Objective: There is an increase in platelet activation in diabetics and patients with diabetic complications. Labile hemoglobin A1c (LHbA1c), an early glycation product, can turn into other glucose metabolites which can be responsible for many kinds of pathologies observed in diabetes mellitus. In this study, we aimed to investigate the relationship between mean platelet volume (MPV), a good indicator of platelet activation, and glycemic control parameters such as fasting blood glucose (FBG), stabile hemoglobin A1c (sHbA1c) and LHbA1c.

Materials and Methods: This retrospective study included data of 560 subjects (370 female, 190 male; mean age 55.4 ± 14.1 years) with HbA1c measurements available and recorded in the laboratory information system. Subjects were grouped according to their sHbA1c and FBG levels as follows; Group I consisted of subjects with FBG < 126 mg/dL and sHbA1c < %6.5, and Group II consisted of subjects with FBG ≥ 126 mg/dL and/or sHbA1c ≥ %6.5. Plasma sHbA1c and LHbA1c levels, complete blood counts (CBC), FBG, age and gender of all the subjects were collected. CBCs were analyzed by Beckman Coulter LH 780, glucose levels by a hexokinase method (Abbott Architect C16000), and LHbA1c and sHbA1c levels by an ion exchange chromotography (TOSOH, G8).

Results: With respect to pre-defined cut-off values for sHbA1c ≥ 6.5 and FBG ≥ 126 mg/dL (Group I, n:218; Group II, n:342), there were significant differences between the two groups in terms of FBG, LHbA1c, sHbA1c and MPV values, meanwhile platelet counts, platelet distribution widths and hemoglobin levels did not differ. To define the factors related to MPV, which reflects a thrombotic complication risk, we performed multivariate regression analysis. Platelet count, LHbA1c and sHbA1c were found to be as independent variables associated with MPV (p<0.05). There was no correlation between MPV and FBG or LHbA1c or sHbA1c (p<0.05), except platelet counts (r=-0.333, p<0.001).

Conclusion: Both MPV and LHbA1c values are influenced from the blood glucose control level in diabetes. As LHbA1c has an effects on MPV in diabetes and displays a good correlation with FBG and sHbA1c, it can be used as an early marker of diabetic complications.