The mean platelet volume in subjects with impaired fasting glucose

Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk factor for atherothrombosis. Impaired fasting glucose (IFG) is probably a frequent glycemic disorder in the general population and is considered as a prediabetic state. The present study was designed to evaluate MPV in subjects with IFG compared with diabetic patients and normoglycemic control subjects. We selected 50 patients with type 2 diabetes mellitus, 50 subjects with IFG, and 50 normoglycemic healthy subjects matched for age, gender, and body mass index. MPV was very significantly higher in diabetic and IFG groups than in control group (p?<?0.00, p?<?0.05, respectively); it was also higher in diabetic group than in IFG group (p?<?0.05). Platelet counts were not different among the study groups (p?>?0.05). Platelet mass was significantly higher in diabetic and IFG groups than in normotensives (p?<?0.00, p?<?0.05, respectively); and it was also higher in diabetic group than in IFG group (p?<?0.05). MPV and platelet mass were positively correlated with fasting glucose and HbA1c in diabetic and IFG groups (p?<?0.05). In conclusion, our data suggests one possible mechanism by which subjects with IFG may be at increased cardiovascular risk.     

糖化血红蛋白与糖调节受损血糖水平相关性的研究

目的 探讨研究糖化血红蛋白(HbAlc)与糖调节受损血糖水平的相关性.方法 2009年2-3月在兰州大学附属白银医院在岗职工中开展口服75 g葡萄糖耐量试验(OGTT)和HbAlc普查,测定空腹血糖、服糖后2 h血糖及HbAlc,采用葡萄糖氧化酶法测定静脉血浆血糖,采用高效液相色谱分析法测定HbAlc.研究资料纳入标准:空腹血糖<7.0 mmol/L且服糖后2 h血糖<11.1mmol/L者,无糖尿病、血红蛋白病、肝、肾疾患等.进入结果分析的对象共726例,男197例,女529例,平均年龄(39±10)岁.其中正常糖耐量636例(87.6%),糖调节受损90例(12.4%),糖调节受损诊断采用1999年世界卫生组织糖尿病诊断标准.率间比较采用χ~2检验,双变量分析采用Pearson相关分析.结果 (1)糖调节受损占HbAlc≤5.7%人群的2.3%,占HbAlc≥5.8%的人群中89.3%.HbAlc≥5.8%时预测OGTT诊断的糖调节受损状态的敏感度、特异度、阳性预测值、阴性预测值分别为83%、99%、0.89和0.98;(2)OGTT诊断的空腹血糖受损、糖耐量减低及糖调节受损状态的患病率,在HbAlc为5.8%组与5.7%组比较差异具有统计学意义(χ~2值分别为10.077、22.219和27.780,P<0.01或P<0.001);(3)HbAlc水平与空腹血糖受损、糖耐量减低、糖调节受损的患病率之间呈显著性正相关(r值分别为0.957、0.928和0.936,均P<0.01).结论 (1)HbAlc预测糖调节受损与OGTT具有一致性,与OGTT诊断的糖调节受损状态相关的HbAlc最佳临界值为5.8%;(2)HbAlc与OGTT诊断空腹血糖受损、糖耐量减低、糖调节受损状态的血糖水平呈显著性正相关,且HbAlc为5.8%与其相关性极其密切.建议当HbAlc≥5.8%时均应行OGTY检查,以明确有无糖调节受损.     

The association of mean platelet volume levels with hypertensive retinopathy

The pathophysiological mechanism of hypertensive retinopathy (HR) is not fully established. Elevated blood pressure alone does not fully account for the extent of retinopathy so other pathogenic mechanisms may be involved, such as increased platelet activation. Mean platelet volume (MPV) is a marker of platelet activation. Therefore, this study was designed to answer the following questions: Do MPV levels change in HR? and is there any relation between degree of HR and MPV levels? This study included newly diagnosed and 57 untreated essential hypertensive patients with HR. The hypertensive patients were divided into two groups according to the Keith, Wagener classification. Group 1 comprised 29 hypertensive patients with grade 1 HR with a mean age of 56.8 ± 9.7 years. Group 2 comprised 28 hypertensive patients with grade 2 HR with a mean age of 58.1 ± 10.3 years. Twenty-seven normotensive subjects who were the healthy participants and had undergone the check-up program were used as the control group. Fundoscopic examination, metabolic parameters and MPV levels were measured in all groups. The level of MPV in group 2 was significantly higher than in group 1 (8.9 ± 0.8 fl vs.8.3 ± 0.8 fl, p = 0.02) and the normotensive control group (8.9 ± 0.8 fl vs 7.8 ± 0.7 fl, p < 0.001). It was also higher in group 1 than in normotensive control group (8.3 ± 0.8 fl vs.7.8 ± 0.7 fl, p < 0.01). In addition, MPV showed a positive correlation with the degree of HR in the hypertensive group (r = 0.41, p = 0.015). Our study suggests that platelet activation, a mechanism known to be involved in vascular lesions, may promote the development of HR.     

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.     

平均血小板体积与心血管疾病的关系

<正>血小板与多种心血管疾病的发病有关,平均血小板体积(mean platelet volume,MPV)是反映血小板活化及功能的重要标记。MPV与冠心病、脑卒中、糖尿病、高血压、代谢综合征、肥胖以及心力衰竭、心脏瓣膜病、周围血管疾病等多种心血管疾病或危险因素密切相关,并且对急性冠状动脉综合征(acute coronary syndrome,ACS)及经皮冠状动脉介入术(percutaneous coronary intervention,PCI)的预后有预测价值。     

Effects of glucose and meal ingestion on incretin secretion in Japanese subjects with normal glucose tolerance

Aims/Introduction: Gastric inhibitory polypeptide (GIP) and glucagon‐like peptide‐1 (GLP‐1) are the major incretins; their secretion after various nutrient loads are well‐evaluated in Caucasians. However, little is known of the relationship between incretin secretion and differing nutritional loading in Japanese subjects. In the present study, we evaluated GIP and GLP‐1 secretion in Japanese subjects with normal glucose tolerance (NGT) after glucose loading (75 g glucose and 17 g glucose) and meal ingestion. Materials and Methods: A total of 10 Japanese NGT subjects participated in 75 g oral glucose tolerance test (OGTT), 17 g OGTT and meal tolerance test (MTT). Plasma glucose (PG), serum insulin (IRI), serum C‐peptide (CPR), plasma total GIP, and plasma total GLP‐1 levels during OGTT and MTT were determined. Results: Area under the curve (AUC)‐GIP was increased in proportion to the amount of glucose, and was highest in MTT, showing that GIP secretion is also stimulated by nutrients other than glucose, such as lipid. In contrast, although the larger glucose load tended to induce a larger GLP‐1 release, AUC‐GLP‐1 was not significantly different among the three loading tests (75 g OGTT, 17 g OGTT, MTT) irrespective of the kind or amount of nutrition load. Conclusions: Our results suggest that nutritional composition might have a greater effect on GIP secretion than that on GLP‐1 secretion in Japanese NGT subjects . (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00143.x, 2012)     

Association between mean platelet volume and autonomic nervous system functions: Increased mean platelet volume reflects sympathetic overactivity

BACKGROUND:

Increased mean platelet volume (MPV) may reflect increased platelet activation or increased numbers of large, hyperaggregable platelets, and is accepted as an independent coronary risk factor. The adrenergic system has effects on platelet activation and thrombocytopoiesis.

OBJECTIVE:

To assess the effects of autonomic nervous system activity on MPV in patients with acute myocardial infarction (MI).

METHODS AND RESULTS:

Forty-seven patients with acute anterior MI were compared with 32 patients with healthy coronary arteries. All patients underwent heart rate (HR) variability analysis using 24 h Holter monitoring. Blood samples were taken for MPV measurements twice a day (day- and nighttime) during Holter monitoring. Mean HR, low frequency band of HR variability power spectrum to high frequency band of HR variability power spectrum (LF:HF) ratio, LF and MPV were higher in patients with anterior MI than in the control group. SD of all NN (RR) intervals, root mean square of successive differences, number of NN intervals that differed by more than 50 ms from the adjacent interval divided by the total number of all NN intervals, HF bands and platelet counts were lower in the patients with anterior MI than in the control group. Daytime LF bands, LF:HF ratio and MPV were significantly higher, and HF bands were significantly lower than the nighttime values for both groups. The differences in daytime and nighttime measurements were more significant in the patients with acute MI than in the control group. Pearson’s correlation analysis showed that MPV was positively correlated with ventricle score, degree of left anterior descending artery stenosis, mean HR, LF bands and LF:HF ratio; and negatively correlated with the SD of all NN intervals, HF bands and platelet count. Multivariate analysis revealed that MPV was significantly affected by ventricle score and the LF:HF ratio.

CONCLUSIONS:

MPV was significantly higher in the patients with acute MI. In both groups, MPV showed great daytime and nighttime variation, which can be attributed to alterations in the autonomic nervous system. The authors suggest that the prognostic role of increased MPV in patients with acute MI is closely associated with increased sympathetic activity and decreased HR variability.     

Platelet and mean platelet volume kinetics in adult patients with sepsis

Abstract

The aims of this study were to evaluate the kinetics of platelet counts and mean platelet volume (MPV) in adults with sepsis and to determine whether the responses are infection-specific. This retrospective cohort study included patients admitted to a tertiary-care teaching hospital with microbiologically proven nosocomial sepsis between January 2006 and January 2011. Platelet counts and MPV measurements were examined daily for 5 days after the onset of sepsis. During the study period, 151 of the 214 sepsis episodes were associated with thrombocytopenia. Gram-positive microorganisms were the most frequently isolated. The decrease in platelet counts was statistically significant for the first 3 days of sepsis in Gram-positive septic patients, for 4 days in Gram-negative septic patients and for all 5 days in fungal septic patients (p?<?0.001). The increase in MPV values was statistically significant for the first 3 days of sepsis in Gram-positive septic patients and for all 5 days in the other groups (p?<?0.001). We conclude that fungal sepsis has a stronger association with thrombocytopenia and increased MPV.     

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.     

肝硬化患者口服葡萄糖耐量试验的变化

目的　了解口服葡萄糖耐量试验的血糖值与肝硬化患者肝功能状况的关系。方法　 3 8例肝硬化患者按Child Pugh肝功能分级 ,分为A级 ( 10例 )、B级 ( 14例 )和C级 ( 14例 )三组。 11例健康者为对照组。抽取空腹血 2ml后 ,行糖耐量试验 ,以葡萄糖氧化酶法测定血糖浓度。结果　肝硬化各组的基础血糖浓度与对照组比较无显著差异 ,60和12 0分钟血糖浓度均显著高于对照组 (P <0 .0 0 2～ 0 .0 5 ) ,且随着肝硬化严重程度的增加 (即A级→B级→C级 ) ,血糖浓度有增高的趋势。肝硬化各组的血糖12 0 /0 值均显著高于对照组 (P <0 .0 0 1～ 0 .0 0 2 ) ,并随着肝硬化严重程度的增加而增高。 12 0分钟血糖及血糖12 0 /0 值与血清白蛋白浓度呈显著负相关 (P <0 .0 0 1) ,与血清总胆红素浓度、凝血酶原延长时间、R151CG及Child Pugh肝功能评分呈显著正相关 (P <0 .0 0 1～ 0 .0 0 5 )。结论　口服葡萄糖耐量试验的 2小时血糖值及血糖12 0 /0 值与肝硬化患者的肝功能状况密切相关 ,是反映肝硬化患者肝功能状况的良好指标 ,有一定的临床应用价值。     

Role of mean platelet volume in triagging acute coronary syndromes

Background: Acute coronary syndromes, characterized by the rupture of unstable plaque and the subsequent thrombotic process involving platelets, have been increasing in relative frequency. The central role of platelet activation has long been noticed in this pathophysiology; hence, many therapies have been directed against it. In this study, we have aimed to search prospectively the value of mean platelet volume (MPV), which is a simple and accurate measure of the functional status of platelets, in patients hospitalized with diagnosis of acute coronary syndromes (ACS). Materials and methods: A total of 216 consecutive patients (156 male, 60 female) hospitalized with the diagnosis of non-ST segment elevation (NSTE) ACS within the first 24 h of their chest pain were enrolled. One hundred and twenty patients, matched according to sex and age, with stable coronary heart disease (CHD) (85 male, 35 female) were enrolled as a control group. Patients were classified into two group: those with unstable angina (USAP, n = 105) and those with non-ST segment elevation myocardial infarction (NSTEMI, n = 111). Results: MPVs were 10.4 +/- 0.6 fL, 10 +/- 0.7 fL, 8.9 +/- 0.7 fL consecutively for NSTEMI, USAP and stable CHD with significant differences. Patients with ischemic attacks in the first day of hospitalization accompanied by >0.05 mV ST segment shift had significantly higher MPV compared to those without such attacks (P = 0.001). Multivariable logistic regression analysis yielded that MPV (P = 0.016), platelet count (P < 0.001), and the presence of >0.05 mV ST segment depression at admission (P = 0.002) were independent predictors of development of NSTEMI in patients presenting with NSTE ACS. Conclusion: In patients presenting with NSTE ACS, higher MPV, though there are overlaps among subgroups, indicates not only more risk of having NSTEMI but also ischemic complications.     

平均血小板体积与急性冠脉综合征的研究进展

血小板在止血和血栓形成中发挥显著作用,活化的血小板通过释放参与炎症、动脉粥样硬化和血栓形成的介质,在心血管疾病的发病机制中发挥重要作用。平均血小板体积是血小板大小和活性的指标,大血小板的代谢和酶促活性更强,具有更强的促炎和血栓形成潜力,与急性冠脉综合征的发生发展密切相关。     

Association between smoking and post-load plasma glucose levels using a 75-g oral glucose tolerance test: The Saku Study

Current smoking was associated with low insulin secretion and high 30-min plasma glucose (PG), 60-min PG, and area under the curve of PG, whereas current smoking was not associated with fasting PG and 2-h PG levels in both individuals with normoglycemia and individuals with pre-diabetes in a large-scale community-based study.     

Mean platelet volume and mean platelet volume/platelet count ratio in infective endocarditis

Abstract

Infective endocarditis (IE), an infection of the endocardial surface, frequently leads to life-threatening complications, such as thromboembolism due to platelet activation. We investigated the mean platelet volume (MPV) in Korean patients with IE and the serial changes thereof, in comparison with other laboratory parameters. We analyzed 248?MPV results from 22 patients diagnosed with IE in our hospital between January 2011 and April 2012. MPV was measured with an Advia 2120 (Siemens Healthcare Diagnostics, Tarrytown, NY) using EDTA-containing tubes. The mean MPV differed significantly between the patient and control groups, 8.74 vs. 7.96?fl, respectively. In addition, the platelet count and MPV/platelet count ratio were significantly decreased in the patient group. The total platelet mass and platelet size in IE might be increased. Further studies should examine more patients to verify the changes in the MPV and MPV/platelet count ratio in IE and assess in greater detail the relationship between MPV and thrombotic complications caused by platelet activation.     

Relationship between oral glucose tolerance and gastric emptying in normal healthy subjects

Summary The relationships between gastric emptying and intragastric distribution of glucose and oral glucose tolerance were evaluated in 16 healthy volunteers. While sitting in front of a gamma camera the subjects drank 350 ml water containing 75 g glucose and 20 MBq ^99mTc-sulphur colloid. Venous blood samples for measurement of plasma glucose, insulin and gastric inhibitory polypeptide were obtained at — 2, 2, 5, 10, 15, 30, 45, 60, 75, 90, 105, 120 and 150 min. Gastric emptying approximated a linear pattern after a short lag phase (3.3±0.8 min). The 50% emptying time was inversely related to the proximal stomach 50% emptying time (r=–0.55, p<0.05) and directly related to the retention in the distal stomach at 120 min (r=0.72, p<0.01). Peak plasma glucose was related to the amount emptied at 5 min (r=0.58, p<0.05) and the area under the blood glucose curve between 0 and 30 min was related to the amount emptied at 30 min (r=0.58, p<0.05). In contrast, plasma glucose at 120 min was inversely related to gastric emptying (r=–0.56, p<0.05) and plasma insulin at 30 min (r=–0.53, p<0.05). Plasma insulin at 120 min was inversely related (r=–0.65, p<0.01) to gastric emptying. The increase in plasma gastric inhibitory polypeptide at 5 min was related directly to gastric emptying (r=0.53, p<0.05). These results indicate in normal subjects that (i) gastric emptying accounts for about 34 % of the variance in peak plasma glucose after a 75-g oral glucose load (ii) plasma glucose levels at 120 min are inversely, rather than directly, related to gastric emptying (iii) the distal stomach influences gastric emptying of glucose.     

The relationship between blood glucose concentration and beat-to-beat variation in asymptomatic subjects

Summary Very little is known about the presence of autonomic neuropathy in subjects with slight abnormalities of glucose metabolism. This study was carried out to investigate whether impaired glucose tolerance (IGT) is associated with abnormalities of beat-to-beat variation (BTBV). Sixty-two subjects, aged 40–59 years, with IGT (according to EASD criteria) and 124 normals, matched for age, sex and body mass index (BMI), were selected among the participants in a health examination survey and tested for BTBV. Among the possible factors influencing this test, sex did not show any effect, while age and BMI were significantly and negatively correlated to BTBV in both groups. Glucose intolerance was not associated with any impairment of BTBV which was almost identical in the normal (15.8±6.3 beats/min) (mean ± SD) and in the IGT group (16.7±7.0 beats/min). Similarly no significant difference was found in BTBV between subjects with constant IGT or normal results at OGTT, repeated on two occasions. All subjects were then stratified according to blood glucose values 2 h after an oral glucose load (after load): only those with blood glucose after load >200 mg/dl displayed a significant decrease in BTBV (9.7±3.8 beats/min) compared to those found normal at the glucose tolerance test (p<0.025). They were also the only ones with an average HbA₁ level significantly higher than in normal individuals (p<0.005). In conclusion, IGT is not associated with abnormalities of BTBV. Presented in part at the 17th Annual Meeting of EASD, Amsterdam, 1981.     

2型糖尿病患者平均血小板体积与冠心病的关系

目的 观察2型糖尿病合并冠心病患者平均血小板体积（MPV）的变化及相关影响因素.方法 接受冠脉造影的2型糖尿病患者495例,其中合并冠心病者307例（合并冠心病组）,无冠心病等大血管病变者（未合并冠心病组）188例.入院时测定MPV、血生化等参数,计算冠脉病变血管支数和Gensini积分.结果 合并冠心病组MPV显著高于未合并冠心病组（P＜0.05）.据MPV将合并冠心病组患者分为MPV低值组（MPV≤9.9fL）、中值组（9.9 fL＞ MPV≤10.6 fL）和高值组（MPV＞ 10.6 fL）,高值组急性冠脉综合征、多支病变、Gensini积分、体重指数、空腹血糖和糖化血红蛋白（HbA1c）显著高于低值组（P＜0.05或P＜0.01）,高密度脂蛋白胆固醇（HDL-C）显著低于低值组（P＜0.05）.多重线性回归分析显示,合并冠心病组患者Gensini积分、多支病变、HbA1c和空腹血糖与MPV显著独立正相关,HDL-C与MPV显著独立负相关.非条件Logistic分析显示,MPV是2型糖尿病合并冠心病的危险因素.结论 2型糖尿病合并冠心病患者MPV显著升高,与冠脉病变严重程度、糖代谢和HDL-C密切相关,MPV是2型糖尿病合并冠心病的危险因素.     

Assessment of mean platelet volume and soluble CD40 ligand levels in patients with non-dipper hypertension,dippers and normotensives

Abstract

Objective: Patients with a lack of nocturnal decline in blood pressure (BP) are at an increased risk for cardiovascular events. Mean platelet volume (MPV) and soluble CD40 ligand (sCD40L) are accepted biomarkers of platelet activation and considered as a risk factor for cardiovascular disease. The aim of this study was to determine whether MPV and sCD40L levels are higher in non-dipper hypertensive (NDHT) patients than in dipper hypertensive (DHT) patients and healthy controls.

Methods: 124 consecutive patients were included to this study. Patients were divided into three groups: NDHT patient group [n?=?43; mean age 51.8?±?6.6; 31?males (72.1%)]; DHT patient group [n?=?41; mean age 50.2?±?7.3; 22?males (53.7%)]; and normotensive group [n?=?40; mean age 49.9?±?6.7; 22?males (55%)]. Physical examination, laboratory work-up and 24-h ABPM were performed for all participants.

Results: The sCD40L and MPV levels were significantly higher in the NDHT group than in the DHT and normotensive groups (p?<?0.05). In correlation analysis, MPV, 24-h systolic blood pressure (SBP), 24-h diastolic blood pressure (DBP), night-time SBP and night-time DBP were positively correlated with sCD40L.

Conclusion: Our study demonstrated that MPV and sCD40L levels were significantly higher in NDHT patients compared to DHT and normotensive patients. sCD40L levels were positively correlated with MPV, 24-h SBP, 24-h DBP, night-time SBP and night-time DBP.