http://informahealthcare.com/plt ISSN: 0953-7104 (print), 1369-1635 (electronic) Platelets, 2015; 26(4): 371–372 ! 2014 Informa UK Ltd. DOI: 10.3109/09537104.2014.887200
LETTER TO THE EDITOR
Mean platelet volume and mean platelet volume/platelet count ratio in patients with chronic alcohol consumption Sun Young Cho1, Hee Joo Lee1, Jong Woo Kim2, & Tae Sung Park1 1
Department of Laboratory Medicine and 2Department of Neuropsychiatry, School of Medicine, Kyung Hee University, Seoul, Korea
Mean platelet volume (MPV) is a parameter generated by fully automated blood count analyzers as a part of routine complete blood count (CBC), and a useful laboratory index for estimating platelet function and activation [1–3]. In the aspect of alcohol effects on MPV, MPV has been investigated in alcohol-associated liver disease such as alcoholic fatty liver disease and alcoholic liver cirrhosis and in vivo condition, respectively [4, 5]. However, data which directly analyzed MPV and laboratory marker for alcohol consumption were very rare, although increased mean corpuscular erythrocyte volume (MCV) is a commonly used CBC index in patients with chronic alcoholics. Therefore, we planned to study this platelet index in patients with chronic alcohol abuse to investigate whether chronic alcohol consumption can influence to MPV. We used carbohydrate-deficient transferrin (CDT) test, the sum of a- and disialotransferrin, to identify patients with chronic alcohol consumption, which is considered the most efficient routine biological marker of alcohol abuse [6, 7]. A total of 178 patients with CDT test results were analyzed in this study at Kyung Hee University Hospital, a tertiary teaching hospital in Seoul, Korea, between March 2012 and October 2012. Among individuals who visited the same hospital for medical check-ups, 143 individuals were randomly selected as a control group and used in our previous studies [1, 2]. After extensive medical chart review, individuals with hypertension and diabetes mellitus were excluded from the control group, to rule out possible confounding factors [6, 7]. CBC test and MPV measurement were performed using EDTA blood in Advia 2120 (Bayer Diagnostics, Tarrytown, NY) within 2 hours from sampling. CDT test was done in capillary II (Sebia, Lyss, France). CDT has been known to be an accurate biomarker for the detection of chronic alcohol abuse and for monitoring abstinence [8, 9]. Sustained alcohol consumption over 2 weeks causes a change in the glycoform pattern of transferrin and an increase in CDT levels. According to the manufacture’s instruction, the negative cut-off value of CDT test was below 1.3% of CDT in total transferrin while positive cut-off level was set at 41.8% of CDT in total transferrin, respectively. The statistical analyses were performed with MedCalc v12.7.7 (MedCalc Software, Mariakerke, Belgium) and Excel 2007 (Microsoft Corporation, Redmond, WA).
Correspondence: Tae Sung Park, MD, PhD, Department of Laboratory Medicine, School of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +822 958 8673. Fax: +822 958 8609. E-mail: [email protected]
Keywords CDT, chronic alcohol consumption, mean platelet volume, mean platelet volume/ platelet count ratio History Received 8 January 2014 Revised 20 January 2014 Accepted 21 January 2014 Published online 11 March 2014
In the total 178 patients with CDT test results, nine patients presented the equivocal results (1.4–1.8%) and 45 patients showed increased CDT level above the upper limit of reference range, 41.8%. In these individuals, final 39 patients with increased CDT level and MPV result were enrolled as the patient group. In the patient group, the mean age was 45.31 (range 23–72 year), and the male to female ratio was 29:10. The mean of CDT level was 5.05% (range 1.9–17%). In the patient group, the mean of MPV (8.300 fL) was significantly increased than the control group (7.9594 fL, p ¼ 0.039), while mean of platelet count (200.13 103/ml) was significantly decreased than patient group (257.96 103/ml, p50.0001), respectively. In MPV/platelet count ratio, the patients group also presented significant difference (Figure 1, p50.0001). There were no direct correlations between CDT levels and platelet indexes. In this study, we found that MPV/platelet count ratio was significantly increased in patients with chronic alcohol consumption verified by the CDT test. This study has some limitations.
Figure 1. Mean of MPV/platelet count ratio is markedly increased in the patient group with increased CDT level.
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First, the number of patients with increased CDT levels was not sufficient and it is a cross-sectional retrospective review. Second, the quantitative analysis related with the amount of alcohol consumption has not done in this study [6, 7]. In the future, the longitudinal follow-up in larger number of patients should be followed to investigate dynamic change of MPV and MPV/platelet count ratio according to quantitative and qualitative features of alcohol consumption.
Declaration of interest This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2013R1A1A3005834). The authors declare no conflicts of interests. The authors thank Hae Jin Lee for her help in this study.
References 1. Cho SY, Jeon YL, Kim W, Kim WS, Lee HJ, Lee WI, Park TS. Mean platelet volume and mean platelet volume/platelet count ratio in infective endocarditis. Platelets 2013 Nov 8. [Epub ahead of print]. doi:10.3109/09537104.2013.857394.
Platelets, 2015; 26(4): 371–372
2. Cho SY, Lee HJ, Park TS. Mean platelet volume in patients with increased g-glutamyl transferase. Platelet 2014, accepted for publication. 3. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des 2011;17:47–58. 4. Ehrlich D, Humpel C. Effects of ethanol on aggregation, serotonin release, and amyloid precursor protein processing in rat and human platelets. Platelets. 2013 Feb 12. [Epub ahead of print]. 5. Lee WS, Kim TY. Alcoholic fatty liver disease and alcoholic liver cirrhosis may be differentiated with mean platelet volume and platelet distribution width. Platelets 2010;21:584–585. 6. Tozzi Ciancarelli MG, Di Massimo C, De Amicis D, Ciancarelli I, Carolei A. Moderate consumption of red wine and human platelet responsiveness. Thromb Res 2011;128(2):124–129. 7. Yazici M, Kaya A, Kaya Y, Albayrak S, Cinemre H, Ozhan H. Lifestyle modification decreases the mean platelet volume in prehypertensive patients. Platelets 2009;20(1):58–63. 8. Maenhout TM, De Buyzere ML, Delanghe JR. Non-oxidative ethanol metabolites as a measure of alcohol intake. Clin Chim Acta 2013;415:322–329. 9. Cho SY, Lee HJ, Park TS. Incidental finding of transferrin variant in capillary electrophoresis: Does it have any clinical meaning? Int J Lab Hematol 2013;35(5):e15–e16.
Copyright of Platelets is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
LETTER TO THE EDITOR
Mean platelet volume and mean platelet volume/platelet count ratio in patients with chronic alcohol consumption Sun Young Cho1, Hee Joo Lee1, Jong Woo Kim2, & Tae Sung Park1 1
Department of Laboratory Medicine and 2Department of Neuropsychiatry, School of Medicine, Kyung Hee University, Seoul, Korea
Mean platelet volume (MPV) is a parameter generated by fully automated blood count analyzers as a part of routine complete blood count (CBC), and a useful laboratory index for estimating platelet function and activation [1–3]. In the aspect of alcohol effects on MPV, MPV has been investigated in alcohol-associated liver disease such as alcoholic fatty liver disease and alcoholic liver cirrhosis and in vivo condition, respectively [4, 5]. However, data which directly analyzed MPV and laboratory marker for alcohol consumption were very rare, although increased mean corpuscular erythrocyte volume (MCV) is a commonly used CBC index in patients with chronic alcoholics. Therefore, we planned to study this platelet index in patients with chronic alcohol abuse to investigate whether chronic alcohol consumption can influence to MPV. We used carbohydrate-deficient transferrin (CDT) test, the sum of a- and disialotransferrin, to identify patients with chronic alcohol consumption, which is considered the most efficient routine biological marker of alcohol abuse [6, 7]. A total of 178 patients with CDT test results were analyzed in this study at Kyung Hee University Hospital, a tertiary teaching hospital in Seoul, Korea, between March 2012 and October 2012. Among individuals who visited the same hospital for medical check-ups, 143 individuals were randomly selected as a control group and used in our previous studies [1, 2]. After extensive medical chart review, individuals with hypertension and diabetes mellitus were excluded from the control group, to rule out possible confounding factors [6, 7]. CBC test and MPV measurement were performed using EDTA blood in Advia 2120 (Bayer Diagnostics, Tarrytown, NY) within 2 hours from sampling. CDT test was done in capillary II (Sebia, Lyss, France). CDT has been known to be an accurate biomarker for the detection of chronic alcohol abuse and for monitoring abstinence [8, 9]. Sustained alcohol consumption over 2 weeks causes a change in the glycoform pattern of transferrin and an increase in CDT levels. According to the manufacture’s instruction, the negative cut-off value of CDT test was below 1.3% of CDT in total transferrin while positive cut-off level was set at 41.8% of CDT in total transferrin, respectively. The statistical analyses were performed with MedCalc v12.7.7 (MedCalc Software, Mariakerke, Belgium) and Excel 2007 (Microsoft Corporation, Redmond, WA).
Correspondence: Tae Sung Park, MD, PhD, Department of Laboratory Medicine, School of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +822 958 8673. Fax: +822 958 8609. E-mail: [email protected]
Keywords CDT, chronic alcohol consumption, mean platelet volume, mean platelet volume/ platelet count ratio History Received 8 January 2014 Revised 20 January 2014 Accepted 21 January 2014 Published online 11 March 2014
In the total 178 patients with CDT test results, nine patients presented the equivocal results (1.4–1.8%) and 45 patients showed increased CDT level above the upper limit of reference range, 41.8%. In these individuals, final 39 patients with increased CDT level and MPV result were enrolled as the patient group. In the patient group, the mean age was 45.31 (range 23–72 year), and the male to female ratio was 29:10. The mean of CDT level was 5.05% (range 1.9–17%). In the patient group, the mean of MPV (8.300 fL) was significantly increased than the control group (7.9594 fL, p ¼ 0.039), while mean of platelet count (200.13 103/ml) was significantly decreased than patient group (257.96 103/ml, p50.0001), respectively. In MPV/platelet count ratio, the patients group also presented significant difference (Figure 1, p50.0001). There were no direct correlations between CDT levels and platelet indexes. In this study, we found that MPV/platelet count ratio was significantly increased in patients with chronic alcohol consumption verified by the CDT test. This study has some limitations.
Figure 1. Mean of MPV/platelet count ratio is markedly increased in the patient group with increased CDT level.
372
S.Y. Cho et al.
First, the number of patients with increased CDT levels was not sufficient and it is a cross-sectional retrospective review. Second, the quantitative analysis related with the amount of alcohol consumption has not done in this study [6, 7]. In the future, the longitudinal follow-up in larger number of patients should be followed to investigate dynamic change of MPV and MPV/platelet count ratio according to quantitative and qualitative features of alcohol consumption.
Declaration of interest This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2013R1A1A3005834). The authors declare no conflicts of interests. The authors thank Hae Jin Lee for her help in this study.
References 1. Cho SY, Jeon YL, Kim W, Kim WS, Lee HJ, Lee WI, Park TS. Mean platelet volume and mean platelet volume/platelet count ratio in infective endocarditis. Platelets 2013 Nov 8. [Epub ahead of print]. doi:10.3109/09537104.2013.857394.
Platelets, 2015; 26(4): 371–372
2. Cho SY, Lee HJ, Park TS. Mean platelet volume in patients with increased g-glutamyl transferase. Platelet 2014, accepted for publication. 3. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des 2011;17:47–58. 4. Ehrlich D, Humpel C. Effects of ethanol on aggregation, serotonin release, and amyloid precursor protein processing in rat and human platelets. Platelets. 2013 Feb 12. [Epub ahead of print]. 5. Lee WS, Kim TY. Alcoholic fatty liver disease and alcoholic liver cirrhosis may be differentiated with mean platelet volume and platelet distribution width. Platelets 2010;21:584–585. 6. Tozzi Ciancarelli MG, Di Massimo C, De Amicis D, Ciancarelli I, Carolei A. Moderate consumption of red wine and human platelet responsiveness. Thromb Res 2011;128(2):124–129. 7. Yazici M, Kaya A, Kaya Y, Albayrak S, Cinemre H, Ozhan H. Lifestyle modification decreases the mean platelet volume in prehypertensive patients. Platelets 2009;20(1):58–63. 8. Maenhout TM, De Buyzere ML, Delanghe JR. Non-oxidative ethanol metabolites as a measure of alcohol intake. Clin Chim Acta 2013;415:322–329. 9. Cho SY, Lee HJ, Park TS. Incidental finding of transferrin variant in capillary electrophoresis: Does it have any clinical meaning? Int J Lab Hematol 2013;35(5):e15–e16.
Copyright of Platelets is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
