ISSN 0975-3583

Journal of Cardiovascular Disease Research

    A study on role of platelet indices - platelet large cell ratio (P‐LCR), mean platelet volume [MPV], platelet distribution width [PDW] and high-sensitivity C- reactive protein (hs CRP) as predictive markers for complications in Type 2 diabetes mellitus

    Dr. Nagelli Rahul, Dr. D Pavan Kumar, Dr. Sanjay H Kalbande
    JCDR. 2023: 762-772


    A "prothrombotic propensity" with enhanced platelet reactivity has been identified in diabetes mellitus (DM). According to theories, the microvascular consequences of diabetes may be influenced by this increased responsiveness. Mean platelet volume (MPV), one of the platelet indices, shows changes in either platelet stimulation or the rate of platelet synthesis. A measurement of platelet heterogeneity is platelet distribution width (PDW), which can be brought on by either the ageing of platelets or the uneven demarcation of megakaryocytes. Platelet-large cell ratio (P-LCR), the third platelet index, is a measurement of bigger platelets. A small number of research on diabetic people have examined MPV. Diabetes, metabolic syndrome, and stroke have all been linked to an increase in MPV. Early detection of the occurrence of such complications would aid in lowering these unfavourable outcomes because microvascular complications of DM are significant sources of morbidity and health care expenditures. High-sensitivity C - reactive protein (hs CRP), according to studies, is a significant risk factor for cardiovascular disease. In order to determine if platelet indices and high-sensitivity C-reactive protein (hs-CRP) levels may be utilised as predictors of glycemic control and vascular problems, this study was conducted. Materials and Methods: In all, 50 diabetes patients and 100 non-diabetic individuals (the control group) participated in this study. Parameters of HbA1c ≥ 6.5 or postprandial plasma glucose (2 h) levels >200 mg/dL or fasting blood glucose ≥ 126 mg/dL were taken into consideration. On the basis of clinical presentation, investigation, and examination, the diabetic group was further classified into diabetics without (60) and with complications (40). Using a complete blood count analyzer, platelet indices (mean platelet volume [MPV], platelet distribution width [PDW], and platelet large cell ratio [P-LCR]) were evaluated. Hs-CRP testing was qualitative, and those samples that proved positive underwent quantitative evaluation. Observation: When compared to the non-diabetic group, all three of the examined platelet indices - MPV, PDW, and P-LCR - were considerably greater in diabetics. They also rose with rising HbA1c levels. Only P-LCR, when linked with HbA1c, however, demonstrated a significant difference between diabetics with and without problems (P = 0.002), while MPV shown a significant difference across all categories (P 0.04). The difference in hs-CRP concentrations between diabetics with and without problems was statistically significant (P = 0.01) Conclusion: Continuously rising MPV, PDW, and P-LCR values with declining glycemic control demonstrate chronic creation of bigger platelets with increased activity in diabetics due to continued inflammation. Since the sole parameter in our study that demonstrated a significant difference between diabetics with and without difficulties, P-LCR should be the preferred index for predicting the likelihood of future complications.


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