The effect and correlation of smoking with platelet indices, neutrophil lymphocyte ratio and platelet lymphocyte ratio

ABSTRACT Introduction: Smoking is associated with the occurrence and progression of cardiovascular diseases, inflammatory disorders and malignancies. Objective: To study the platelet indices, neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) in smokers and their correlation with smoking pack-years. Method: A total of 110 smokers and 110 non-smokers were included. The smokers were grouped into three groups: mild (<5 pack-years), moderate (5-10 pack-years) and heavy (>10 pack-years). The platelet count, plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) were noted. The NLR and PLR were calculated and the statistical analysis was made using the Student's T-test, Analysis of Variance (ANOVA) and Spearman's correlation coefficient. Results: The platelet count, PCT and PDW were significantly higher with mean values: 218.56 ± 121.31 vs 203.23 ± 80.35 (p-value = 0.038), 0.27 ± 0.10 vs 0.26 ± 0.10 (p-value = 0.041) and 12.54 ± 1.45 vs 11.99 ± 1.70 (p-value = 0.001) in smokers and non-smokers, respectively. The PLR differed significantly with mean values: 119.40 ± 84.81 in smokers and 181.99 ± 313.09 in non-smokers, with a p-value of 0.045. A significant positive correlation was found between pack-years of smoking and platelet count and PLR with the Pearson correlation coefficient of 0.250 and 0.198 and p-values, 0.008 and 0.037, respectively. The Platelet Count, PCT, MPV and PDW varied significantly between mild, moderate and heavy smoker groups, with p-values of 0.045, 0.010, 0.015 and 0.017, respectively. Conclusion: The platelet indices and inflammatory markers NLR and PLR are derived from routine blood investigations, which are easily available and inexpensive. The monitoring of platelet indices, along with the PLR, can be used as early predictors of morbidity in smokers.

Role of platelet distribution width and plateletcrit in assessment of nonthrombocytopenic preeclampsia and eclampsia in a tertiary care hospital of Odisha: an observational study

Background: Preeclampsia (PE) is a major cause of maternal and foetal morbidity and mortality in pregnancy. A decreased platelet count is observed during the progression of preeclampsia, and is considered a marker of the severity of preeclampsia. Considering the role of the PDW, PCT and platelet indices during the disease, the aim of this study was to evaluate the feasibility of using platelet indices as a severity marker for PE.Methods: This was a prospective, observational study, hospital-based study, from 2017-19 with 400 pregnant women being included on the basis of a predefined inclusion and exclusion criteria, through antenatal clinic, and labour room of the department of obstetrics and gynecology, S. C. B. Medical College, Cuttack, Odisha, India.Results: Study found that platelet count and plateletcrit showed a significant negative correlation with MAP whereas platelet distribution width showed a maximum positive correlation. In the preeclampsia group, subjects with PCT <0.22% were at risk of developing severe disease with a sensitivity of 53.5% and a high specificity of 85.5%. The AUC of 0.75 showed that it has a good predictability. In the eclampsia group, subjects with PCT <0.16% had a risk of developing severe disease with a sensitivity of 89.5% and specificity of 73.7%. The AUC 0.9 shows PCT to be a good predictor for assessing severity of eclampsia.Conclusions: This study suggests that platelet distribution width and plateletcrit are useful in risk evaluation of preeclampsia. These are a valid measurement tool to predict the severe progression of PE even when normal platelet counts are observed.

A correlation between platelet indices and preeclampsia

ABSTRACT Background: Preeclampsia is one of the major health problems causing maternal morbidity and mortality, complicating 3-8% of pregnancies. It has been suggested that the alterations in the coagulation and fibrinolysis play a role in the pathogenesis of preeclampsia. The markers of platelet activation include platelet count, platelet distribution width, mean platelet volume and plateletcrit. Study design: It was a case-controlled study which included a total of 60 patients (30 cases and 30 controls). Blood samples were collected and the platelet indices - platelet count, plateletcrit, mean platelet volume and platelet distribution width - were evaluated using the Sysmex XN1000 and compared between the two groups. Results: The MPV and PDW also showed a significant difference (p > 0.05) between the two groups, with a significant positive correlation with increasing blood pressure (MPV - r = +0.6126, p < 0.05 and PDW - r = +0.6441, p < 0.05). The PC and PCT had lower values in the preeclampsia patients, however the difference between the two groups was not statistically significant. Conclusion: The MPV and PDW showed a significant difference between the two groups and increasing values with increasing BP. However, the PC and PCT in our study did not show a significant correlation with preeclampsia. Thus, the platelet indices, mainly the MPV and PDW, which are economical and easily available, can be reliable in the prediction and early diagnosis of preeclampsia, as well as a marker for the severity of preeclampsia.

Red cell distribution width may help to discriminate synthetic cannabinoid users in the emergency department

Background: Differentiating bonsai users from the suspected users is problematic. The aim was to determine whether bonsai using men and the others can be distinguished via the hemogram parameters such as mean corpuscular volume (MCV), mean platelet volume (MPV), red cell distribution width (RDW) and Plateletcrit (PCT).Methods: In this retrospective case-control study, a total of 138 men admitted to ED were investigated in Kanuni Sultan Suleyman Hospital, Istanbul, Turkey in 2014. The patients were divided into 2 groups which were the first group had included bonsai users whereas the second group was consist of men not using bonsai. Complete blood count tests were performed on all patients.Results: Among the suspected bonsai users, 68 were diagnosed to use bonsai. It was found that MCV, RDW and PCT levels were significantly higher in bonsai users compared to controls while MPV levels were lower in the users. Author put all these parameters to logistic regression analysis model using enter method. RDW (OR: 3.98, 95%CI:2.180-7.266, p<0.0001), MPV (OR:0.526, 95%CI:0.373-0.742, p<0.0001) and PCT (OR:<0.0001, 95%CI:0.000-0.058, p=0.007) were independent variables to discriminate bonsai users from that of suspected users. The most promising parameter to differentiate bonsai users from suspected users was RDW (AUC: 0.748, 95%CI: 0.668-0.828, p:<0.0001). The optimal cut-off value was found as 10.8 for RDW with a sensitivity, specificity, +LR and -LR as 66.2%, 64.3%, 1.85, 0.53, respectively.Conclusions: RDW marker can be a reliable parameter to discriminate bonsai users from that of suspected users with moderate sensitivity and specificity.

The relationship between the continuous opening of arterial catheters and platelet parameters in preterm infants / 中华实用儿科临床杂志

Objective@#To analyze the correlation between the continuous opening of patent ductus arteriosus(PDA) in preterm infants and platelet parameters in the first 24 hours of life.@*Methods@#The preterm infants (gestational age <34 weeks) admitted to Neonatal Intensive Care Unit(NICU)of the Affiliated Xuzhou Hospital of Southeast University from November 2012 to July 2018 were enrolled.The following data were collected retrospectively: the platelet parameters in the first 24 hours of life, clinical factors possibly related to continuous opening of PDA, and echocardiography examination fin-dings on the 4th-7th day after birth.According to the diagnostic criteria of PDA, all preterm infants were divided into symptomatic PDA(sPDA) group, non-sPDA (nsPDA) group, and non-PDA (nPDA) group.SPSS 20.0 software was used for data analysis.Data were analyzed by Chi-square test, LSD or Tambane′s T2 of One-Way analysis of variance, and binary Logistic regression analysis of the receiver operating characteristic (ROC) curve.@*Results@#Totally 760 preterm infants were chosen, and among them there were 67 cases (8.8%) in sPDA group, 106 cases (14.0%) in nsPDA group, and 587 cases (77.2%) in nPDA group.There were significant diffe-rences in the terms of gestation age, birth weight, platelet counts (PLT), and plateletcrit (PCT) in the first 24 hours of life among 3 groups (all P<0.05). The smaller gestation age, the lower birth weight, the lower PLT and PCT in the first 24 hours of life, and the higher incidence of PDA in preterm infants.There were no significant differences in the platelet distribution width, mean platelet volume, and platelet large cell ratio in the first 24 hours of life among 3 groups (all P>0.05). The low lower birth weight and PCT in the first 24 hours of life were independent risk factors for the occurrence of sPDA in preterm infants (P=0.013, 0.000). The risk of occurrence of sPDA in preterm infants will be increased by 3.279-fold (95%CI: 2.369-4.479) if PCT in the first 24 hours of life is decreased by 0.10%.The area under the ROC curves of PCT and PLT in the first 24 hours of life for prediction of sPDA in preterm infants was 0.757 (95%CI: 0.712-0.814) and 0.718 (95%CI: 0.671-0.768), respectively.The best cutoff values of PCT and PLT were 0.178% (sensitivity was 75.7%, specificity was 71.9%) and 207.5×109/L (sensitivity was 71.4%, specificity was 63.2%).@*Conclusions@#The continuous opening of PDA in preterm infants may have correlation with the platelet.The low PCT, rather than PLT, in the first 24 hours of life was an independent risk factor and has medium predictive value for the occurrence of sPDA in preterm infants on the 4th-7th day after birth.

The relationship between the continuous opening of arterial catheters and platelet parameters in preterm infants / 中华实用儿科临床杂志

Objective To analyze the correlation between the continuous opening of patent ductus arteriosus (PDA) in preterm infants and platelet parameters in the first 24 hours of life.Methods The preterm infants (gestational age ＜ 34 weeks) admitted to Neonatal Intensive Care Unit(NICU) of the Affiliated Xuzhou Hospital of Southeast University from November 2012 to July 2018 were enrolled.The following data were collected retrospectively:the platelet parameters in the first 24 hours of life,clinical factors possibly related to continuous opening of PDA,and echocardiography examination fin-dings on the 4th-7th day after birth.According to the diagnostic criteria of PDA,all preterm infants were divided into symptomatic PDA (sPDA) group,non-sPDA (nsPDA) group,and non-PDA (nPDA) group.SPSS 20.0 software was used for data analysis.Data were analyzed by Chi-square test,LSD or Tambane's T2 of One-Way analysis of variance,and binary Logistic regression analysis of the receiver operating characteristic (ROC) curve.Results Totally 760 preterm infants were chosen,and among them there were 67 cases (8.8％) in sPDA group,106 cases (14.0％) in nsPDA group,and 587 cases (77.2％) in nPDA group.There were significant differences in the terms of gestation age,birth weight,platelet counts (PLT),and plateletcrit (PCT) in the first 24 hours of life among 3 groups (all P ＜ 0.05).The smaller gestation age,the lower birth weight,the lower PLT and PCT in the first 24 hours of life,and the higher incidence of PDA in preterm infants.There were no significant differences in the platelet distribution width,mean platelet volume,and platelet large cell ratio in the first 24 hours of life among 3 groups (all P ＞ 0.05).The low lower birth weight and PCT in the first 24 hours of life were independent risk factors for the occurrence of sPDA in preterm infants (P =0.013,0.000).The risk of occurrence of sPDA in preterm infants will be increased by 3.279-fold (95 ％ CI:2.369-4.479) if PCT in the first 24 hours of life is decreased by 0.10％.The area under the ROC curves of PCT and PLT in the first 24 hours of life for prediction of sPDA in preterm infants was 0.757 (95 ％ CI:0.712-0.814) and 0.718 (95 ％ CI:0.671-0.768),respectively.The best cutoff values of PCT and PLT were 0.178％ (sensitivity was 75.7％,specificity was 71.9％) and 207.5 × 109/L (sensitivity was 71.4％,specificity was 63.2％).Conclusions The continuous opening of PDA in preterm infants may have correlation with the platelet.The low PCT,rather than PLT,in the first 24 hours of life was an independent risk factor and has medium predictive value for the occurrence of sPDA in preterm infants on the 4th-7th day after birth.

Association Between High Platelet Indices and Proteinuria in Patients With Hypertension

BACKGROUND: We aimed to determine the association between platelet indices including plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and proteinuria associated with hypertension (HT) as well as the relative power of each to predict proteinuria. METHODS: The study included 223 patients (68 men and 155 women) with primary HT. PCT, MPV, PDW, and proteinuria levels were measured. The patients were divided into two groups according to proteinuria status based on 24-hr urinary protein excretion: proteinuria (+) group (15 men and 40 women) and proteinuria (-) group (53 men and 115 women). RESULTS: The mean and SD of platelet count, PDW, PCT, and MPV were 278.8+/-49.6x10(9)/L, 13.5+/-1.8%, 0.31+/-0.07%, and 11.3+/-2.6 fL, respectively. The mean platelet count, PCT, MPV, and PDW were significantly higher in the proteinuria (+) group than in the proteinuria (-) group (P<0.05); there were no significant differences in the other blood parameters between the two groups. The platelet count, PCT, MPV, and PDW were independent risk factors predictive of proteinuria according to a stepwise regression analysis of PDW, PCT, and MPV. PCT was the strongest independent predictor of proteinuria. CONCLUSIONS: The platelet indices PCT, PDW, and MPV were significantly higher in patients with proteinuria than in those without it. Among these three indices, PCT was the strongest predictor of proteinuria.

Change of platelet parameters in septic shock patients / 中华危重病急救医学

Objective To observe the changes in platelet parameters including platelet volume distribution width (PDW),plateletcrit (PCT) and platelet large cell ratio (PLCR) in patients with septic shock,and to approach its predictive effect on prognosis to obtain the indexes predicting the prognosis quickly and conveniently.Methods A retrospective study was conducted.Data from septic shock patients admitted to Peking Union Medical College Hospital from January 1 to December 31,2012 were collected.The patients were divided into two groups according to prognosis.The general condition,laboratory parameters,infection,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,and platelet parameters at 5 days after admission and 2 days before discharge from hospital,such as platelet count (PLT),Mean platelet volume (MPV),PDW,PCT and PLCR were recorded.Receiver operating characteristic curve (ROC curve) was drawn for those parameters and the area under curve was compared.Results A total 124 septic shock patients were enrolled finally,88 of the patients died and 36 remained alive.PDW and PLCR were elevated with the progress of the disease,the PLT and PCT were declined,and MPV maintained at a high level.The control group showed an opposite trend.MPV in non-survivor group was significantly higher than that in survivor group [fl:11.2 (10.5,12.5) vs.10.3 (9.7,11.0),relative risk (RR)=3.362,P=0.009].There was no significant difference in PLT,PDW,PCT and PLCR between non-survivor group and survivor group [PLT(× 109/L):105.0(47.5,191.5) vs.164.0 (85.0,236.0),RR=1.004,P=0.441; PDW:0.14 (0.12,0.17) vs.0.12 (0.11,0.13),RR=1.053,P=0.795;PCT:0.13 (0.07,0.21)％vs.0.18 (0.09,0.24)％,RR=0.234,P=0.747; PLCR:33.7 (28.1,42.8)％vs.26.8 (23.2,32.0)％,RR=0.924,P=0.324].ROC curve showed the best cutoff value for PLT was ＞487.0 × 109/L,with AUC of 0.377,sensitivity of 1.14％,specificity of 100％,diagnosis accuracy of 29.27％ and Youden index of 0.011; the best cutoff value for MPV was ＞ 10.5 fl,with AUC of 0.812,sensitivity of 81.82％,specificity of 65.71％,diagnosis accuracy of 75.61％ and Youden index of 0.475; the best cutoff value for PLCR was ＞39.3％,with AUC of 0.758,sensitivity of 48.86％,specificity of 91.43％,diagnosis accuracy of 60.98％ and Youden index of 0.403;the best cutoff value for PCT was ＞0.33％,with AUC of 0.380,sensitivity of 7.96％,specificity of 97.14％,diagnosis accuracy of 32.52％ and Youden index of 0.051 ; the best cutoff value for PDW was ＞0.12,with AUC of 0.747,sensitivity of 82.96％,specificity of 57.14％,diagnosis accuracy of 74.80％ and Youden index of 0.401.Conclusions Different change trends of platelet parameters can be seen between the non-survivors and survivors of septic shock patients.If PDW,PLCR and MPV show increased trend while PLT and PCT show decreased trend,a poor prognosis maybe indicated.MPV may be most useful in prognosis forecast because of its biggest AUC.