THE CORRELATION BETWEEN THE MEAN PLATELET VOLUME VALUES WITH THROMBOCYTE AGGREGATION IN NEPHROPATHY DIABETIC PATIENTS
DOI:
https://doi.org/10.24293/ijcpml.v25i1.1510Keywords:
, Platelet aggregation, diabetic nephropathy, MPV valuesAbstract
Diabetic nephropathy is the most important cause of end-stage renal failure. Chronic hyperglycemia will cause glomerular endothelial damage, and this damage will stimulate hemostasis activation including platelets so that platelet aggregation will increase. The increase of platelet aggregation will increase platelet consumption, which further stimulates thrombopoiesis which will lead to immature platelets of large size to be released into the circulation. This research aimed to determine the positive correlation between MPV with platelet aggregation in patients with diabetic nephropathy. This study was an analytic observational study with a cross-sectional study design. The research was conducted in the Dr. Hasan Sadikin Hospital Bandung from July 2016 to October 2017. A total of 52 subjects who met the inclusion criteria were included in the study. Mean platelet volume and platelet aggregation were performed with venous examination with EDTA and sodium citrate 3.2% anticoagulants. The result of platelet aggregation examination showing platelet hyper-aggregation was found in 44.2% of subjects, 50% normal-aggregation, 5.8% hypo-aggregation. While the median value of MPV in this study was 9.2 fL with the range of 8.00 – 11.80 fL. A positive correlation was found between MPV value with platelet aggregation with r= 0.067, p= 0.634. The conclusion was that there was no correlation between MPV values with platelet aggregation in diabetic nephropathy patients. This small and insignificant r-value might be due to several factors that also affect platelet aggregation in diabetic nephropathy patients, requiring further investigation.
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References
Powers AC. Diabetes mellitus. In: Dennis L, Kasper M, Stephen L, Hauser M, Jameson JL, Fauci A, et al. Editor: Harrison's principles of internal medicine. New York, McGraw-Hill Education, 2015; 2399-403.
Kaku K. Pathophysiology of type 2 diabetes and its treatment policy. JMAJ, 2010; 53(1): 41-6.
American Diabetes Association. Diagnosis and classiï¬cation of diabetes mellitus. Diabetes Care, 2015; 37: S81.
Nathan DM, McGee P, Steffes MW, Lachin JM, Group DER. Relationship of glycated albumin to blood glucose and HbA1c values and to retinopathy, nephropathy, and cardiovascular outcomes in the DCCT/EDIC study. Diabetes, 2014; 63(1): 282-90.
Yenigün EC, Okyay GU, Pirpir A, Hondur A, Is Y. Increased mean platelet volume in type 2 diabetes mellitus. Dicle Medical Jour, 2014; 41(1): 17-22.
Ulutas KT, Dokuyucu R, Sefil F, Yangil E, Sumbul AT, Rizaoglu H, et al. Evaluation of mean platelet volume in patients with type 2 diabetes mellitus and blood glucose regulation: A marker for atherosclerosis?. Int J Clin Exp Med, 2014; 7(4): 955-61.
Shimodaira M, Niwa T, Nakajima K, Kobayashi M, Hanyu N, et al. Correlation between mean platelet volume and fasting plasma glucose level in prediabetic and normoglycemic individuals. Cardiovascular Diabetology, 2013; 12(14): 2-7.
Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest, 2005; 115: 3378-84.
Johansen JV. Involvement of neutrophils in the pathogenesis of lethal myocardial reperfusion injury. J Cardiore, 2003; 61: 481-97.
Assert R, Scherk G, Bumbure A, Pirags V, Schatz H, et al. Regulation of protein kinase C by short-term hyperglycemia in human platelets in-vivo and in-vitro. Diabetologia, 2001; 44: 188-95.
Tang WH, Stitham J, Gleim S, Di Febbo C, Porreca E, et al. Glucose and collagen regulate human platelet activity through aldose reductase induction of thromboxane. J Clin Invest. 2011; 121: 4462-76.
Gibbins JM. Platelet adhesion signaling and the regulation of thrombus formation. J Cell Sci, 2004; 117: 3415-25.
Randriamboavonjy V. Mechanisms involved in diabetes-associated platelet hyperactivation. Germany, Goethe University, Frankfurt am Main, 2015; 178-9.
Dahlan MS. Besar sampel dan cara pengambilan sampel. Ed ke-3., Jakarta, Salemba Medika, 2013; 25-77.
Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian klinis. Ed ke-4., Jakarta, Sagung Seto, 2011; 40-55.
Badan Penelitian dan Pengembangan Kesehatan. Riset kesehatan dasar. Jakarta, Badan Penelitian dan Pengembangan Kesehatan, 2013; 90-2.
De Tata V. Age-related impairment of pancreatic beta-cell function: Pathophysiological and cellular mechanisms. Frontiers in Endocrinology, 2014; 5(138): 1-6.
Ulutas KT, Dokuyucu R, Sefil F, Yangil E, Sumbul AT, et al. Evaluation of mean platelet volume in patients with type 2 diabetes mellitus and blood glucose regulation: A marker for atherosclerosis?. Int J Clin Exp Med, 2014; 7(4): 955-61.
El-Khawaga G, Abdel-Wahab F. Knowledge, attitudes, practices, and compliance of diabetic patients. Europ J of Res Med Sci, 2015; 3(1): 1-5.
Guyton AC, Hall JE. Textbook of medical physiology. 12th Ed., Philadelphia, Elsevier Saunders, 2011; 939-50.
World Health Organization. Hemoglobin concentrations for the diagnosis of anemia and assessment of severity. Geneva, Switzerland2011 [Accessed on 3 August 2017]. Available from: http://www.who.int.
Jerums G, Maclsaac R, Panagiotopoulos S, Thomas M. Anemia and diabetic nephropathy. In: Cortes P, Mogensen E, editor. Contemporary diabetes: The diabetic kidney. Totowa NJ, New York, Humana Press Inc, 2010; 527-44.
Astor BC, Munther P, Levin A, Eustace JA. Association of kidney function with anemia: The third national health and nutrition examination survey (1988-1994). Arch Intern Med, 2002; 162: 1401-8.
Horwich TB, Fonarow GC, Hamilton MA, MacLellan WR. Anemia is associated with worse symptoms, greater impairment in functional capacity and a significant increase in mortality in patients with diabetic nephropathy. Am J Med, 2002; 39: 1780-6.
Harmening DM, Escobar CE, McGlasson DL. Introduction to hemostasis. In: Harmening DM, editor. Clinical hematology and fundamentals of hemostasis. 5th Ed., Philadelphia, F.A. Davis Company, 2009; 543-76.
Clemetson KJ, Clemetson JM. Platelet receptors. In: Ad M, editor. Platelets. 2nd Ed., California, Elsevier, 2007; 117-43.
Ninama NJ, Nirali KS. Impedance platelet count in severe microcytosis-study of 161 patients. NHL Journal Medicine Science, 2014; 3(1): 32-6.
Shattil SJ, Cunningham M, Hoxie JA. Detection of activated platelet in whole blood using activation-dependent monoclonal antibodies and flow cytometry. Blood, 1987; 70: 307-15.
Sysmex educational enhancement and development. SEED hematology. Sysmex. August 2016; 1-7.
Schmitz G, Rothe G, Ruf A, Barlage S. European working group on clinical cell analysis: Consensus Protocol for the flow cytometric characterization of platelet function. Thromb Hemost, 1998; 79: 885-96.
