Diabetes - Clinical

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Introduction and Aims: The level and prognostic value of various cardiovascular biomarkers differ in patients with proteinuria and renal failure. Mean thrombocyte volume (MPV) is an independent cardiovascular disease (CVD) predictor in non-renal patients. The value of this marker in patients with diabetic nephropathy and factors related with this issue has not been investigated yet. The determination of MPV values in patients, which are at different stages of diabetic nephropathy and to compare these values with normal subjects as well as with diabetic subjects not having nephropathy. Also we aimed to find out the associated factors related with MPV Methods: Totally 621 patients consisting of 4 groups were recruited to this study. Group 1 was the control one consisting of 157 non-diabetic subjects. Group 2 with a number of 160 patients involved the subjects with type 2 diabetes mellitus (DM) which have not shown chronic complications yet. Group 3 with 144 subjects were the diabetic people showing clinical proteinuria (>500 mg/day) where as group 4 which had 160 people were composed of chronic kidney disease patients due to diabetes. For all groups; patients under antiaggregant and/or anticoagulant treatment, subjects with hematological and/or symptomatic cardiovascular disease were excluded from the study. MPV value, platelet count, serum creatinine level, lipid profile, fasting plasma glucose level, proteinuria and microalbuminuria in 24 hour collected urine, glomerular filtration rate (GFR), HbA1c, albumin, parathyroid hormone and demographic values were evaluated. Results: MPV level was found to be increased in diabetic subjects as the complication ratio increased (For all group comparisons p value <0.05). Gender status and smoking did not have effect on MPV values within the groups (p>0.05). While MPV values had positive correlation with the age, serum creatinine, HbA1c, waist circumstance, proteinuria and duration of the diabetes, a negative correlation with the GFR was detected (For all parameters p value <0.001, r values; 0.34, 0.39, 0.53, 0.56, 0.42, 0.56 and -0.36 respectively). Conclusions: MPV values were higher in diabetic groups than normal subjects, and tended to increase with the progression of diabetic nephropathy. HbA1c, waist circumstance, proteinuria and duration of the DM were found to be the most powerful determinants of MPV in patients with DM and diabetic nephropathy.

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