Affiliations: Department of Clinical Biochemistry, Medical School,
University of Athens, "Attikon" General University Hospital, Athens,
Greece | Department of Hematology Laboratory, NIMTS General
Hospital, Athens, Greece | Department of Internal Medicine-Dermatology Section,
Medical School, University of Athens, "Attikon" General University Hospital, Athens, Greece
Note: [] Corresponding author: Maria Dalamaga, MD, MS, MPH, PhD, Ass.
Professor in Clinical Biochemistry, 19, 28th October, Agia Paraskevi, Post Code
15341 Athens, Greece. Tel.: +30 6977440344; Fax: +30 2106082467; E-mail:
madalamaga@med.uoa.gr
Abstract: Background: Altered thrombocyte morphology and function have been
reported in patients with diabetes mellitus (DM) type 2. The aim of the present
study was to determine the associations between platelet morphology markers and
hemoglobin A1C (HbA_{1c}), fasting glucose (FG), hypertension and coronary
heart disease (CHD) in patients with myelodysplastic syndromes (MDS) and DM, in
patients with DM and in controls. Methods: This cross-sectional study
included 30 cases with primary MDS with normal platelet count and non-insulin
dependent diabetes, 30 non-insulin dependent diabetic patients and 30
non-diabetic, non-MDS controls matched on age and gender. Results: After
adjusting for body mass index, platelet number, CHD and hypertension,
HbA_{1c} and FG were significant predictors of mean platelet volume (MPV) and
platelet distribution width (PDW) in diabetic patients. There was no
correlation between platelet parameters and HbA_{1c} or FG in diabetic MDS
patients. In controls, FG and hypertension predicted significant differences in
platelet morphology. Platelet count correlated with platelet morphology in
diabetic MDS and control groups, but not in diabetics. Conclusions: MPV and PDW are associated with glycemic indices in diabetic patients but not in
diabetic MDS patients with normal platelet counts. Non-diabetic controls also
exhibit FG related changes in platelet morphology. This suggests other factors
inherent to bone marrow dysplasia, platelet turnover and biochemistry, or
vascular environment affect platelet morphology in diabetic MDS patients even
with normal platelet count. Platelet morphology in this population may be an
early marker for myelodysplasia. These findings also support platelet
morphology change as a marker for elevated macrovascular disease risk.
Keywords: Myelodysplastic syndrome, diabetes, glycohemoglobin, glucose, mean platelet volume
