title: Diabetes, glucose control and mean platelet volume: a single-centre cohort study.
abstract: Diabetes is a major determinant of cardiovascular risk, mainly due to higher prothrombotic status and enhanced platelet reactivity. Mean platelet volume (MPV) has been suggested as indicator of platelet reactivity and moreover, diabetics have been shown to have larger MPV. The aim of our study was to evaluate the impact of diabetes and glycemic control on MPV in a large cohort of patients.
  
  
  METHODS
  Our population is represented by 3414 patients undergoing coronary angiography at Azienda Ospedaliera-Universitaria, "Maggiore della Carità", Novara, Italy. We obtained a fasting blood sample for glycemic assessment and for MPV evaluation. History of diabetes and pharmacological treatment, together with main cardiovascular risk factors were recorded. New diagnosis of diabetes was defined as nonfasting glucose >200mg/dL, fasting glucose ≥126mg/dL, or HbA1c >48mmol/L.
  
  
  RESULTS
  Diabetes was observed in 1272 patients (37.2%). Diabetes was related to older age, waist circumference, arterial hypertension, smoking, hypercholesterolemia, renal failure, previous MI and PCI, therapy with ACE-inhibitors, ARBs, beta-blockers, diuretics, statins (respectively p<0.001) and ASA (p=0.004). Diabetics had lower haemoglobin (p<0.001), higher fibrinogen (p=0.001) and worst lipid profile (p<0.001). MPV was related with diabetes mellitus (p<0.001) and glycemic control (p=0.05; at linear regression r=0.07; p<0.001 for fasting glycaemia; r=0.09; p<0.001 for HbA1c, respectively). However, this relationship was not confirmed at multivariate analysis (OR[95%CI]=1.2[0.97-1.5], p=0.09 for diabetes, OR[95%CI]=1.05[0.96-1.15], p=0.25 for HbA1c). Independent predictors of MPV above median value (10.8fL) resulted to be age (OR[95%CI]=1.02[1.01-1.03], p=0.002), treatment with ARBs (OR[95%CI]=1.4[1.1-1.8], p=0.007) and haemoglobin levels (OR[95%CI]=1.2[1.15-1.23], p<0.001), while inverse relationship was found with total cholesterol (OR[95%CI]=0.99[0.99-1], p=0.002).
  
  
  CONCLUSIONS
  Larger MPV is associated with ageing, treatment with ARBs, cholesterol and haemoglobin levels. Diabetes mellitus and glycemic control are not independently associated with larger platelet size.
authors: Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy.
authors: Monica
authors: M
authors: Verdoia
authors: Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy.
authors: Alon
authors: A
authors: Schaffer
authors: Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy.
authors: Lucia
authors: L
authors: Barbieri
authors: Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy.
authors: Ettore
authors: E
authors: Cassetti
authors: Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy.
authors: Matteo
authors: M
authors: Nardin
authors: Division of Clinical Chemistry, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy.
authors: Giorgio
authors: G
authors: Bellomo
authors: Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy.
authors: Paolo
authors: P
authors: Marino
authors: Departement of Translational Medicine, Eastern Piedmont University, Novara, Italy; Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy.
authors: Fabiola
authors: F
authors: Sinigaglia
authors: Division of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy; Centro di Biotecnologie per la Ricerca Medica Applicata (BRMA), Eastern Piedmont University, Novara, Italy. Electronic address: giuseppe.deluca@med.unipmn.it.
authors: Giuseppe
authors: G
authors: De Luca
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001792:Blood Platelets / Q000502:physiology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D063847:Mean Platelet Volume; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose
keywords: Diabetes mellitus; HbA1c; Platelet size