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Thromb Haemost 2008; 99(06): 1079-1084
DOI: 10.1160/TH07-12-0712
Platelets and Blood Cells
Schattauer GmbH

Determinants of mean platelet volume (MPV) in an elderly population: Relevance of body fat, blood glucose and ischaemic electrocardiographic changes

Antonio Muscari
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
,
Susanna De Pascalis
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
,
Andrea Cenni
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
,
Cosimo Ludovico
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
,
Nicola Castaldini
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
,
Serafina Antonelli
2   Laboratory of the Azienda USL Bologna, Bologna, Italy
,
Giampaolo Bianchi
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
,
Donatella Magalotti
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
,
Marco Zoli
1   Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Italy
› Author Affiliations
Further Information

Publication History

Received 03 December 2007

Accepted after major revision 14 April 2008

Publication Date:
27 November 2017 (online)

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Summary

Mean platelet volume (MPV) is increased in patients with coronary heart disease or at risk for stroke. However, MPV determinants have never been assessed in a population study. The present investigation is a cross-sectional study involving 366 non-selected subjects (both sexes, mean age 72.9 ± 5.5 [1 SD] years). The main cardiovascular risk factors, several indexes of adiposity (including percent body fat as estimated by skinfold measurement, and ultrasound detection of hepatic steatosis and thickness of abdominal subcutaneous and visceral fat) and ischaemic electrocardiographic (ECG) changes were assessed in all subjects. Platelet parameters were determined by a Bayer ADVIA 120 counter. In addition to being associated directly with platelet distribution width (PDW) and inversely with platelet count (p<0.0001 for both), MPV values were associated with subcutaneous abdominal fat (p=0.02), fasting blood glucose (p=0.002) and the prevalence of ischaemic ECG changes (p=0.004), and tended to be higher in the subjects with a greater prevalence of hepatic steatosis (p=0.07) and higher Homeostasis Model Assessment (HOMA) index (p=0.09). In multiple logistic regression, of the non-platelet parameters only percent body fat (p=0.006), ischaemic ECG changes (p=0.01) and blood glucose (p=0.03) remained independently associated with an MPV ≥8.4 fl (high tertile). The relative risk (odds ratio) of having ischaemic ECG changes for the subjects with MPV ≥8.4 fl was 4.2 (95% confidence interval: 2.5–7.1; p=0.006) with respect to the subjects with lower MPV values. Blood glucose, percent body fat and ischaemic ECG changes were the main MPV determinants in our elderly population.

Keywords

Mean platelet volume - obesity - diabetes mellitus - ischaemic heart disease - elderly
 

  • References

  • 1 Cameron HA, Phillips R, Ibbotson RM. et al. Platelet size in myocardial infarction. Br Med J (Clin Res Ed) 1983; 287: 449-451.
    CrossrefPubMedGoogle Scholar
  • 2 Kilicli-Camur N, Demirtunc R, Konuralp C. et al. Could mean platelet volume be a predictive marker for acute myocardial infarction?. Med Sci Monit 2005; 11: CR387-392.
    PubMedGoogle Scholar
  • 3 Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991; 338: 1409-1411.
    CrossrefPubMedGoogle Scholar
  • 4 Pizzulli L, Yang A, Martin JF. et al. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J 1998; 19: 80-84.
    CrossrefPubMedGoogle Scholar
  • 5 O’Malley T, Langhorne P, Elton RA. et al. Platelet size in stroke patients. Stroke 1995; 26: 995-999.
    CrossrefPubMedGoogle Scholar
  • 6 Greisenegger S, Endler G, Hsieh K. et al. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events?. Stroke 2004; 35: 1688-1691.
    CrossrefPubMedGoogle Scholar
  • 7 Bath P, Algert C, Chapman N. et al. PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004; 35: 622-626.
    CrossrefPubMedGoogle Scholar
  • 8 van der Loo B, Martin JF. Megakaryocytes and platelets in vascular disease. Baillieres Clin Haematol 1997; 10: 109-123.
    CrossrefPubMedGoogle Scholar
  • 9 Thompson CB, Jakubowski JA, Quinn PG. et al. Platelet size as a determinant of platelet function. J Lab Clin Med 1983; 101: 205-213.
    PubMedGoogle Scholar
  • 10 Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996; 7: 157-161.
    CrossrefPubMedGoogle Scholar
  • 11 Yilmaz MB, Saricam E, Biyikoglu SF. et al. Mean platelet volume and exercise stress test. J Thromb Thrombolysis 2004; 17: 115-120.
    CrossrefPubMedGoogle Scholar
  • 12 Hendra TJ, Oswald GA, Yudkin JS. Increased mean platelet volume after acute myocardial infarction relates to diabetes and to cardiac failure. Diabetes Res Clin Pract 1988; 5: 63-69.
    CrossrefPubMedGoogle Scholar
  • 13 Sharpe PC, Trinick T. Mean platelet volume in diabetes mellitus. Q J Med 1993; 86: 739-742.
    PubMedGoogle Scholar
  • 14 Hekimsoy Z, Payzin B, Ornek T. et al. Mean platelet volume in Type 2 diabetic patients. J Diabetes Complications 2004; 18: 173-176.
    CrossrefPubMedGoogle Scholar
  • 15 Papanas N, Symeonidis G, Maltezos E. et al. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 2004; 15: 475-478.
    CrossrefPubMedGoogle Scholar
  • 16 Kario K, Matsuo T, Nakao K. Cigarette smoking increases the mean platelet volume in elderly patients with risk factors for atherosclerosis. Clin Lab Haematol 1992; 14: 281-1287.
    CrossrefPubMedGoogle Scholar
  • 17 Coban E, Yazicioglu G, Berkant Avci A. et al. The mean platelet volume in patients with essential and white coat hypertension. Platelets 2005; 16: 435-438.
    CrossrefPubMedGoogle Scholar
  • 18 Coban E, Ozdogan M, Yazicioglu G. et al. The mean platelet volume in patients with obesity. Int J Clin Pract 2005; 59: 981-982.
    CrossrefPubMedGoogle Scholar
  • 19 Coban Md E, Afacan B.. The effect of rosuvastatin treatment on the mean platelet volume in patients with uncontrolled primary dyslipidemia with hypolipidemic diet treatment. Platelets 2007; 1-4.
    PubMedGoogle Scholar
  • 20 Muscari A, Antonelli S, Bianchi G. et al. Serum C3 is a stronger inflammatory marker of insulin resistance than C-reactive protein, leukocyte count, and erythrocyte sedimentation rate: comparison study in an elderly population. Diabetes Care 2007; 30: 2362-2368.
    CrossrefPubMedGoogle Scholar
  • 21 Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). J Am Med Assoc 2001; 285: 2486-2497.
    CrossrefPubMedGoogle Scholar
  • 22 Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 1974; 32: 77-97.
    CrossrefPubMedGoogle Scholar
  • 23 Joseph AE, Saverymuttu SH, al-Sam S. et al. Comparison of liver histology with ultrasonography in assessing diffuse parenchymal liver disease. Clin Radiol 1991; 43: 26-31.
    CrossrefPubMedGoogle Scholar
  • 24 Endler G, Klimesch A, Sunder-Plassmann H. et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002; 117: 399-404.
    CrossrefPubMedGoogle Scholar
  • 25 Matthews DR, Hosker JP, Rudenski AS. et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419.
    CrossrefPubMedGoogle Scholar
  • 26 Coban E, Bostan F, Ozdogan M. The mean platelet volume in subjects with impaired fasting glucose. Platelets 2006; 17: 67-69.
    CrossrefPubMedGoogle Scholar
  • 27 Coban E, Yilmaz A, Sari R. The effect of weight loss on the mean platelet volume in obese patients. Platelets 2007; 18: 212-216.
    CrossrefPubMedGoogle Scholar
  • 28 Senaran H, Ileri M, Altinbas A. et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 2001; 24: 405-408.
    CrossrefPubMedGoogle Scholar
  • 29 Smyth DW, Martin JF, Michalis L. et al. Influence of platelet size before coronary angioplasty on subsequent restenosis. Eur J Clin Invest 1993; 23: 361-367.
    CrossrefPubMedGoogle Scholar
  • 30 Yang A, Pizzulli L, Luderitz B. Mean platelet volume as marker of restenosis after percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris. Thromb Res 2006; 117: 371-377.
    CrossrefPubMedGoogle Scholar
  • 31 Huczek Z, Kochman J, Filipiak KJ. et al. Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. J Am Coll Cardiol 2005; 46: 284-290.
    CrossrefPubMedGoogle Scholar
  • 32 Gyöngyösi M, Strehblow C, Sperker W. et al. Platelet activation and high tissue factor level predict acute stent thrombosis in pig coronary arteries: prothrombogenic response of drug-eluting or bare stent implantation within the first 24 hours. Thromb Haemost 2006; 96: 202-209.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Cay S, Biyikoglu F, Cihan G. et al. Mean platelet volume in the patients with cardiac syndrome X. J Thromb Thrombolysis 2005; 20: 175-178.
    CrossrefPubMedGoogle Scholar
  • 34 McShine RL, Sibinga S, Brozovic B. Differences between the effects of EDTA and citrate anticoagulants on platelet count and mean platelet volume. Clin Lab Haematol 1990; 12: 277-285.
    PubMedGoogle Scholar
  • 35 Smith NM, Pathansali R, Bath PM. Platelets and stroke. Vasc Med 1999; 4: 165-172.
    CrossrefPubMedGoogle Scholar
  • 36 Hartwig JH.. The platelet: form and function. Semin Hematol 2006; 43: S94-100.
    CrossrefPubMedGoogle Scholar
  • 37 Bancroft AJ, Abel EW, Mclaren M. et al. Mean platelet volume is a useful parameter: a reproducible routine method using a modified Coulter thrombocytometer. Platelets 2000; 11: 379-387.
    CrossrefPubMedGoogle Scholar
  • 38 Kaushansky K, Drachman JG. The molecular and cellular biology of thrombopoietin: the primary regulator of platelet production. Oncogene 2002; 21: 3359-3367.
    CrossrefPubMedGoogle Scholar
  • 39 Kuter DJ. Rosenberg The reciprocal relationship of thrombopoietin (c-Mpl ligand) to changes in the platelet mass during busulfan-induced thrombocytopenia in the rabbit. Blood 1995; 85: 2720-2730.
    PubMedGoogle Scholar
  • 40 Metcalf D, Burgess AW, Johnson GR. et al. In vitro actions on hemopoietic cells of recombinant murine GM-CSF purified after production in Escherichia coli: comparison with purified native GM-CSF. J Cell Physiol 1986; 128: 421-431.
    CrossrefPubMedGoogle Scholar
  • 41 Kimura H, Ishibashi T, Shikama Y. et al. Interleukin-1 beta (IL-1 beta) induces thrombocytosis in mice: possible implication of IL-6. Blood 1990; 76: 2493-2500.
    CrossrefPubMedGoogle Scholar
  • 42 Debili N, Masse JM, Katz A. et al. Effects of the recombinant hematopoietic growth factors interleukin-3, interleukin-6, stem cell factor, and leukemia inhibitory factor on the megakaryocytic differentiation of CD34+ cells. Blood 1993; 82: 84-95.
    PubMedGoogle Scholar
  • 43 Leonard JP, Quinto CM, Kozitza MK. et al. Recombinant human interleukin-11 stimulates multilineage hematopoietic recovery in mice after a myelosuppressive regimen of sublethal irradiation and carboplatin. Blood 1994; 83: 1499-1506.
    PubMedGoogle Scholar
  • 44 Battinelli E, Willoughby SR, Foxall T. et al. Induction of platelet formation from megakaryocytoid cells by nitric oxide. Proc Natl Acad Sci USA 2001; 98: 14458-14463.
    CrossrefPubMedGoogle Scholar
  • 45 Mukaida N. Interleukin-8: an expanding universe beyond neutrophil chemotaxis and activation. Int J Hematol 2000; 72: 391-398.
    PubMedGoogle Scholar
  • 46 Jurcut R, Arsenescu I, Puscariu T. et al. Is interleukin-18 correlated with endothelial dysfunction and platelet activation in patients with unstable angina?. Rom J Intern Med 2005; 43: 199-209.
    PubMedGoogle Scholar
  • 47 Lefer AM, Ma XL.. Cytokines and growth factors in endothelial dysfunction. Crit Care Med 1993; 21: S9-14.
    CrossrefPubMedGoogle Scholar
  • 48 Robinson SD, Harding SA, Cummins P. et al. Functional interplay between platelet activation and endothelial dysfunction in patients with coronary heart disease. Platelets 2006; 17: 158-162.
    CrossrefPubMedGoogle Scholar
  • 49 Gawaz M, Langer H, May AE. Platelets in inflammation and atherogenesis. J Clin Invest 2005; 115: 3378-3384.
    CrossrefPubMedGoogle Scholar
  • 50 Rondinone CM. Adipocyte-derived hormones, cytokines, and mediators. Endocrine 2006; 29: 81-90.
    CrossrefPubMedGoogle Scholar