Analysis of changes in tromboside indicators in morbid obesity treatment

Aim: In this study, thrombocyte indicators of weight loss recorded in 6 months with obesity treatment in cases diagnosed with morbid obesity; it is aimed to investigate the effects on mean platelet volume (MPV), platecrit (PCT), platelet to lymphocyte ratio (PLR) and platelet distribution width (PDW). Method: This study includes 300 patients who were diagnosed with morbid obesity by applying and regularly examined by the Obesity and Diabetes Center of Zonguldak Bülent Ecevit University (ZBEÜ) between May 1, 2017 and March 2019. Demographic, clinical and biochemical data of the cases were defined according to the International Prognostic Scoring System (IPSS). It is studied the height, weight, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, complete blood counts [Platelet (PLT) count, lymphocyte, platecrit (PCT), platelet to lymphocyte ratio (PLR) and platelet distribution width (PDW)], biochemical data [triglyceride (TAG), LDL-cholesterol, fasting blood sugar (AKŞ)] in the beginning and 6th mounth control parameters. Statistical analysis of the study was done in SPSS 19.0 package program. Descriptive statistics of qualitative variables are determined by frequency and percentage; quantitative variables are given with arithmetic mean, standard deviation, median, minimum and maximum values. The consistency of continuous variables to normal distribution was examined with the Shapiro Wilk test. Mann Whitney U test in comparisons between non-normally distributed variables between independent groups; Wilcoxon Test was used for intragroup comparisons. In the comparison of qualitative variables between groups, the Yates Chi-square Test was used. In all statistical analyzes in the study, results below p value of 0.05 were considered statistically significant. Results: In the study, the data of 300 morbid obese cases with BMI 40 and above were analyzed. 267 (89%) of the cases were female and 33 (11%) were male and the majority of the group were female. The average age of this group was 48.91 ± 11.68 years, BMI average was 46.53 ± 5,15 kg / m2, the lowest body mass index was 40 kg/m2, the highest body mass index was 66,4 kg/m2. In the analysis made; mean fasting blood glucose levels of morbidly obese patients were above the normal defined range with 116 mg /dl. Waist circumference was found 124 cm, which is above the acceptible highest waist circumference number 110 cm. The mean triglyceride levels were above 163 mg/dl with the metabolic syndrome diagnostic criteria of 150 mg/dl. Blood pressure averages ranged from systolic pressure to 135,6 diastolic pressure to 84,8 to pre-hypertension. The values in the initial weight of all cases were compared with the parameters taken at the end of the 6th month when they lost weight. Weight loss, BMI and waist circumference change were statistically significant (p<0.05). The improvement in systolic and diastolic blood pressure was statistically significant (p<0.05). It was determined that the decrease in fasting blood sugar, LDL-k and TAG levels was statistically significant (p<0.05). The decrease in platelet counts with weight loss was statistically significant (p<0.05). PDW, MPV, PCT, PLR values, which are platelet parameters, decreased with weight loss, but this change was not statistically significant (p>0.05). Morbidly obese patients included in the study were divided into two groups as, those who lost 10% or more of their weight were divided into "Meaningful" group, and those who lost less than 10% of their weight "Meaningless". In the statistical analysis, the decrease recorded in the platelet counts with weight loss was found to be statistically significant (p <0.05). The PDW and MPV percentage change rates, which are among the platelet parameters, decreased compared to the baseline values as a result of weight loss; but, this difference was found statistically insignificant. The change in PCT number and platelet to lymphocyte ratio (PLR) with weight loss was found statistically significant. This showed that PCT number and PLR, which are platelet indicators, may be related to the degree of weight loss. Conclusion: In this study, the changes in platelet count and platelet indicators were investigated in patients with morbid obesity after 6 months of weight loss. It was found that the number of PLT, PCT and PLR decreased statistically significantly with p <0.05 in the group that lost 10% or more. We have found that platelet indicators, which have been investigated to show a tendency to thrombosis, can be used as a treatment parameter in the follow-up and treatment of obesity that causes many diseases such as coronary artery disease, cerebrovascular event, deep vein thrombosis, myocardial infarction. Platelet indicators are simple, inexpensive hemogram parameters that can be used in the follow-up of obese patients. They are also promising prognosis indicators. PLT number and platelet parameters can be used in the monitoring of comorbidities of obese patients, instead of definitive but high cost examination such as coronary angiography which is used for coronary plaque detection, ultrasound that is used in finding deep vein thrombosis and computed tomography for cerebrovascular event. Large-scale cohort group studies, which eliminate the weaknesses of the study, are needed to better evaluate the outcome. Keywords: Morbid obesity, metabolic syndrome, obesity treatment, platelet count, platelet parameters, platelet indicators, PCT, PDW, PLR, MPV