UNASSIGNED: Platelets play a significant role in the innate and adaptive processes of immunity and inflammation. Inflammatory bowel disease (IBD) is an autoimmune disease that is widely understood to be caused by a combination of genetic predisposition, aberrant immune responses, etc.
UNASSIGNED: To examine the relationships between genetically determined platelet indices and IBD, we conducted a Mendelian randomization (MR) study. Data associated with platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) were used from the UK Biobank. The outcome data, including IBD, Crohn\'s disease (CD), ulcerative colitis (UC), were from the FinnGen database. The inverse variance-weighted (IVW), MR-Egger, weighted median methods were used for MR analyses.
UNASSIGNED: The MR estimations from the IVW approach show a significant connection between PLT and IBD. Similarly, PCT and IBD have a relationship following the IVW and MR-Egger approaches. While PLT and PCT have strong relationships with CD, according to the findings of all three approaches respectively. Nevertheless, PDW was the only relevant indicator of UC. The only significant result was IVW\'s.
UNASSIGNED: Our findings suggest that the fluctuation of platelet indicators is of great significance in the development of IBD. PLT and PCT have a close association with IBD and CD, respectively; PDW only has a connection with UC. Platelets play an important role in the progression of IBD (UC, CD).

UNASSIGNED: The aim of this study is to compare children diagnosed with type 1 diabetes mellitus (T1DM) with healthy controls in terms of some laboratory parameters and platelet indices.
UNASSIGNED: This study is retrospective. We used glycated hemoglobin (HbA1c) values to classify patients as <7% (good) and ≥7% (poor). The platelet mass (PM) value was calculated from the hemogram data (PM=PLTxMPV).
UNASSIGNED: The study included a total of 87 patients who had been diagnosed with T1DM and 120 healthy participants. Fasting glucose, urea, creatinine, hemoglobin (HGB), red blood cell (RBC), mean platelet volume (MPV) and platelet distribution width (PDW) were significantly higher in the patient group than in the healthy control group. Platelet (PLT), plateletcrit (PCT) and PM were significantly lower in the poor glycemic control than in the good glycemic control and healthy groups. The PDW in the healthy control group was statistically significantly lower than in the good and poor glycemic control groups. In the group with poor glycemic control, there was a positive and significant correlation between the MPV and the level of HbA1c (r=0.401, p<0.05).
UNASSIGNED: To sum up, our results show that the MPV and the PDW are significantly higher in children with T1DM than in healthy control. In the group with poor glycemic control, PLT levels were significantly lower than in the other two groups, leading to a decrease in PCT and PM levels. Further studies are needed to understand whether the decrease in PLT levels is due to the hyperactivity and rapid turnover of PLT.

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.

BACKGROUND: Platelets are pivotal players in the pathophysiology of pre-eclampsia, with observed lower counts in affected individuals compared to normotensive counterparts. Despite advancements, the elusive cause of pre-eclampsia persists, motivating intense global efforts to identify reliable predictors. The currently recommended predictors of pre-eclampsia are not readily available in many resource-limited regions like Nigeria. This cohort study explores the potential of mean platelet volume (MPV) and platelet distribution width (PDW) as predictive markers of early-onset pre-eclampsia. Both platelet indices are components of the full blood count, a widely available routine test in pregnancy.
METHODS: In this prospective cohort study, 648 healthy pregnant women attending antenatal care at Lagos State University Teaching Hospital and General Hospital Ifako-Ijaiye, Lagos, were recruited between 14-18weeks gestational age. Platelet count (PC), MPV and PDW were measured from their venous blood at recruitment. Participants were monitored until 34weeks of gestation, focusing on the occurrence of early-onset preeclampsia as the outcome of interest. Individuals with chronic medical conditions were excluded from the study. Data analysis involved t-test, Chi-Square and Mann-Whitney U tests, with statistical significance set at a confidence level of 95% and p < 0.05. Sensitivity, specificity, and predictive values were determined using receiver operating characteristics (ROC) curves.
RESULTS: The incidence of early-onset pre-eclampsia in the study was 5.9%. Women who later developed pre-eclampsia had higher median MPV and PDW at 14-18weeks (10.8 fl. and 24.8 fl.) compared to normotensive women (8.1 fl. and 13.3 fl.)(p < 0.001). The median PC was lower in pre-eclamptics (190 × 103/µl) compared to normotensives(264 × 103/µl)(p < 0.001). Using Youden\'s test, cut-off values identified: PC < 211.5 × 103/µl, MPV > 9.4 fl., and PDW > 21.3 fl., predicted early-onset pre-eclampsia with 96.6% sensitivity and 65.6% specificity for PC; 79.3% sensitivity and 97.7% specificity for PDW; and 82.8% sensitivity and 96.1% specificity for MPV. Cut-offs of PC < 185 × 103/µl, MPV > 10.7 fl., and PDW > 28.3 fl., predicted severe early-onset pre-eclampsia with 100.0% sensitivity and 90.9% specificity for PC, 100.0% sensitivity and 99.4% specificity for MPV, and 100.0% sensitivity and 99.8% specificity for PDW, with corresponding area under the ROC curves of 0.983, 0.996, and 0.998, respectively.
CONCLUSIONS: The evaluation of MPV and PDW between 14 and 18 weeks of gestation appears to be a reliable predictor of severe early-onset pre-eclampsia.

UNASSIGNED: Platelet indices (PIs) are hematological parameters that indicate the number, morphology, and activation of platelets. Although some clinical trials suggest an association between PIs and the risk of stroke, the lack of robust evidence is attributed to confounding effects and reverse causation.
UNASSIGNED: This study aimed to evaluate the association between PIs and stroke risk through Mendelian randomization (MR) while exploring the mediating effect of blood pressure in this association.
UNASSIGNED: We identified genetic variants associated with PIs, including platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet crit (PCT), in the UK Biobank (n = 350,474). Relevant genome-wide association studies were utilized to gather summary statistics pertaining to the traits of interest. We primarily used the inverse-variance weighted analysis to obtain estimates for individual causal power.
UNASSIGNED: We observed a positive correlation between genetically predicted increases in PCT levels with the stroke onset [PCT: OR (95%CI) = 1.113(1.047, 1.183), p < 0.001]. However, no significant causal relationship was found between PLT, PDW, and MPV and the risk of stroke [PLT: OR (95%CI) = 1.037(0.979, 1.098), p = 0.221; PDW: OR (95%CI) = 0.973(0.923, 1.024), p = 0.294; MPV: OR (95%CI) = 0.990(0.945, 1.038), p = 0.675]. Multivariable MR analyses and mediation analysis found that the proportion mediated by systolic blood pressure (SBP) is 23.71% [95%CI (10.85-33.31%)] and the proportion mediated by diastolic blood pressure (DBP) is 28.09% [95%CI (12.92-39.63%)].
UNASSIGNED: This large MR study presents evidence for the potential causal relationship between the PCT level and the risk of ischemic stroke, which might be mediated by blood pressure.

This study investigates the relationship between smoking and blood parameters in the Iranian Kurdish population.
The current study was conducted based on the recruitment phase of the Ravansar Non-Communicable Disease (RaNCD) cohort study.
Current smokers had higher levels of RBC count, HCT, HGB, MCV, MCH, MCHC, WBC count, and GR%, than in other groups significantly. Passive smokers had higher levels of PLT count and PCT statistically. The increasing exposure time of smoking positively affected WBC count, GR%, PLT count, PCT, and RDW in female passive smokers. In addition, heavy smokers, as well as participants with a higher duration time of smoking, had the same results for significantly lower levels of lymphocyte and monocyte and a higher level of RBC indices.
According to the present study, along with the current smokers, the intensity of smoking, as well as the duration time of the smoke, could have a positive correlation with blood parameters. Furthermore, passive smokers and specifically secondhand female smokers were more vulnerable to smoke.

Background Unraveling sepsis remains the holy grail of clinical medicine and the commonest cause of in-hospital mortality worldwide. Various newer biomarkers have emerged in recent years that aid in the diagnosis and prognostication of sepsis. However, the widespread use of these is limited by availability, cost, and long turnaround times. Considering the crucial role of hematological parameters in infectious conditions, the present study aimed to evaluate the association of various platelet indices with the severity and outcomes in patients diagnosed with sepsis. Methods This was a single-center, prospective, observational study comprising 100 consecutive patients who fulfilled the selection criteria in the emergency department of a tertiary care hospital from June 2021 to May 2022. All patients underwent history taking, physical examination, and necessary laboratory investigations, including complete blood counts, biochemistry panel, and radiographic and microbiological tests. A detailed assessment of various platelet indices (platelet count, mean platelet volume, and platelet distribution width) was performed, and its association with outcomes was derived. The Sequential Organ Failure Assessment (SOFA) score was recorded for all patients. Results The majority of the study population was male (52%) with a mean age of 48.05±19.27 years. Respiratory infection (38%) was the most common origin of sepsis followed by genitourinary infections in 27%. The mean platelet count on admission was 1.83±1.21 lakhs/mm3. The incidence of thrombocytopenia (<1.5 lakhs/ mm3) in our study sample was 35%. The overall in-hospital mortality of the study group was 30%. Thrombocytopenia was significantly associated with a higher SOFA score (7.4±3 vs. 3.7±1.9, P<0.05), longer hospital stays (10.8±4.6 vs. 7.8±3.9; p<0.05), and mortality (17 vs. 13; p<0.05). The change in platelet count, platelet distribution width, and mean platelet volume from Day 1 to Day 3 also correlated with outcomes. There was a decrease in platelet count among the non-survivors compared to an increase in platelet count among survivors from Day 1 to Day 3 (p<0.05). Similarly, the change in platelet distribution width showed a decreasing trend among the survivors compared to an increasing trend among the non-survivors (p<0.05). The mean platelet volume of non-survivors increased from Day 1 to Day 3 compared to a downward trend among the survivors (p<0.05). Conclusion Septic patients with thrombocytopenia on admission had a higher SOFA score and were associated with worse outcomes. Additionally, platelet indices, such as platelet distribution width and mean platelet volume, serve as important prognostic markers among sepsis patients. Change in these parameters from Day 1 to Day 3 also correlated with outcomes. These indices are simple and affordable, allowing for their serial assessment to aid in the prognosis of sepsis.

UNASSIGNED: India is facing a galloping diabetes epidemic with an estimated 62 million patients and is projected to explode beyond 85 million by the year 2030. There is platelet dysfunction with platelet hyper-reactivity in diabetes mellitus.
UNASSIGNED: To assess for any correlation between HbA1c levels with various platelet indices like mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR).
UNASSIGNED: Applying inclusion and exclusion criteria, diabetes mellitus patients have undergone detailed history, clinical examination, and laboratory investigations. Data is statistically analyzed for levels of HbA1c and their correlation to platelet indices.
UNASSIGNED: 58.7% study population is with HbA1c levels of more than 8%. In patients with normal range HbA1c levels between 4-6%, the MPV, PDW, and P-LCR are found to be 9.9 ± 0.97 fl, 10.84 ± 2.08 fl, and 23.75 ± 7.99%, respectively. In patients with HbA1c levels of 6.1 to 7%, the MPV, PDW, and P-LCR are found to be 10.22 ± 1.04 fl, 11.79 ± 1.8 fl, and 26.36 ± 7.05%, respectively. In patients with HbA1c levels of 7.1 to 8%, the MPV, PDW, and P-LCR values are found to be 10.21 ± 1.06 fl, 12.03 ± 2.52 fl, and 26.65 ± 8.05%, respectively. In patients with poor glycemic control with HbA1c levels more than 8%, the MPV, PDW, and P-LCR are found to be 10.64 ± 1.1 fl, 12.81 ± 2.61 fl, and 30.26 ± 8.24%, respectively.
UNASSIGNED: In type 2 diabetes mellitus patients, HbA1c is positively correlated with platelet indices.

BACKGROUND: In clinical practice, laboratory results are of great importance for the diagnosis and treatment. Reference intervals of different parameters aid health-care professionals in the interpretation of results. There are very few studies on reference intervals from India. This prospective study was conducted to determine the reference intervals for platelet count (PLT) and PLT indices; mean PLT volume (MPV), PLT distribution width (PDW), and PLT large cell ratio (P-LCR). These values can be obtained as a part of a routine complete blood count (CBC) and have diagnostic and prognostic significance in certain diseases. PLT count is an important criterion for the selection of donors for repeat plateletpheresis donation.
METHODS: Sixteen hundred and thirty-four first-time healthy volunteer plateletpheresis donors were enrolled for the study. CBC was done, values of PLT, MPV, PDW, and P-LCR were noted, and the results were analyzed. The 95% of the reference distribution was estimated using the 2.5th and 97.5th percentiles following Clinical and Laboratory Standards Institute guidelines. Adverse donor reactions, if any and quality parameters of single donor PLTs (SDP) were also studied.
RESULTS: Reference range values of PLT, MPV, PDW, and P-LCR were 137,825-355,175/μl, 8.1-13.9/fl, 9.1-22.5/fl, and 11.7%-52.9%, respectively, and compared well with other published studies from India. It was observed that reference values of PLT count obtained in the study were lower than reference values that are currently used in most laboratories (150,000-450,000/μl) in India.
CONCLUSIONS: Based on our results, we are of the opinion that the PLT count cutoffs for repeat plateletpheresis donation may need to be revised downwards for our country which would also mitigate the scarcity of apheresis donors.

UNASSIGNED: Thrombocytopenia may result from mechanisms such as marrow hypoplasia, increased destruction of platelets, and splenic sequestration. The gold standard method for discriminating the causes of thrombocytopenia is bone marrow examination, but it is invasive and expensive. Therefore, an alternative method should be introduced as a first-line diagnostic procedure. Of late, the automated blood cell analyzer has made it possible to assess the cause of thrombocytopenia through various machine-derived parameters, known as platelet indices, which include the mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), which are provided as a part of routine complete blood count.
UNASSIGNED: The objectives of the present study are to study the variation and effectiveness of platelet indices in establishing the etiology of thrombocytopenia.
UNASSIGNED: An observational, prospective, and comparative study was conducted on 134 patients with thrombocytopenia, and 67 cases were taken as the normal group. The study group was classified into two groups: hypo-productive and hyper-destructive. Platelet indices were recorded and compared in the two groups along with the normal group.
UNASSIGNED: The mean platelet count (10^3 μL) in the normal, hypo-productive, and hyper-destructive groups was 232.03 ± 74.84, 73.00 ± 36.52, and 68.28 ± 38.24, respectively. The MPV and mean PCT in the normal, hypo-productive, and hyper-destructive groups were 9.46 ± 1.68fL, 8.99 ± 1.49fL, and 11.35 ± 1.35fL and 0.22 ± 0.06%, 0.07 ± 0.04%, and 0.08 ± 0.05%, respectively. The mean PDW in the normal, hypo-productive, and hyper-destructive groups was 15.66 ± 1.76fL, 17.63 ± 1.01fL, and 18.32 ± 1.10fL, respectively.
UNASSIGNED: In the present study, platelet indices such as MPV, PCT, and PDW are higher in the hyper-destructive group and may discriminate hyper-destructive from hypo-productive causes of thrombocytopenia.