Platelet volume indices: markers of carotid atherosclerosis in type 2 diabetes mellitus?

Background. Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) are the indicators of platelet activity and may have a role in subclinical atherosclerosis and microvascular complications in type 2 diabetes mellitus (T2DM). We evaluated PVI in diabetics for their association with carotid intima media thickness (CIMT) and microvascular complications. Methods. Participants - 105 T2DM patients and age, gender matched 105 controls were evaluated by history and complete blood counts (CBC) including PVI, blood sugars, HbA 1c, lipid profile and microvascular complications. PVI were compared between cases and controls. Carotid Doppler was done and CIMT was correlated with PVI. Results. PVI were found significantly higher in diabetic patients compared to controls. Mean MPV in cases vs. controls was (11.09 +/- 1.02 fL vs. 10.28 +/- 0.96 fL, p <= 0.001), mean PDW (13.46 +/- 1.96 fL vs. 12.85 +/- 3.54 fL, p = 0.12), mean P-LCR (31.92 +/- 6.23% vs. 27.94 +/- 5.94%, p <= 0.001). CIMT showed a positive significant association with MPV, PDW and PLCR, dyslipidemia and negative with glycemic control. PVI, especially MPV was significantly elevated in those with neuropathy, nephropathy and retinopathy. Conclusion. PVI i.e. MPV, PDW, P-LCR are increased in diabetic patients. They correlate positively with CIMT, implying cardiovascular risk. PVI have a positive association with microvascular complications also. PVI as determined by simple automated CBC can be used as markers of subclinical atherosclerosis and predictor of future cardiovascular events in T2DM.