Ann Lab Med.  2015 Nov;35(6):630-634. 10.3343/alm.2015.35.6.630.

Association Between High Platelet Indices and Proteinuria in Patients With Hypertension

• Ates I
• Bulut M
• Ozkayar N
• Dede F

• KMID: 2363267
• DOI: http://doi.org/10.3343/alm.2015.35.6.630

Abstract

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.

Keyword

Hypertension; Plateletcrit; Platelet indices; Proteinuria

MeSH Terms

Adult
Aged
Area Under Curve
Asian Continental Ancestry Group
Blood Platelets/*cytology
Female
Humans
Hypertension/complications/*diagnosis
Male
Mean Platelet Volume
Middle Aged
Platelet Count
Proteinuria/*complications
ROC Curve
Retrospective Studies
Turkey

Figure

• 

  Fig. 1 ROC curve analysis, the determination of the possible cut-off value of plateletcrit level predicting the risk of proteinuria. Cutoff values were determined from the Youden index. Arrow indicates the Youden index.Abbreviations: AUC, area under the curve; CI, confidence interval.

Reference

1. Kannel WB. Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA. 1996; 275:1571–1576. PMID: 8622248.

2. Kalaitzidis R, Bakris G. Pathogenesis and treatment of microalbuminuria in patients with diabetes: the road ahead. J Clin Hypertens (Greenwich). 2009; 11:636–643. PMID: 19878372.

3. Nadar S, Lip GY. The prothrombotic state in hypertension and the effects of antihypertensive treatment. Curr Pharm Des. 2003; 9:1715–1732. PMID: 12871204.

4. Ruf A, Patscheke H. Flow cytometric detection of activated platelets: comparison of determining shape change, fibrinogen binding, and P-selectin expression. Semin Thromb Hemost. 1995; 21:146–151. PMID: 7544916.

5. Pizzulli L, Yang A, Martin JF, Lüderitz B. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J. 1998; 19:80–84. PMID: 9503179.

6. Nadar SK, Blann AD, Kamath S, Beevers DG, Lip GY. Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol. 2004; 44:415–422. PMID: 15261941.

7. Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol. 2002; 117:399–404. PMID: 11972524.

8. Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke. 2004; 35:1688–1691. PMID: 15143290.

9. Uğur M, Ayhan E, Bozbay M, Çiçek G, Ergelen M, Işik T, et al. The independent association of plateletcrit with long-term outcomes in patients undergoing primary percutaneous coronary intervention. J Crit Care. 2014; 29:978–981. PMID: 25124920.

10. Akpinar I, Sayin MR, Gursoy YC, Aktop Z, Karabag T, Kucuk E, et al. Plateletcrit and red cell distribution width are independent predictors of the slow coronary flow phenomenon. J Cardiol. 2014; 63:112–118. PMID: 24012331.

11. Bekler A, Ozkan MT, Tenekecioglu E, Gazi E, Yener AU, Temiz A, et al. Increased platelet distribution width is associated with severity of coronary artery disease in patients with acute coronary syndrome. Angiology. 2015; 66:638–643. PMID: 25112777.

12. Wang RT, Jin D, Li Y, Liang QC. Decreased mean platelet volume and platelet distribution width are associated with mild cognitive impairment and Alzheimer's disease. J Psychiatr Res. 2013; 47:644–649. PMID: 23395109.

13. Ozdemir R, Karadeniz C, Doksoz O, Celegen M, Yozgat Y, Guven B, et al. Are mean platelet volume and platelet distribution width useful parameters in children with acute rheumatic carditis? Pediatr Cardiol. 2014; 35:53–56. PMID: 23780555.

14. Levey AS, Berg RL, Gassman JJ, Hall PM, Walker WG. Modification of Diet in Renal Disease (MDRD) Study Group. Creatinine filtration, secretion and excretion during progressive renal disease. Kidney Int Suppl. 1989; 27:S73–S80. PMID: 2636677.

15. Kashif W, Siddiqi N, Dincer AP, Dincer HE, Hirsch S. Proteinuria: how to evaluate an important finding. Cleve Clin J Med. 2003; 70:535–537. 541–544. 546–547. PMID: 12828224.

16. Lee KW, Blann AD, Lip GY. High pulse pressure and nondipping circadian blood pressure in patients with coronary artery disease: relationship to thrombogenesis and endothelial damage/dysfunction. Am J Hypertens. 2005; 18:104–115. PMID: 15691624.

17. Boos CJ, Beevers GD, Lip GY. Assessment of platelet activation indices using the ADVIATM 120 amongst 'high-risk' patients with hypertension. Ann Med. 2007; 39:72–78. PMID: 17364453.

18. Giles H, Smith RE, Martin JF. Platelet glycoprotein IIb-IIIa and size are increased in acute myocardial infarction. Eur J Clin Invest. 1994; 24:69–72. PMID: 8187810.

19. Guagnano MT, Ferroni P, Santilli F, Paoletti V, Manigrasso MR, Pescara L, et al. Determinants of platelet activation in hypertensives with microalbuminuria. Free Radic Biol Med. 2009; 46:922–927. PMID: 19280705.

20. Blann AD, Nadar S, Lip GY. Pharmacological modulation of platelet function in hypertension. Hypertension. 2003; 42:1–7. PMID: 12782643.

21. Yarlioglues M, Kaya MG, Ardic I, Dogdu O, Kasapkara HA, Gunturk E, et al. Relationship between mean platelet volume levels and subclinical target organ damage in newly diagnosed hypertensive patients. Blood Press. 2011; 20:92–97. PMID: 21105760.

22. Hekimsoy Z, Payzin B, Ornek T, Kandogan G. Mean platelet volume in Type 2 diabetic patients. J Diabetes Complications. 2004; 18:173–176. PMID: 15145330.

23. Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. White blood cell, hemoglobin and platelet distribution width as short-term prognostic markers in patients with acute myocardial infarction. J Korean Med Sci. 2014; 29:519–526. PMID: 24753699.

24. Akpek M, Kaya MG, Yarlioglues M, Dogdu O, Ardic I, Sahin O, et al. Relationship between platelet indices and spontaneous echo contrast in patients with mitral stenosis. Eur J Echocardiogr. 2011; 12:865–870. PMID: 21893553.