Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Sep 15, 2024; 15(9): 1889-1902
Published online Sep 15, 2024. doi: 10.4239/wjd.v15.i9.1889
Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital, Ethiopia
Dereje Abebe Regassa, Gebeyaw Arega Berihun, Bisrat Fikadu Habtu, Woyesa Beyene Haile, Rahel Shumi Nagaash, Girum Tesfaye Kiya
Dereje Abebe Regassa, Bisrat Fikadu Habtu, Rahel Shumi Nagaash, Department of Medical Laboratory Sciences, Wolkite University, Wolkite 11330, Ethiopia
Gebeyaw Arega Berihun, Girum Tesfaye Kiya, School of Medical Laboratory Sciences, Jimma University, Jimma 47, Ethiopia
Woyesa Beyene Haile, Department of Medical Laboratory Sciences, Dire Dawa University, Dire Dawa 3000, Ethiopia
Author contributions: Regassa DA contributed to the conceptualization and design of the study; Regassa DA, Berihun GA, Habtu BF, Haile WB, Nagaash RS, and Kiya GT participated in data acquisition, analysis, and interpretation, and drafted the manuscript; All authors contributed to data analysis, drafting, and approved the final version of the manuscript for submission.
Institutional review board statement: Ethical clearance was approved by the Institutional Review Board of the Jimma University Institute of Health under Reference No. IHRPGD 84412/2022 GC. Additionally, a supplementary letter, with Reference No. BEFO/10339 dated June 13, 2022GC was obtained from the Oromia Regional Office, Department of Research Review Board. This letter was submitted to the administration office of Bishoftu General Hospital and directed to the offices of the medical laboratory head and chronic clinic head. Subsequently, it was sent to both headquarters along with a letter of support from the School of Medical Laboratory Sciences, Jimma University.
Informed consent statement: After obtaining permission from the Hospital administrator, the head of the Chronic Clinic care unit, and the head of the medical laboratory, a clear explanation of the study’s objectives, procedures, benefits, possible risks, and the participant’s right to voluntarily participate, written informed consent was obtained from each study subject. Codes were used instead of participants’ names to protect the confidentiality of the data obtained, and unauthorized access to the collected data was prohibited. For participants with abnormal platelet count indices physicians were informed to ensure appropriate treatment of these patients.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets analyzed during the current study are available from the corresponding author upon reasonable request at sifaanabebe@gmail.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dereje Abebe Regassa, MSc, Lecturer, Department of Medical Laboratory Sciences, Wolkite University, PO Box 07, Wolkite 11330, Ethiopia. sifaanabebe@gmail.com
Received: February 5, 2024
Revised: April 30, 2024
Accepted: August 1, 2024
Published online: September 15, 2024
Processing time: 203 Days and 15.2 Hours
Abstract
BACKGROUND

Diabetes is a chronic metabolic syndrome that has become a global public health problem with significant morbidity and mortality. It is a pro-inflammatory and pro-thrombotic condition characterized by increased platelet activation and alterations in platelet indices. However, the use of platelet indices as predictors of poor glucoregulation has not been fully evaluated in this context, and evidence for their role as predictors of poor glycemic status in diabetic patients is limited.

AIM

To evaluate platelet indices and determine their prognostic significance in relation to inadequate glucoregulation among individuals diagnosed with type 2 diabetes at Bishoftu General Hospital in Ethiopia, from June 15 to August 12, 2022.

METHODS

A comparative cross-sectional study was conducted in 261 participants including 174 individuals with type 2 diabetes mellitus (T2DM) and 87 non-diabetic controls. The systematic random sampling technique was used to select par-ticipants. Data were collected using structured questionnaires, physical measurements, checklists, and laboratory tests. Platelet parameters and fasting blood glucose levels were determined from blood samples using Sysmex-XN550 and CobasC311 analyzers, respectively. The hematology analyzer output was checked and participants were also screened for malaria parasites using a prepared blood smear. Collected data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. The χ2 test, Mann-Whitney U test, Kruskal-Wallis test, post hoc test, Spearman correlation, and receiver operating characteristic curve were used for analysis. A P value < 0.05 was considered statistically significant.

RESULTS

The results of our study indicate that diabetic patients have significantly higher levels of platelet distribution width (PDW), mean platelet volume (MPV), platelet large cell ratio (PLCR), and plateletcrit (PCT) compared to healthy individuals (P < 0.001). Furthermore, these indices were found to be significantly elevated in individuals with poor glycemic control in T2DM compared to those with good glycemic control and healthy controls. We also observed significant correlations between these indices and various anthropometric and clinical variables. Our findings suggest that PDW, with a cut-off value of 15.75 fL and an area under the curve (AUC) of 0.803, MPV, with a cut-off value of 12.25 fL and an AUC of 0.774, PLCR, with a cut-off value of 36.3% and an AUC of 0.775, and PCT, with a cut-off value of 0.24% and an AUC of 0.761, can serve as predictors of poor glycemic control in patients with diabetes mellitus.

CONCLUSION

The observed correlation between diabetic patients and a significant increase in platelet indices has highlighted their potential as predictors of poor glycemic control in diabetes. Therefore, regular screening and profiling of platelet indices is recommended as part of the follow-up process for individuals with diabetes mellitus.

Keywords: Platelet indices; Type 2 diabetes mellitus; Controls; Adult; Ethiopia

Core Tip: The main aim of this study was to evaluate platelet indices and their ability to predict poor glucoregulation in patients with type 2 diabetes mellitus (T2DM). Platelet indices such as platelet distribution width, mean platelet volume, platelet large cell ratio, and plateletcrit showed varying levels of specificity, sensitivity, area under the curve, and cutoff value, and were identified as potential markers of poor glucoregulation in patients with type 2 diabetes. Therefore, these platelet indices could be utilized in the monitoring of patients with T2DM, especially in developing nations like Ethiopia.