性房颤组与对照组间比较差异均具有统计学意义（均P=0.004）。而MPV在阵发性房颤组及持续性/永久性房颤组间比较,未见统计学差异（P=0.570）。MPV预测T2DM患者发生心房颤动的ROC曲线下面积为0.644（P<0.01,95%CI 0.569～0.719）。结论：2型糖尿病患者平均血小板容积与心房颤动的发生间具有相关关系。     

糖尿病视网膜病与血小板体积关系

测定100例Ⅱ型糖尿病患者平均血小板体积(MPV),血小板压积(PGT),血小板分布宽度(PDW),血小板计数(PLT),并与50例健康人比较,发现Ⅱ型糖尿病平均MPL、PLT、PDW高于对照组(P＜0.05),说明Ⅱ型糖尿病存在血小板功能异常.比较有视网膜病变与无视网膜病变且与对照组之间关系,示均有显著性差异(P＜0.05),而以有视网膜病变组差异更为显著(P＜0.01),说明血小板功能异常在视网膜病变的发生发展中起重要作用.     

The relationship between mean platelet volume and albuminuria in patients with type 2 diabetes mellitus

Background&aimMean platelet volume (MPV) is suggested as a marker of platelet reactivity and tendency for thrombosis and microvascular complications like albuminuria in patients with type 2 DM. We aimed to measure the MPV in patients with type 2 DM and its correlation with albuminuria, body mass index (BMI), duration of DM, hypertension (HTN), stroke, ischemic heart disease (IHD), and HbA1c level.MethodsA cross sectional study included 100 patients with type 2 DM ≥ 18 y of both genders who were randomly selected from the medical units of Baghdad Teaching Hospital. After taking verbal consents; MPV was measured&correlated with aimed variables. Diabetics with HbA1c ≤ 7% were considered as having adequate control while those with (HbA1c) > 7% as having poor control. Albumin creatinine ratio (ACR) in urine was measured and classified into normal, moderately and severely increased. Odds ratios with 95% CI were calculated and P ≤ 0.05 was considered as statistically significant.ResultsThe mean MPV was 7.7 fl ± 1.2. Regarding ACR, 42% had normal level, 37% with moderately increased and 21% had severely increased level. Regarding HbA1c, 68% were having poorly controlled DM. Mean platelets’ count and MPV were higher in the uncontrolled group with a statistically significant association. There was a statistically significant positive correlation between MPV and albuminuria, duration of DM, HTN, IHD, Stroke, BMI, HbA1c, and platelets count.ConclusionsThe mean MPV was statistically significantly higher in the uncontrolled DM group and there was a statistically significant positive correlation between MPV and albuminuria.     

Coronary heart disease is associated with mean platelet volume in type 2 diabetic patients

Background: Mean platelet volume (MPV) is an indicator of platelet activation which is a central process in the pathophysiology of coronary heart disease (CHD). The aim of the study was twofold; first to determine whether MPV values is increased in patients with DM, and secondly to evaluate the relation between diabetic complications and MPV. Methods: The study population included 258 patients divided into two groups. Group A composed of 158 type 2 diabetic patients with coexistent coronary artery disease (stenotic lesions of 50%) (78 women, 80 men; mean age 53.9_10.8; mean diabetes duration 13.1_6.0). One hundred subjects (48 women, 52 men; mean age 53.9_11) without type 2 diabetes with normal coronary angiographies were taken as the control group (group B). To evaluate the extension of CHD, Gensini scoring system was used. Results: The MPV was significantly different in the patient group compared to the controls (9.79 ± 1.5 fl vs 8.3 ± 0.9 fl, P<0.001). The existence of CHD was associated with MPV with odds ratio (95% CI) of 2.31 (1.55–4.42, p50.001). Conclusion: We have found that diabetic patients with coronary heart disease have significantly higher MPV values compared to control subjects without diabetes and with angiographically normal coronary arteries.     

The relationship between mean platelet volume and metabolic syndrome in patients with type 2 diabetes mellitus: A retrospective study

This study aimed to investigate the association between mean platelet volume (MPV) and metabolic syndrome (MetS) in patients with type 2 diabetes mellitus (T2DM). Data for 1240 patients with T2DM admitted to the Department of Endocrinology at the First Affiliated Hospital of Guangxi Medical University between January 1, 2017 and June 1, 2020 were collected retrospectively via electronic medical records, including demographic information, complete blood count, lipid profile, and glucose metabolism indexes. MetS was defined according to the Chinese Diabetes Society. Among the 1240 patients enrolled, 873 (70.40%) had MetS. MPV was significantly higher in patients with MetS (P < .001). For individual MetS components, MPV was significantly higher in the presence of abdominal obesity (P = .013) and hypertriglyceridemia (P = .026), but did not differ in the presence of elevated blood pressure (P = .330) or low high-density lipoprotein cholesterol (P = .790). Moreover, MPV was independently associated with MetS after adjustment for sex, smoking, alcohol drinking, white blood cell count, fasting C-peptide, and body mass index (odds ratio 1.174, 95% confidence interval 1.059–1.302). The odds ratio for MetS in the highest tertile, compared with the lowest MPV tertile, was 1.724 (95% confidence interval 1.199–2.479, P for trend = .003) after multiple adjustment. In stratified analyses, the positive correlation of MPV with MetS was significant only in patients who were older, male, or overweight, or who had poor glycemic control. In conclusion, high MPV was positively associated with the presence of MetS in patients with T2DM, particularly older, male, or overweight patients, or those with poor glycemic control.     

Impact of metabolic syndrome on mean platelet volume and its relationship with coronary artery disease

Platelets represent one of the main actors involved in pathogenesis of coronary artery disease (CAD). Mean platelet volume (MPV) has been proposed as marker of platelet reactivity and thrombotic risk. However, still debated is whether higher MPV constitutes an independent determinant of CAD or just the consequence of an association with several cardiovascular risk factors. Therefore, the aim of the present study was to assess the impact of metabolic syndrome (MetS), on MPV and its relationship with angiographically defined CAD.

Consecutive patients undergoing coronary angiography were included. Admission samples were collected for MPV and chemistry assessment. MetS was defined according to IDF-criteria. Significant CAD was defined as at least 1 vessel stenosis > 50%, while severe CAD as left main and/or 3-vessel disease, as evaluated by quantitative coronary angiography.

We included 4730 patients, among them 2167 (45.8%) had MetS. Patients with MetS were older (p < 0.001), more often females (p < 0.001), and displayed higher BMI, higher prevalence of hypercholesterolemia, renal failure, hypertension, diabetes mellitus, history of myocardial infarction (MI), previous PCI (p < 0.001, respectively), previous CABG (p = 0.002),treatment with ACE inhibitors, ARB, beta-blockers, nitrates, statins, ASA, calcium channel blockers, diuretics (p < 0.001, respectively), higher values of glycemia, HbA1c, fibrinogen (p < 0.001, respectively), creatinine (p = 0.01), uric acid (p = 0.02), and lower values of hemoglobin (p = 0.001),total-cholesterol, LDL-cholesterol, and HDL-cholesterol (p < 0.001, respectively). MetS patients showed a higher prevalence of CAD (p = 0.002) and severe CAD (p = 0.01).

MPV values were slightly higher in patients with MetS (10.91 ± 1.01 vs. 10.84 ± 1.03 fL, p = 0.02), although MetS did not emerge as an independent predictor of higher MPV values (above 4^th quartile; adjusted OR OR[95%CI] = 1.01[0.84–1.22], p = 0.93).

When metabolic syndrome patients were analyzed according to MPV quartiles, higher MPV values did not result as an independent predictor of CAD (adjusted OR[95%CI] = 0.79[0.61–1.03], p = 0.08) and severe CAD (adjusted OR[95%CI] = 0.82 [0.65–1.03], p = 0.084). Results did not change when applying the new harmonized definition of MetS.

This study shows that among patients undergoing coronary angiography MetS is not an independent predictor of higher MPV. Moreover, among MetS patients, larger-sized platelets are not associated to the prevalence and extent of CAD.     

The mean platelet volume in gestational diabetes

Objective: To compare the platelet count and mean platelet volume (MPV) values of pregnancies diagnosed with gestational diabetes with those of healthy pregnancies. Material—method: Between June 2003 and September 2004, 100 healthy pregnancies and 100 pregnancies with gestational diabetes were studied at Gazi University, Department of Obstetrics and Gynecology. Results: While no statistically significant difference was observed in the platelet count between the two groups, the MPV of the gestational diabetes group (9.4 ± 1.6 fl) was evaluated to be significantly higher than the MPV of the healthy pregnancy group (8.3 ± 1.1 fl). Additionally, when linear regression analysis was performed an inverse relationship was observed between platelet number and MPV. Conclusion: There is a need for further research focusing on the platelet function in the observation and treatment of gestational diabetes, which can pose the risk of developing Type 2 diabetes for the mother and has negative consequences for the fetus.     

The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus

Microalbuminuria is the best predictor of diabetic nephropathy development in patients with type II diabetes mellitus (DM). It is also accepted as an indicator of diabetic microangiopathy. Increased activation of platelets has been suggested to be involved in the pathogenesis of vascular complications. In light of these findings, this study was designed to investigate the association of microalbuminuria — an indicator glycemic control and microangiopathy — with mean platelet volume (MPV). Subjects underwent laboratory analyses and their MPV, HbA1c, serum creatinine, fasting, and postprandial blood glucose levels and 24-hour urine albumin levels were recorded. All statistical analyses were performed using SPSS v13.0 for Windows XP. Mann–Whitney U-test, student's t-test, spearman correlation analysis, ROC analysis, categorical regression analysis, and chi-square test were used for statistical evaluations. The study included 354 patients with type II DM. The median MPV value of microalbuminuria-positive patients was 9 (8–9.5)?fl while MPV of patients without microalbuminuria was 8.5 (8–9.2)?fl and the difference was statistically significant (p?=?0.004). We determined positive correlation between MPV and 24-hour urine microalbuminuria (r?=?0.14, p?=?0.009). There were no significant differences between patients with HbA1c levels below and above 7% in terms of MPV (p?>?0.05). We determined no correlation between MPV and HbA1c levels (r?=??0.36, p?=?0.64). This study determined a significant positive relationship between microalbuminuria — a microvascular complication of diabetes — and MPV. No significant correlation was identified between poor glycemic control and MPV in diabetic patients. However, we are in the opinion that the association between poor glycemic control and MPV in type II diabetic patients should be investigated in prospective studies with larger samples.     

Atrial fibrillation is associated with increased mean platelet volume in patients with type 2 diabetes mellitus

Platelet abnormalities in diabetes mellitus (DM) and atrial fibrillation (AF) may underline the etiology of a prothrombotic state in these conditions. Increased mean platelet volume (MPV) is a marker of abnormal platelet function and activation. We aimed to investigate the possible association of chronic AF with MPV in patients who have type 2 DM. Patients who had type 2 DM with either chronic (≥6 months) AF or normal sinus rhythm (NSR) were included in the study. A total of 162 patients (aged 38–89 years) were divided into 2 groups according to the presence of either AF or NSR. Group 1 consisted of 81 diabetic patients with AF, and group 2 consisted of 81 diabetic patients with NSR. The two groups were not significantly different in terms of age, and gender, as well as in hypertension, smoking, history of coronary artery disease, previous cerebrovascular accidents, microalbuminuria, retinopathy, duration of DM, body mass index, hemoglobin A_1c, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride (p?>?0.05 for all variables). Although no significant difference was present between groups concerning platelet count; for patients with AF, MPV was higher compared with patients with NSR (9.0?±?0.2?fl vs. 8.4?±?0.2?fl; p?=?0.001). Furthermore, no significant difference was noted between groups regarding routine medications received by patients. In multivariate logistic regression analysis, MPV was the only variable independently related to AF (OR?=?2.659; 95% CI, 1.286–5.498; p?=?0.008). Consequently, it is concluded that AF is associated with increased MPV in patients with type 2 DM, suggesting the presence of tentatively related processes leading to reciprocal interaction.     

Thrombopoietin and mean platelet volume in coronary artery disease

BACKGROUND: Large platelets are shown to be hemostatically more active. It has been suggested that mean platelet volume (MPV) is increased during acute myocardial infarction (AMI) and unstable angina pectoris (USAP). However, the underlying mechanism of the phenomenon remains unclear. HYPOTHESIS: In this study, platelets, MPV, and thrombopoietin (TP) levels were investigated in patients with coronary artery disease (CAD) and healthy controls. METHODS: Twenty patients with AMI and 20 patients with USAP were included in this study. Seventeen healthy adult subjects served as controls. Venous blood samples of the subjects were drawn within 12 h after admission. Thrombopoietin levels were measured by ELISA and platelet counts and MPV were assayed by autoanalyzer. RESULTS: Patients with AMI and USAP had higher platelet counts than those in the control group. Although the platelet counts were slightly higher in AMI than in USAP, this did not reach statistical significance. Mean platelet volume and levels of TP were found to be elevated in patients with AMI and USAP compared with control subjects (p < 0.001). Thrombopoietin levels were higher in AMI than USAP, but this was not statistically significant. There was a positive correlation between TP levels and MPV values (p < 0.05). CONCLUSION: Increased TP levels may increase both platelet counts and platelet size, resulting in hemostatically more active platelets, which may contribute to the development and progression of CAD.     

2型糖尿病患者的脂代谢紊乱及其与冠心病的关系

目的：探讨2型糖尿病患脂代谢紊乱与并发冠心病（CHD）的关系。方法：56例2型糖尿病（DM）患（其中32例并发冠心病），测定其血脂、载脂蛋白浓度及血糖、胰岛素水平，与30例例健康人比较。结果：与对照组比较，2型DM并发CHD患高密度脂蛋白胆固醇（HDL－C）水平降低（P＜0．005），低密度脂蛋白胆固醇（LDL－C）及载脂蛋白B（ApoB)水平升高（P＜0．05）。单纯2型DM组仅有HDL－C水平的降低（P＜0．005）及LDL－C水平的升高（P＜0．05），无ApoB的变化，单纯DM及DM＋CHD组血糖及胰岛素水平无显差别，但均较对照组升高非常显（P＜0．005）；DM＋CHD组的ApoB水平较单纯DM组的显升高（P＜0．05）。结论：本组结果提示HDL－C水平的降低，LDL－C及ApoB水平的升高是2型DM并发冠心病的重要危险因素。