Mean Platelet Volume (MPV): New diagnostic indices for co-morbidity of Tuberculosis and Diabetes Mellitus
Abstract Background: Tuberculosis (TB) and type 2 diabetes mellitus (DM) are global health diseases with high morbidity and lethality . Few studies had focus on the platelet indices in TB-DM co-morbidity patients. The objective of this work was to analyze the platelet indices in TB, DM and TB+DM to assess the predictive value of platelet index for the risk of these diseases. Methods: In total, 246 patients were distribute d into three groups (113 TB, 59 DM and 74 TB+DM) admitted in our hospital along with 133 healthy controls (HC). Platelet indices namely platelet count (PC), mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW) were compared among the four groups and explored the relationship with inflammatory markers by using statistical software. Results: Our study discovered that MPV and PCT were significantly down-expressed in TB+DM patients (9.95±1.25fL, 0.20±0.05%, P <0.0001, P =0.0121, separately ) than those in DM individuals (10.92±1.17fL, 0.22±0.04%). Moreover, on comparison of TB (9.42±1.01fL), the changes of MPV were significantly higher in TB+DM patients (9.95±1.25fL, P =0.0041). No differences were found in PLT and PDW among the four groups ( P >0.05). The sensitivity and specificity of MPV in differential diagnosis of DM patients vs TB+DM patients were defined as 64.9% and 66.1% ( P <0.0001), as well as 60.8% and 66.4% of MPV in differ from TB patients and TB+DM patients ( P =0.003). MPV improved the diagnosis sensitivity when combined with clinical golden parameters as fasting blood glucose in DM and mycobacterium tuberculosis culture result in TB. In addition, the sensitivity and specificity of PCT in the differential diagnosis of DM patients vs TB+DM patients were defined as 69.5% and 59.4% ( P =0.008). PCT improved the diagnosis sensitivity when combined with fasting blood glucose in DM (72.9% vs 64.9%, P =0.004). In addition, MPV was connected with CRP and ESR in the TB+DM patients rather than PCT. Conclusions: Our research shows that MPV and PCT might be the clinical laboratory markers distinguished TB+DM patients from TB or DM individuals, thus providing support for earlier clinical diagnosis, prevention, and therapy.