Evaluation of relationship between glycosylated hemoglobin A1c and mean platelet volume levels in patients with type 2 diabetes mellitus who applied to the family medicine and endotem polyclinics Ankara Atatürk Training and Research Hospital from years of 2016-2017

Aim: Diabetes mellitus is a metabolic disease presenting with hyperglycemia. Macrovascular and microvascular complications are majority responsible for mortality and morbidity in diabetic patients which developed over time and reduced quality of life. HbA1c is the most commonly used test for glycemic control. The prevalence of cardiovascular complications in patients with type 2 DM have been reported to be associated with HbA1c and MPV levels in several studies. Improved glycemic control reduces the MPV. Thus, reduction of platelet activity can be achieved with appropriate glycemic control and vascular complications can be prevented or delayed in these patients. It is thought that MPV as a platelet activation indicator can be used as a simple and cost-effective test to monitor DM progression and thus prevent vascular complications in primary health care. The aim of this study was to evaluate the relationship between HbA1c and increased MPV, PDW level in Type 2 DM patients. Matherial and Methods: The study was conducted retrospectively to demographic information and laboratory records of patients over 18 years old who were admitted to Ankara Atatürk Training and Research Hospital Family Medicine and Endotem policlinics for general health check-up and diagnosed with Type 2 DM between June 2016 and April 2017. Fasting plasma glucose, glycosylated hemoglobin A1c, platelet count, mean thrombocyte volume, platelet distribution width, total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol values were collected. Patients according to HbA1c values were divided into 3 groups as control group, HbA1C ≤7 (group 1) and HbA1C> 7 (group 2). It was analyzed comparing with each other. Results: There was no statistically significant difference between groups 1 and 2 in terms of age.( p>0.05) The MPV and PDW values increased as the average age increased. There was a statistically significant difference between the groups in terms of FBG, HbA1c, Triglyceride values.(p=0,001) (p=0,001) (p=0,001) There was no statistically significant difference between LDL and T. cholesterol values between group 1 and group 2.(p=0,330) (p=0,592) There was a positive weak correlation between triglyceride with MPV and PDW, and this correlation was statistically significant.(p = 0.002) (p = 0.014) There is no statistically significant difference between MPV and PDW with LDL and T. Cholesterol.(p=0,171, p=0,361) (p=0,172, p=0,378) As HbA1c increases, PLT decreases and MPV and PDW values increase.This correlation is statistically significant. There is a positive correlation between PDW and MPV and this correlation is statistically significant. (p = 0.001) Conclusıons: Our study showed that impaired glycemic regulation causes an increase in platelet activation markers such as MPV and PDW, and vascular complications can more frequent in these patients.The values obtained, MPV and at the same time PDW as a hematological marker to predict the burden of diabetes mellitus in terms of vascular complications. As a result of our study, it is thought that MPV and PDW can be used as a simple and low cost test to monitor DM progression and thus to prevent and screen vascular complications in primary health care. Early diagnosis and appropriate treatment can delay the onset or progression. However, further studies with larger populations required. Key Words : Type 2, DM, MPV, PDW, HbA1c