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Abstract：
Background Diabetic patients exhibit increased platelet activity. Insulin inhibits the activation of platelets. Therefore, a relative or absolute deficiency of insulin would increase platelet reactivity. The younger (larger) platelets are also more metabolically and enzymatically active. If detected early, microvascular complications could alert us regarding the possible macrovascular complications. Thus, the aims and objectives of the present study were to determine platelet indices in patients with type 2 diabetes mellitus with controls (non-diabetics) and to find an association of platelet indices with microvascular complications. Material & methods In this prospective case-control study conducted from 2021 to 2022 (2 years), a total number of 200 subjects were taken and were divided into two groups of 100 each, cases (I) and controls (II). The cases included patients of diabetes mellitus (DM) of a duration of more than 5 years, which were further divided into two groups of 50 each, IA and IB. Group IA consisted of patients with diabetes mellitus of a duration of more than five years with at least one microvascular complication and group IB was diabetics of more than five years duration without any microvascular complications, which includes diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. An automated cell counter (Thermo Fisher Scientific, Waltham, MA, US) provided hemoglobin values along with the platelet count and platelet indices, i.e. mean platelet volume (MPV), platelet large cell ratio (P-LCR), and platelet distribution width (PDW). Results The present study consisted of 200 subjects divided into 2 groups of 100 each, cases (I) and controls (II). The average MPV (9.4-12.3 femtolitre) in diabetics was 12.089±1.450 fL as compared to the controls where it was 9.464±1.424 fL with a statistically significant p-value of 0.001. PDW among the cases was 16.868±2.352 fL while in controls, it was 12.753±10.559 fL (p=0.001). The mean P-LCR was 34.975±8.056% among the cases, in comparison to the mean P-LCR among the controls, which was 26.031±7.004 (p=0.001). In this study, the MPV, PDW, and P-LCR were significantly raised in individuals having diabetes with microvascular complications when compared with patients without complications. The mean MPV in diabetics with complications was 12.5960±0.95660 fL and in those without complications was 11.5820±1.67609 fL (with a p-value of P = 2×10-3)which is statistically significant. Similar results were obtained in cases of PDW and P-LCR. The mean PDW in diabetics with complications was 17.1140±2.58228 fL and without complications was 15.6220±2.10532 fL ((with a p-value of P = 2×10-3)). The mean P-LCR in diabetics with microvascular complications was 35.408±3.5490% and without complications was 33.542±4.8694% (with a p-value of P = 3.1×10-3). Conclusion Based on the findings of the present study, there is a statistical correlation between type 2 diabetes and variations in platelet indices, resulting in the associated microvascular complications. Higher MPV, PDW, and P-LCR values suggest that these parameters are more reliable predictors of early vascular complications in individuals with type 2 diabetes mellitus and can be utilized as an easy-to-use, low-cost method. They are a readily available, economical, practical, noninvasive, and simple-to-understand approach for assessing platelet dysfunction, which in turn helps anticipate the existence of microvascular complications.
摘要：
背景糖尿病患者表现出增加的血小板活性。胰岛素抑制血小板的活化。因此,胰岛素的相对或绝对缺乏会增加血小板反应性。较年轻(较大)的血小板也更具代谢活性和酶活性。如果早期发现，微血管并发症可以提醒我们可能的大血管并发症。因此，本研究的目的和目标是确定2型糖尿病患者和对照组(非糖尿病患者)的血小板指数,并发现血小板指数与微血管并发症的相关性.材料和方法在2021年至2022年(2年)进行的这项前瞻性病例对照研究中，共抽取200名受试者，分为两组，每组100人，病例(I)和对照(II)。这些病例包括持续时间超过5年的糖尿病（DM）患者，进一步分为两组，每组50人，IA和IB。IA组包括病程超过5年的糖尿病患者，至少有一种微血管并发症，IB组是病程超过5年的糖尿病患者，没有任何微血管并发症。其中包括糖尿病视网膜病变，糖尿病肾病，和糖尿病神经病变。自动细胞计数器(ThermoFisherScientific，沃尔瑟姆,MA,US)提供血红蛋白值以及血小板计数和血小板指数，即平均血小板体积（MPV），血小板大细胞比率（P-LCR），和血小板分布宽度（PDW）。结果本研究由200名受试者组成，分为2组，每组100人。病例(I)和对照(II)。糖尿病患者的平均MPV（9.4-12.3毫微微）为12.089±1.450fL，而对照组为9.464±1.424fL，统计学上显着的p值为0.001。病例的PDW为16.868±2.352fL，而对照组为，它是12.753±10.559fL（p=0.001）。平均P-LCR为34.975±8.056％，与对照组的平均P-LCR相比，为26.031±7.004(p=0.001)。在这项研究中,MPV,PDW,与无并发症的患者相比,有微血管并发症的糖尿病患者的P-LCR显著升高.有并发症的糖尿病患者的平均MPV为12.5960±0.95660fL，无并发症的患者为11.5820±1.67609fL（p值P=2×10-3），具有统计学意义。在PDW和P-LCR的情况下获得了类似的结果。有并发症的糖尿病患者的平均PDW为17.1140±2.58228fL，无并发症的平均PDW为15.6220±2.10532fL（（p值P=2×10-3））。有微血管并发症的糖尿病患者的平均P-LCR为35.408±3.5490％，无并发症的平均P-LCR为33.542±4.8694％（p值P=3.1×10-3）。结论根据本研究的结果，2型糖尿病与血小板指数的变化之间存在统计学相关性，导致相关的微血管并发症。MPV更高,PDW,和P-LCR值表明，这些参数是2型糖尿病患者早期血管并发症的更可靠的预测因子，可以用作易于使用的，低成本的方法。它们是现成的，经济,实用,非侵入性，和简单易懂的方法来评估血小板功能障碍，这反过来有助于预测微血管并发症的存在。
