Relationship between platelet indices and diabetic retinopathy in patients with type 2 diabetes mellitus: a hospital-based prospective study

Kate E Egor; Elizabeth D  Nkanga; Ernest I Ezeh; Bassey A Etim; Ofem Egbe Enang; Dennis G Nkanga; Marcus Inyama  Asuquo; Edim Enang Egor; Martha-Mary Udoh; Safinatu W Mohammed; Diamond  Tonye-Obene

Authors

Kate E. Egor Department of Ophthalmology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
Elizabeth D. Nkanga UDepartment of Ophthalmology, University of Calabar, Calabar, Cross River State, Nigeria
Ernest I. Ezeh Department of Ophthalmology, University of Calabar, Calabar, Cross River State, Nigeria
Bassey A. Etim Department of Ophthalmology, University of Calabar, Calabar, Cross River State, Nigeria
Ofem Egbe Enang Department of Internal Medicine, University of Calabar, Calabar, Cross River State, Nigeria
Dennis G. Nkanga Department of Ophthalmology, University of Calabar, Calabar, Cross River State, Nigeria
Marcus Inyama Asuquo Department of Haematology, University of Calabar, Calabar, Cross River State, Nigeria
Edim Enang Egor Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, Cross River State, Nigeria
Martha-Mary Udoh Department of Ophthalmology, University of Calabar, Calabar, Cross River State, Nigeria
Safinatu W. Mohammed Department of Ophthalmology, University of Port Harcourt Teaching Hospital, River State, Nigeria
Diamond Tonye-Obene Department of Ophthalmology, University of Port Harcourt Teaching Hospital, River State, Nigeria

Abstract

BACKGROUND

Diabetic retinopathy (DR) is the most common microvascular complication of Type 2 diabetes mellitus (T2DM) patients.^1,2 Increased platelet activity is an important pathogenic factor. Platelet count (PLT), mean platelet volume (MPV) and platelet distribution width (PDW) are important indices that reflect platelet activity.^3-6 These indices may serve as measures associated with the development and progression of DR. This study was aimed at determining the relationship between platelet indices and diabetic retinopathy in patients with type 2 diabetes mellitus.

METHODS

A cross-sectional study was conducted on 181 T2DM participants under the Tenets of the Declaration of Helsinki.⁷ Ethical clearance for this study was obtained from the University of Calabar Teaching Hospital Health Research Ethics Committee, and written informed consent was obtained from each of the eligible participants. After fundoscopic examination, participants were divided into two groups: T2DM with DR and T2DM without DR. Their PLT, MPV and PDW were assayed. Statistical analyses, including Chi-square test, Student T-test, and binary logistic regression, were performed using Statistical Package for the Social Sciences Version 25.0 (Chicago, IL).

RESULTS

The T2DM patients were aged 35 to 80 years, with a mean age of 56.4±10.9 years. There were more females than males, with a ratio of 3:1. The PLT, MPV and PDW were significantly higher among type 2 diabetes mellitus with DR as compared with type 2 diabetes mellitus without DR (Table 1). On regression analysis, elevated PDW was found as an independent determinant for the likelihood of diabetic retinopathy (Odds ratio: 1.259; 95% confidence interval: 1.081-1.466; p = 0.003).

CONCLUSION

The study demonstrated that elevated levels of PLT, MPV and PDW were significantly associated with the development of DR. However, PDW appears to be a more likely predictor of DR in T2DM. We hold the view that the utility of these platelet indices as hemorheological markers of DR makes potential sense for early diagnosis and monitoring of DR.

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