The authors declare that they have no competing interest.
BM, BT, ABJ, OW and AS collected the data. BM and BT participated in study design and drafted the manuscript. BM performed data analysis. WF conceived of the study and together with WM participated in its design and coordination and prepared the final version of the manuscript. All authors read and approved the final manuscript.
Platelet hyperreactivity is a factor which contributes towards increased risk of cardiovascular events in adults with type 2 diabetes (T2DM). However, little is known about platelets’ disturbances among children with type 1 diabetes (T1DM). The aim of the study was to investigate whether platelets’ morphology or function are altered in children with type 1 diabetes, potentially predisposing them to cardiovascular events in the future.
The study group consisted of 389 children with T1DM during the 2008–2010 period. Patients with acute diabetes complications and ongoing infections were excluded from the study. An equinumerous (N = 389), age and sex-matched control group was assembled from children undergoing routine, minor surgical procedures in the same hospital. Platelet: count (PLT), mean volume (MPV), distribution width (PDW) and platelet large cell ratio (P-LCR) as well as HbA1c levels were measured. For statistical analysis we used Chi-square tests, the student’s t-test, one-way analysis of variance (ANOVA), the Pearson’s correlation coefficient and linear regression models in order to adjust for covariates.
MPV, PDW and P-LCR were significantly higher among children with diabetes in comparison with the control group (MPV 10.47+/−0.85 fL vs 10.23+/−0.94 fL, p = 0.0007; PDW 12.09+/−1.80% vs 11.66+/−1.90%, p = 0.0032; P-LCR 28.21+/−6.15% vs 26.29+/−6.38%, p < 0.0001). PLT however, were shown to be similar (263.55+/−60.04 vs 268.77+/−65.78 103/μl; p = 0.5637). In both cases and controls age was inversely correlated with platelet count (for study group: r = −0.30, p < 0.0001; for control group: r = −0.34, p < 0.0001), positively correlated with MPVs (r = 0.20, p < 0.0001; r = 0.26, p < 0.0001), PDW (r = 0.25, p < 0.0001 and r = 0.24, p < 0.0001) and P-LCR (r = 0.26, p < 0.0001; r = 0.26, p < 0.0001). After adjustment for confounding factors, higher platelet counts were associated with poorer metabolic control (beta = 0.20; 0.0001).
Platelets of paediatric patients with T1DM show morphological evidence of hyperreactivity (higher MPV, PDW and P-LCR), while poorer metabolic control increases their number potentially predisposing the patients to future cardiovascular events.
Glassman AB. Platelet abnormalities in diabetes mellitus. Ann Clin Lab Sci. 1993;23(1):47–50. PubMed
Sharpe PC, Trinick T. Mean platelet volume in diabetes mellitus. Q J Med. 1993;86(11):739–42. PubMed
Lattanzio S, Santilli F, Liani R, Vazzana N, Ueland T, Di Fulvio P, et al. Circulating dickkopf-1 in diabetes mellitus: association with platelet activation and effects of improved metabolic control and low-dose aspirin. J Am Heart Assoc. 2014; doi: 10.1161/JAHA.114.001000.
Standards of medical care in diabetes-2014. Diabetes Care. 2014;37(Suppl 1):S14-80.
Wong T, Pedvis L, Frojmovic M. Platelet size affects both micro- and macro-aggregation: contributions of platelet number, volume fraction and cell surface. Thromb Haemost. 1989;62(2):733–41. PubMed
Debili N, Masse JM, Katz A, Guichard J, Breton-Gorius J, Vainchenker W. 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(1):84–95. PubMed
Kahler P, Grevstad B, Almdal T, Gluud C, Wetterslev J, Vaag A, et al. Targeting intensive versus conventional glycaemic control for type 1 diabetes mellitus: a systematic review with meta-analyses and trial sequential analyses of randomised clinical trials. BMJ Open. 2014;4(8):e004806. CrossRefPubMedPubMedCentral
- Altered Platelets’ morphological parameters in children with type 1 diabetes – a case-control study
- BioMed Central
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