Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital, Ethiopia

doi:10.4239/wjd.v15.i9.1889

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Sep 15, 2024 (publication date) through Aug 27, 2024

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Control Study

World J Diabetes. Sep 15, 2024; 15(9): 1889-1902
Published online Sep 15, 2024. doi: 10.4239/wjd.v15.i9.1889

Table 1 Socio-demographic characteristics of the study participants at Bishoftu General Hospital, central Ethiopia, from June 15 to August 12, 2022, n (%)

Variables	Categories	T2DM patients	Healthy controls	P value
Age (years)	Median (IQR)	33 (28-39)	31 (27-38)	0.322
Sex	M	139 (79.9)	66 (75.9)	0.46
Sex	F	35 (20.1)	21 (24.1)	0.46
Residence	Urban	147 (84.5)	68 (78.2)	0.21
Residence	Rural	27 (15.5)	19 (21.8)	0.21
Educational level	Unable to write & read	8 (4.6)	2 (2.3)	0.04
	Can write and read	11 (6.3)	2 (2.3)
	Primary school	25 (14.4)	9 (10.3)
	Secondary school	66 (37.9)	50 (57.5)
	Higher education	64 (36.8)	24 (27.6)
Occupation status	Unemployed	37 (21.3)	37 (42.5)	0.004
	Merchant	47 (27.0)	20 (23)
	Farmer	25 (14.4)	7 (8)
	Gov’t employee	65 (37.4)	23 (26.4)
Marital status	Single	59 (33.9)	33 (37.9)	0.94
	Married	75 (43.1)	35 (40.2)
	Divorced	29 (16.7)	14 (16.1)
	Widowed	11 (6.3)	5 (5.7)

IQR: Interquartile range; T2DM: Type 2 diabetes mellitus; M: Male; F: Female.

Table 2 Anthropometric and clinical characteristics distribution of study participants at Bishoftu General Hospital, central Ethiopia, from June 15 to August 12, 2022, n (%)

Variables	Categories		T2DM patients	Healthy control	P value
BMI (kg/m²)	Median (IQR)		23.2 (20.6-25.3)	20.3(19.1-22.03)	< 0.001
WC (cm)	Median (IQR)		90 (87-97)	89 (86-92)	0.017
WHR	Median (IQR)		0.91 (0.86-0.98)	0.87 (0.83-0.92)	< 0.001
SBP (mmHg)	Median (IQR)		141 (133-150)	131 (126-135)	< 0.001
DBP (mmHg)	Median (IQR)		101 (94.0-109.0)	90 (87.0-92.0)	< 0.001
FBG level (mg/dL)	Median (IQR)		131.2 (114.7-150)	-	-
Duration of DM illness (years)	Median (IQR)		6.0 (3.0-10.0)	-	-
Presence of microvascular complications at least one type	Poor glycemic DM (87)	Yes	45 (51.7)	-	-
	Poor glycemic DM (87)	No	42 (48.3)	-
	Good glycemic DM (87)	Yes	0 (0)	-
	Good glycemic DM (87)	No	87 (100)	-
Current oral hypoglycemic therapy used by DM patients	Glibenclamide		41 (23.60)	-	-
	Metformin		89 (51.1)	-
	Metformin + Glibenclamide		44 (25.3)	-

IQR: Interquartile range; T2DM: Type 2 diabetes mellitus; BMI: Body mass index; WC: Waist circumference; WHR: Waist to hip ratio; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; DM: Diabetes mellitus; FBG: Fasting blood glucose.

Table 3 Comparisons of platelet indices between diabetic patients and the healthy control group at Bishoftu Hospital, central Ethiopia, from June to August 2022

Platelet parameters	Diabetes mellitus group, media (IQR)	Healthy control group, media (IQR)	P value
Platelet count (10³/µL)	198 (160-291)	208 (170-232)	0.269
PDW (fL)	13.7 (11.8-20.1)	11.1 (10.1-13.1)	< 0.001
MPV (fL)	11.1 (10.3-13.2)	9.9 (9.6-10.9)	< 0.001
PLCR (%)	33.2 (27.3-46.2)	24.5 (21.2-31.8)	< 0.001
PCT (%)	0.24 (0.2-0.32)	0.23 (0.19-0.26)	0.001

IQR: Interquartile range; PDW: Platelet distribution width; MPV: Mean platelet volume; PLCR: Platelet large cell ratio; PCT: Plateletcrit.

Table 4 Kruskal Wallis and Bonferroni pairwise comparisons of platelet indices between poor glycemic controlled type 2 diabetes mellitus, good glycemic controlled type 2 diabetes mellitus, and healthy controls at Bishoftu Hospital, central Ethiopia, from June to August 2022

Platelet indices	Poorly controlled T2DM median (IQR)	Good controlled T2DM median (IQR)	Healthy controls median (IQR)	Kruskal Wallis test	Post hoc test (Bonferroni test)
Platelet indices	Poorly controlled T2DM median (IQR)	Good controlled T2DM median (IQR)	Healthy controls median (IQR)	P value	^aP value	^bP value	^cP value
PLT count (10³/µL)	188 (159-350)	210 (162-251)	208 (170-232)	0.512	-	-	-
PDW (fL)	19.1 (13.3-24.2)	12.4 (11.6-13.7)	11.1 (10.1-13.1)	< 0.001	0.009	< 0.001	< 0.001
MPV (fL)	12.8 (10.8-14.8)	10.7 (10-11.2)	9.9 (9.6-10.9)	< 0.001	0.01	< 0.001	< 0.001
PLCR (%)	44.4 (31.6-55.2)	30 (25.8-34)	24.5 (21.2-31.8)	< 0.001	0.009	< 0.001	< 0.001
PCT (%)	0.27 (0.22-0.38)	0.23 (0.2-0.28)	0.23 (0.19-0.26)	< 0.001	1.000	0.001	< 0.001

^aP < 0.05 represents comparison of good glycemic controlled type 2 diabetes mellitus (T2DM) and the healthy control group.

^bP < 0.05 represents comparison of good glycemic controlled T2DM and poor controlled T2DM.

^cP < 0.05 represents comparison of healthy controls and poor controlled T2DM group.

PDW: Platelet distribution width; MPV: Mean platelet volume; PLCR: Platelet large cell ratio; PCT: Plateletcrit; IQR: Interquartile range; T2DM: Type 2 diabetes mellitus; PLT: Platelet counts.

Table 5 Comparisons of platelet indices between microvascular complicated type 2 diabetes mellitus and uncomplicated type 2 diabetes mellitus patients at Bishoftu Hospital, central Ethiopia, from June to August 2022

Platelet indices	Complicated diabetic patients, median (IQR) (n = 45)	Uncomplicated diabetic patients, median (IQR) (n = 42)	P value
Platelet count (10³/µL)	169 (142-187)	334 (193-422)	< 0.001
PDW (fL)	23.1 (19.1-24.8)	14.7 (12-18.1)	< 0.001
MPV (fL)	13.9 (12.9-15.1)	11.4 (10.1-12.7)	< 0.001
PLCR (%)	52.8 (47.0-57.0)	33.3 (26.2-42.8)	< 0.001
PCT (%)	0.24 (0.20-0.28)	0.38 (0.27-0.42)	< 0.001

PDW: Platelet distribution width; MPV: Mean platelet volume; PLCR: Platelet large cell ratio; PCT: Plateletcrit; IQR: Interquartile range.

Table 6 Spearman’s correlation (rho) of platelet indices with body mass index, waist circumference, & waist-to-hip ratio among type 2 diabetes mellitus patients and healthy controls at Bishoftu Hospital from June to August 2022

PLT indices	T2DM patient group			Healthy control group
PLT indices	BMI rho (P)	WC rho (P)	WHR rho (P)	BMI rho (P)	WC rho (P)	WHR rho (P)
PLT	0.092 (0.227)	0.117 (0.124)	0.192 (0.011)^a	-0.209 (0.052)	0.079 (0.467)	0.075 (0.49)
PDW	0.162 (0.033)^a	0.063 (0.408)	0.072 (0.348)	0.126 (0.246)	-0.117 (0.282)	-0.129 (0.234)
MPV	0.132 (0.081)	0.058 (0.445)	0.033 (0.667)	0.142 (0.188)	-0.043 (0.692)	-0.049 (0.652)
PLCR	0.179 (0.018)^a	0.044 (0.568)	0.016 (0.833)	0.135 (0.212)	-0.082 (0.448)	-0.076 (0.483)
PCT	0.199 (0.009)^b	0.208 (0.006)^b	0.298 (0.001)^b	-0.088 (0.417)	0.083 (0.444)	0.159 (0.142)

^aP < 0.05 correlation is significant at 0.05 level (two-tailed); rho is Spearman’s correlation coefficient.

^bP < 0.01 Correlation is significant at 0.01 level; rho is Spearman’s correlation coefficient.

PDW: Platelet distribution width; MPV: Mean platelet volume; PLCR: Platelet large cell ratio; PCT: Plateletcrit; IQR: Interquartile range; T2DM: Type 2 diabetes mellitus; BMI: Body mass index; WC: Waist circumference; WHR: Waist-to-hip ratio; PLT: Platelet counts.

Table 7 Spearman’s correlation (rho) of platelet indices with systolic blood pressure, diastolic blood pressure, fasting blood sugar & duration of diabetes mellitus among type 2 diabetes mellitus and control groups at Bishoftu Hospital, from June to August 2022

Platelet indices	Diabetic patient group				Healthy control group
Platelet indices	SBP rho (P)	DBP rho (P)	FBS rho (P)	Duration rho (P)	SBP rho (P)	DBP rho (P)
PLT	07 (0.358)	0.067 (0.378)	0.048 (0.529)	0.133 (0.137)	-0.024 (0.826)	-0.071 (0.511)
PDW	0.416 (0.001)^b	0.44 (0.001)^b	0.525 (0.001)^b	0.351 (0.001)^b	-0.12 (0.27)	0.031 (0.779)
MPV	0.355 (0.001)^b	0.398 (0.001)^b	0.474 (0.001)^b	0.298 (0.001)^b	-0.061 (0.575)	-0.005 (0.964)
PLCR	0.421 (0.001)^b	0.394 (0.001)^a	0.509 (0.001)^b	0.372 (0.001)^b	-0.059 (0.586)	-0.005 (0.965)
PCT	0.12 (0.113)	0.206 (0.006)^b	0.164 (0.03)^a	0.078 (0.304)	-0.036 (0.738)	0.139 (0.198)

^aP < 0.05 correlation is significant at 0.05 level (two-tailed); rho is Spearman’s correlation coefficient.

^bP < 0.01 Correlation is significant at 0.01 level; rho is Spearman’s correlation coefficient.

SBP: Systolic blood pressure; DBP: Diastolic blood pressure; FBS: Fasting blood sugar; DM: Diabetes mellitus; PLT: Platelet count.

Table 8 Determination of predictive values of platelet indices for poor glycemic control of type 2 diabetes mellitus patients attending Bishoftu Hospital, from June to August 2022

Platelet indices	Sensitivity (%)	Specificity (%)	PPV (%)	NPV (%)	Cut-off value	AUC	95%CI	P value
PDW (fL)	68	90	87.2	73.8	≥ 15.75	0.803	0.735-0.871	< 0.001
MPV (fL)	61	93	89.7	70.5	≥ 12.25	0.774	0.702-0.847	< 0.001
PLCR (%)	69	83	80.2	72.3	≥ 36.3	0.775	0.704-0.838	< 0.001
PCT (%)	83	57	65.9	87.7	≥ 0.24	0.761	0.69-0.831	< 0.001

PPV: Positive predictive value; NPV: Negative predictive value; AUC: Area under the curve; PDW: Platelet distribution width; MPV: Mean platelet volume; PLCR: Platelet large cell ratio; PCT: Plateletcrit.

Citation: Regassa DA, Berihun GA, Habtu BF, Haile WB, Nagaash RS, Kiya GT. Platelet indices as predictors of poor glucoregulation in type 2 diabetes mellitus adults at Bishoftu General Hospital, Ethiopia. World J Diabetes 2024; 15(9): 1889-1902
URL: https://www.wjgnet.com/1948-9358/full/v15/i9/1889.htm
DOI: https://dx.doi.org/10.4239/wjd.v15.i9.1889