Abstract 13701: The Relationship Between Diabetes Mellitus, Metabolic Syndrome and Platelet Activity as Measured by Mean Platelet Volume, Tte National Health and Nutrition Examination Survey, 1999-2004
Background: Diabetes mellitus is a major cause of platelet mediated cardiovascular morbidity and mortality. However, the association between platelet activity, diabetes, and glucometabolic control is uncertain. We sought to investigate mean platelet volume (MPV), a marker of platelet size and platelet activity, with the prevalence of diabetes, metabolic syndrome, and degree of glycemic control.
Methods: This is a retrospective analysis of 13,021 participants in the National Health and Nutrition Examination Survey (NHANES) from 1999-2004. Prevalence of diabetes was defined as random glucose >200mg/dL, fasting blood glucose >126mg/dL, or treatment of hyperglycemia with insulin or oral hypoglycemic agents. Presence of metabolic syndrome was determined by the National Cholesterol Education Program Adult Treatment Panel III definition. Odds ratios and 95% CIs were estimated by logistic regression.
Results: The mean prevalence of diabetes was 9.7% and metabolic syndrome was 31%. MPV was significantly higher in the population with diabetes (8.20 femtoliter [fl] vs. 8.06fl, p<0.01), but no significant difference in MPV was observed between those with and without metabolic syndrome (8.09fl vs. 8.07fl, P=0.24). For the components of the metabolic syndrome, MPV was significantly higher in the population with abdominal obesity (p=0.03) and low HDL (p=0.04), and not different in those with high blood pressure (p=0.07), abnormal glucose metabolism (p=0.71) and hypertiglyceridemia (p=0.46). There was a significant correlation between MPV and glucose (p<0.0001) and between MPV and hemoglobin A1C (p<0.0001) in the population with diabetes. These correlations were no longer significant in the non-diabetic population. The adjusted odds of having diabetes rose with increasing MPV levels and were most pronounced in subjects with MPV levels in excess of the 90th percentile (≥9.31fl). The independent association between MPV and diabetes was most apparent in those with the poorest glucose control.
Conclusions: Mean platelet volume is strongly and independently associated with the presence of diabetes. Furthermore, glucose control modifies the association of MPV and diabetes. These data support the role of platelet activity measurement in diabetes.
- © 2011 by American Heart Association, Inc.