Mean Platelet Volume Abstracts 1

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Mean Platelet Volume and Platelet Distribution Width in Patients With Obstructive Sleep Apnea Syndrome and Concurrent Chronic Obstructive Pulmonary Disease.
            (Archontogeorgis et al., 2018) Download
Evidence suggests that there is platelet activation in obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). Our objective is to evaluate mean platelet volume (MPV) and platelet distribution width (PDW) in patients with overlap syndrome (OS), that is, concurrent COPD with OSAS. Mean platelet volume and PDW were assessed in consecutive patients who had undergone polysomnography and pulmonary function testing. They were divided into the following groups: controls (apnea-hypopnea index [AHI] <5/hour, and forced expiratory volume in 1st second [FEV1]/forced vital capacity [FVC] >70%), OSAS group (AHI ≥5/hour and FEV1/FVC >70%), and OS group (AHI ≥5/hour and FEV1/FVC <70%). A total of 485 patients (360 males and 125 females) were included. Mean platelet volume in controls was lower compared with the other groups: 10 ± 0.9 fL for controls versus 10.3 ± 1.2 fL for OSAS ( P = .006), versus 10.7 ± 1 fL for OS ( P < .001). Additionally, MPV was higher in OS group than OSAS: 10.7 ± 1 fL versus 10.3 ± 1.2 fL, respectively ( P = .002). Platelet distribution width was lower in controls compared with the other groups: 12.9 ± 2 fL for controls versus 13.6 ± 1.9 fL for OSAS ( P = .007), versus 13.8 ± 2.3 fL for OS ( P = .008), while there was no difference between OS and OSAS groups. Mean platelet volume and PDW are increased in patients with OS compared with healthy controls, with respiratory function being the major contributor in platelet activation in this series.

Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, randomized, open-label study.
            (Bolaman et al., 2003) Download
BACKGROUND:  Cobalamin (vitamin B12) deficiency, the most common cause of megaloblastic anemia, is treated with intramuscular (IM) cobalamin. It has been suggested by some investigators that oral (p.o.) cobalamin treatment may be as effective in the treatment of this condition, with the advantages of ease of administration and lower cost. OBJECTIVE:  This study assessed the effects and cost of p.o. versus i.m. cobalamin treatment in patients with megaloblastic anemia due to cobalamin deficiency. METHODS:  This was a 90-day, prospective, randomized, open-label study conducted at the Division of Hematology, Department of Internal Medicine, Adnan Menderes University Research and Practice Hospital (Aydin, Turkey). Patients aged > or =16 years with megaloblastic anemia due to cobalamin deficiency were randomized to receive 1000-microg cobalamin p.o. once daily for 10 days (p.o. group) or 1000-microg cobalamin i.m. once daily for 10 days (i.m. group). After 10 days, both treatments were administered once a week for 4 weeks, and after that, once a month for life. Patients were assessed for the presence of reticulocytosis between treatment days 5 and 10 until it was detected. Therapeutic effectiveness was assessed by measuring hematologic parameters on days 0, 10, 30, and 90 and serum vitamin B12 concentration on days 0 and 90. The Mini-Mental State Examination was used before and after the B12 therapy for cognitive function assessment and 125-Hz diapozone was used for vibration threshold testing. Neurologic sensory assessment, including soft-touch and pinprick examinations, was used to identify neuropathy at baseline and study end. Tolerability was assessed using laboratory tests and patient interview. Cost was assessed using the cost of the study drug and of the injection. RESULTS:  Sixty patients completed the study 26 in the p.o. group (16 men, 10 women; mean [SD] age, 60 [15] years) and 34 in the i.m. group (17 men, 17 women; mean [SD] age, 64 [10] years). Reticulocytosis was observed in all patients. In the p.o. group, at days 30 and 90, all hematologic parameters changed significantly versus day 0 (mean hemoglobin levels increased [both P<0.001]; mean corpuscular volume decreased [both P<0.001]; mean white blood cell count increased [day 30, P<0.01; day 90, P<0.001]; and mean platelet count increased [both P<0.001]). The mean serum vitamin B12 concentration increased significantly from day 0 to 90 (P<0.001). These hematologic parameters and the recovery patterns were similar between the 2 groups. Neurologic findings included sensitive peripheral neuropathy in 9 patients (15.0%), alteration of cognitive function (loss of memory, impaired concentration) in 7 patients (11.7%), and loss of sense of vibration in 5 patients (8.3%). Neurologic improvement was detected in 7 of 9 patients (77.8%) in the p.o. group and 9 of 12 patients (75.0%) in the i.m. group at day 30. CONCLUSIONS:  In this study of patients with megaloblastic anemia due to cobalamin deficiency, p.o. cobalamin treatment was as effective as i.m. cobalamin treatment. P.o. treatment also was better tolerated and less expensive compared with IM treatment. However, because of the small sample size and the short term of this study, further long-term studies are needed to determine the efficacy of p.o. cobalamin treatment.

Mean platelet volume and vitamin D level.
            (Cumhur Cure et al., 2014) Download
BACKGROUND:  Vitamin D deficiency and a high mean platelet volume (MPV) are related to cardiovascular disease. We investigated whether vitamin D deficiency is associated with high MPV. METHODS:  This study included 434 patients without chronic disease who were not taking vitamin D or calcium supplements. Vitamin D was measured by chemiluminescent microparticle immunoassay on the Architect-I2000 system (Abbott Diagnostics, USA), and MPV was measured on the Cell-Dyn Ruby analyzer (Abbott Diagnostics). Patients were divided into Groups 1 (138 [men/women, 46/92]), 2 (148 [men/women, 54/94]), and 3 (148 [men/women, 50/98]) according to vitamin D levels of <10 ng/mL, 10-20 ng/mL, and >20 ng/mL, respectively. RESULTS:  The vitamin D level in Group 1 (7.7±1.9 ng/mL) was lower than that in Group 2 (15.1±1.6 ng/mL, P<0.001) and Group 3 (25.6±6.3 ng/mL, P<0.001). The MPV in Group 3 (7.5±1.0 fL) was lower than that in Group 1 (8.1±1.1 fL, P<0.001) and Group 2 (7.9±1.0 fL, P=0.009). Linear regression analysis showed that low levels of vitamin D (β=-0.109, P=0.019) was independently associated with increased MPV. CONCLUSIONS:  There was a strong association between a low vitamin D level and a high MPV; therefore, vitamin D deficiency may be associated with increased MPV.

Is the mean platelet volume predictive of hip fractures in the elderly
            (Cure et al., 2013) Download
Patients above the age of 65 who were treated for femur neck or intertrochanteric region fractures between 2006 and 2012 were screened in this study. Exclusion criteria were as follows: a fracture due to a traffic accident or other major trauma and femur fractures in other regions. A total of 102 patients were included in the femur neck group, and 95 patients were included in the intertrochanteric group. MPV is affected by medications, such as rosuvastatin, aspirin, clopidogrel, and metformin. Most chronic disease patients in our study were under these medications. In conclusion, we demonstrated that a high MPV was associated with fractures, even in old age. A high MPV may be related to osteoporosis and an impaired blood supply; consequently, the risk of fracture may be increased. Since our case-control study involved a small study sample, additional large prospective studies are needed to confirm these results.

The effect of metformin on mean platelet volume in dıabetıc patients.
            (Dolasık et al., 2013) Download
Diabetes mellitus (DM) is an independent risk factor for cardiovascular diseases. Metformin, the most commonly used antidiabetic, also has an antiatherogenic effect. Mean platelet volume (MPV) is increased in patients with high thrombogenic activation and also at risk for atherosclerosis. The purpose of this study was to examine the effects of metformin on MPV values in newly diagnosed type II DM patients on metformin monotherapy. In this study, 60 newly diagnosed type II DM patients (45 females, 15 males), who had applied to the Kocaeli University School of Medicine Endocrinology outpatient clinic, and 47 healthy individuals (35 females, 12 males) were included. The two groups have similarity for age, sex and body mass index. The patients with additional disease, nephropathy, smoking and using drugs that may affect the MPV were excluded. At baseline and 6 months after metformin treatment, patient demographics and laboratory values were compared. MPV was higher among type II DM patients than the control group (p < 0.001). After 6 months of metformin treatment, MPV values were significantly decreased (p < 0.001). HbA1c and mean platelet mass were also significantly decreased (p = 0.022 and 0.001, respectively). There was no correlation between MPV and HbA1c values (r = -0.13, p = 0.926). Metformin, which has been shown to exhibit antiatherogenic effect through positive effects on cholesterol levels, inflammatory markers and vascular adhesion molecules, decreased MPV values that appear to play a crucial role at the beginning of atherosclerosis development. We conclude that our result may contribute to the explanation for antiatherogenic effect of metformin.

Association of mean platelet volume and platelet count with the development and prognosis of ischemic and hemorrhagic stroke.
            (Du et al., 2016) Download
INTRODUCTION:  Mean platelet volume (MPV) and platelet (PLT) count are the two major parameters that reflect the functions and activities of PLTs. The associations of MPV and PLT count with the occurrence and prognosis of stroke have not been fully clarified. This study aimed to investigate the association of MPV and PLT count with the development and prognosis of first-ever ischemic and hemorrhagic stroke in order to provide evidence for early diagnosis and treatment of both strokes. METHODS:  This study included 281 first-ever ischemic stroke and 164 first-ever hemorrhagic stroke patients between 2010 and 2012. All participants received routine blood tests within 2 h after admission and were categorized into good or poor prognosis group based on the Modified Rankin Scale (mRS) score. MPV and PLT counts were transformed into categorical variables and their association with the occurrence and prognosis of both strokes was evaluated by multivariate logistic regression. RESULTS:  The risk of ischemic and hemorrhagic stroke in MPV group (>13 fL) was 22.17 and 5.21 times higher compared with normal MPV group. The PLT count was positively correlated with the risk of ischemic stroke, but negatively correlated with the risk of hemorrhagic stroke. MPV and PLT count was not correlated with the prognosis of either stroke. CONCLUSIONS:  Increased MPV is an independent risk factor for both strokes. Elevated PLT count increases the risk for ischemic stroke, but decreases the risk for hemorrhagic stroke. However, neither MPV nor PLT count has significant association with the prognosis of either stroke.

Relationship between mean platelet volume and coronary blood flow in patients with atrial fibrillation.
            (Feng et al., 2013) Download
INTRODUCTION:  Atrial fibrillation (AF) is associated with impaired coronary flow by means of Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC). Mean platelet volume (MPV) is elevated in patients with AF. In the present study we aimed to investigate the relationship between MPV and TFC in patients with AF in the absence of obstructive coronary artery disease (CAD). METHODS:  This observational study enrolled 185 AF patients and 189 control subjects, all with angiographically documented normal coronary arteries. MPV was measured at baseline and mean TFC was assessed after diagnostic coronary angiography. RESULTS:  The MPV was 9.95±1.32 in the AF group and 9.02±1.16 in the control group (p<0.001). In AF patients, MPV was significantly correlated with mean TFC (r=0.419, p<0.001), AF duration (r=0.407, p<0.001), AF classification (r=0.378, p<0.001), systemic hypertension (r=0.165, p=0.024), diabetes mellitus (r=0.233, p=0.001), left ventricular ejection fraction (r=-0.347, p<0.001), and baseline use of diuretics (r=0.177, p=0.016). In linear regression analysis, mean TFC, left ventricular ejection fraction and diabetes mellitus were found to be independently associated with MPV (p<0.001, p=0.028 and p=0.045 respectively). CONCLUSION:  Mean platelet volume seems to be independently associated with coronary blood flow in patients with atrial fibrillation in the absence of obstructive coronary artery disease.

Effects of cod liver oil on lipids and platelets in males and females.
            (Hansen et al., 1993) Download
Thirty-four healthy non-smoking subjects (20 men and 14 women) were given 25 ml cod liver oil (CLO) daily as dietary supplement for 8 weeks in a controlled cross-over study. Prior to intervention, women had significantly higher serum total (P < 0.05) and high density lipoprotein (HDL) (P < 0.001) cholesterol values, higher platelet counts (P < 0.05) and lower thromboxane B2 (TxB2) generation (P < 0.01) in response to collagen stimulation in platelet-rich plasma (PRP) than men. Before intervention, no gender differences in platelet aggregation were observed. Following CLO intervention, serum triglycerides were reduced by 0.21 +/- 0.09 mmol/l (P < 0.05) in men. LDL cholesterol increased in men by 0.28 +/- 0.12 mmol/l (P < 0.05), while the values in women decreased insignificantly. The response in LDL cholesterol to CLO supplementation differed significantly between genders (P < 0.05). HDL cholesterol was not altered in any group. Mean platelet volume (MPV) increased by approximately 6% in both sexes (P < 0.01). After CLO intake, platelet sensitivity to collagen in PRP decreased in men only (P < 0.01), and the response was significantly different from that in women (P < 0.05). Thromboxane B2 generation following platelet aggregation in PRP was equally decreased by CLO. Our findings indicate sex differences in the response to CLO regarding LDL cholesterol and platelet sensitivity to collagen in PRP.

Mean platelet volume is increased in patients with hypertensive crises.
            (Karabacak et al., 2014) Download
Platelets may be activated in hypertension (HT). Hypertensive crisis is an extreme phenotype of HT and HT-related thrombotic complications. We aimed to assess mean platelet volume (MPV) in patients with hypertensive crises. This study included 215 hypertensive urgency (HU) patients (84 male, mean age = 66 ± 15 years) and 60 hypertensive emergency (HE) patients (26 male, mean age = 68 ± 13 years), who were admitted to the emergency department with a diagnosis of hypertensive crises. Control group was composed of age- and sex-matched 39 normotensive patients. Blood samples were withdrawn for whole blood count and routine biochemical tests. Systolic blood pressure (BP) was significantly higher in the HE group than in the HU group (p < 0.001). Median mean platelet volume (MPV) was higher in the HE group compared with HU and control groups [9.5 (Interquartile range, IQR: 8.7-10.1), 8.4 (IQR: 7.7-9.1), and 8.3 (IQR: 7.7-8.7) fl, each p < 0.001, respectively). In linear regression analysis, systolic BP (β = 0.18, 95% confidence intervals (CI): 0.002-0.015, p = 0.007) and diabetes mellitus (β = 0.24, 95% CI: 0.28-0.95, p < 0.001) were independently associated with MPV levels. Our findings show that MPV can be elevated in patients with HE and HU. It can be independently associated with systolic BP and diabetes mellitus. These findings imply that platelet activation contribute to the pathogenesis of thrombotic complications in hypertensive crises.

Mean Platelet Volume, Neutrophil-To-Lymphocyte Ratio, and Platelet-To-Lymphocyte Ratio as İnflammatory Markers in patients with Recurrent Aphthous Stomatitis.
            (Karaer, 2020) Download
Objective:  The aim of this study is to examine the associations between white blood cell (WBC), hemoglobin (Hb), neutrophil, lymphocyte, platelet, mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels in patients with recurrent aphthous stomatitis (RAS). Materials and Methods:  For this study, 137 patients with RAS and 137 healthy controls were recruited. The study participants had no systemic diseases except RAS. Serum WBC, Hb, neutrophil, lymphocyte, platelet, MPV, PLR, NLR, ESR, and CRP levels were recorded in the active period for all patients with RAS and controls. Results:  There was no statistically significant difference in the WBC, Hb, neutrophil, lymphocyte, platelet, MPV, NLR PLR, ESR, and CRP levels between patients with RAS and controls. Conclusion:  No differences were observed for WBC, Hb, neutrophil, lymphocyte, platelet, MPV, NLR, PLR, ESR, and CRP levels between patients with RAS and controls. These parameters therefore cannot be used as markers for inflammation or inflammation severity in patients with RAS.

Mean platelet volume and platelet distribution width in vascular dementia and Alzheimer's disease.
            (Liang et al., 2014) Download
Activated platelets play a substantial role in Alzheimer's disease (AD) and atherothrombosis. Mean platelet volume (MPV) is an early marker of platelet activation, which is linked to a variety of pro-thrombotic and pro-inflammatory diseases. This study is to examine the association between platelet indices and vascular dementia (VaD) and AD. In this cross-sectional study, we investigated the levels of platelet count, MPV, and platelet distribution width (PDW) in 150 VaD patients, 110 AD patients, and 150 non-demented controls. MPV and PDW were significantly lower in patients with VaD and AD as compared with controls. The decrease in PDW for AD patients as compared with VaD patients was also significant (p < 0.001). In addition, there was a positive correlation between Mini-Mental State Examination (MMSE) and MPV and PDW, after adjusting confounding factors (r = 0.532 for MPV and r = 0.425 for PDW, p < 0.001 for both). Multivariate regression analysis showed that MPV and PDW were significantly associated with MMSE (β = 0.366 for MPV and β = 0.273 for PDW, p < 0.001 for both). In conclusion, MPV and PDW were both decreased in VaD and AD. PDW levels were significantly lower in AD as compared to those in VaD. Our findings suggest that PDW in combination with MMSE scores could be potential indicators for distinguishing VaD from AD.

The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences.
            (Park et al., 2012) Download
Metabolic syndrome (MS) is becoming globally prevalent and it is clinically important because of its association with type 2 diabetes and cardiovascular disease, and some cancers. Recently, platelet count has been linked to insulin resistance and MS in addition to being a marker of hemostasis. Also, mean platelet volume (MPV) has been known to represent platelet activity. Platelet counts and MPV are modified by various biosocial and lifestyle factors such as race, age, gender, smoking habit, alcohol consumption, and physical activity. Thus, the direction and magnitude of this association may differ by gender. In this regard, proper interpretion of platelet counts and MPV by gender could be important in the people with MS. We examined the relationship between platelet counts, MPV, and MS through gender-specific analyses for 3827 Korean adults (2169 men and 1658 women) in a health examination program. In women, platelet counts were significantly higher in subjects with MS compared to in those without MS (p < 0.001), whereas MPV was significantly lower (p = 0.001). However, no such trend was observed in men. Multiple regression analyses also showed that MS is positively associated with platelet counts and inversely associated with MPV, independently of confounding variables only in women. The results suggest that platelet counts and MPV might be a surrogate marker associated with clustered MS in women.


 

EPA, but not DHA, decreases mean platelet volume in normal subjects.
            (Park and Harris, 2002) Download
The first indication of platelet activation is an increase in mean platelet volume (MPV). n-3 FA are known to inhibit platelet function and to reduce the risk for coronary heart disease. The purpose of this study was to determine the effects of EPA and DHA on MPV. Healthy subjects received olive oil placebo for 4 wk and then were randomly assigned to receive 4 g of ethyl esters of either safflower oil (n = 11), EPA (n = 10), or DHA (n = 12) for 4 wk. At the end of placebo run-in and treatment periods, MPV (fL; mean +/- SEM) and platelet count (PLT-CT; 10(3)/microL blood) were measured in the basal state and after ex vivo stimulation with collagen (10 microg/mL), cold (4 degrees C), and heat (37 degrees C). Unlike DHA, EPA lowered MPV as compared with safflower oil (7.2 +/- 0.1 vs. 7.5 +/- 0.1 fL; P < 0.05) and raised PLT-CT (211 +/- 18 vs.192 +/- 18 10(3)/microL; P < 0.05) in the fasting state. Collagen and cold significantly increased MPV whereas heat lowered MPV regardless of treatment. All stimuli decreased PLT-CT. EPA significantly increased platelet EPA (0.2 +/- 0.1 vs. 3.3 +/- 0.4%) and docosapentaenoic acid (DPA; 2.2 +/- 0.3 vs. 2.9 +/- 0.3%) concentrations, but not DHA. DHA treatment significantly increased DHA (1.4 +/- 0.2 vs. 4.1 +/- 0.5%) and DPA (2.0 +/- 0.4 vs. 3.0 +/- 0.4%) concentrations, but not EPA. In conclusion, EPA, but not DHA, reduces platelet activation, an early step in platelet aggregation.

Effects of gamma-tocopherol supplementation on thrombotic risk factors.
            (Singh et al., 2007) Download
OBJECTIVE:  The antioxidant activity of vitamin E is derived primarily from alpha-tocopherol (alpha-T) and gamma-tocopherol (gamma-T). Results of epidemiological studies have demonstrated an inverse relationship between vitamin E intake and coronary disease. However, the results of clinical trials using alpha-T are equivocal. We determined the effect of 5 weeks of 100 mg/d or 200 mg/d gamma-T supplementation on thrombotic markers such as platelet reactivity, lipid profile and the inflammation marker C-reactive protein (CRP). METHODS AND RESULTS:  Fourteen healthy subjects consumed 100 mg/day while 13 consumed 200 mg/d of gamma-T and 12 received placebo (soybean capsules with less than 5 mg/d gamma-T) in a double-blinded parallel study design. Fasting pre and post dose blood samples were analysed. Blood gamma-T concentrations increased significantly (p<0.05) relative to dose during the intervention period. Both groups receiving active ingredients showed significantly lower platelet activation after supplementation (p<0.05). Subjects consuming 100 mg/d gamma-T had significantly decreased LDL cholesterol, platelet aggregation and mean platelet volume (MPV) (p<0.05). Little effect of gamma-T was observed on other parameters. CONCLUSIONS:  These data suggest that gamma-T supplementation may have a permissive role in decreasing the risk of thrombotic events by improving lipid profile and reducing platelet activity.

Overt and mild subclinical hypothyroidism do not influence mean platelet volume in premenopausal women having low cardiac risk.
            (Torun et al., 2012) Download
Mean platelet volume (MPV) was studied in subclinical hypothyroidism (SH) and the results are conflicting. The aim of this study is to assess how MPV is affected in overt hypothyroidism (OH) and mild SH, the 2 end points of hypothyroidism, in patients having low cardiac risk. Premenopausal women without any cardiac risk, 18 with OH, 30 with mild SH, and 37 euthyroid controls were enrolled. Overt hypothyroidism group had higher low-density lipoprotein cholesterol (LDL-C) and total cholesterol levels than the control group (P < .001 and P < .05, respectively). Increase in MPV was insignificant in OH group when compared with SH and control groups. No correlation was observed between MPV and metabolic and hormonal parameters. Both OH and SH did not influence MPV and high-sensitivity C-reactive protein (hs-CRP) in patients with low cardiovascular risk, but these findings need to be further evaluated in this patient group.

Usefulness of mean platelet volume for predicting stroke risk in atrial fibrillation patients.
            (Turfan et al., 2013) Download
Early detection of atrial fibrillation patients at high risk for stroke is important. There are some studies which indicate that mean platelet volume (MPV) determines the prognosis and risk in patients with a stroke. In this study, our aim was to investigate the association between the MPV measured in stroke patients with atrial fibrillation. Consecutive patients referred to our center between January 2010 and April 2012 were included in this study. The patients with atrial fibrillation were classified into two groups according to presence or absence of a history of stroke by combining data from the medical histories after a thorough review of the medical records. MPV determination was made within 24 h following the onset of stroke. We studied 63 consecutive stroke patients with atrial fibrillation and 77 atrial fibrillation patients without stroke history. In receiver-operating characteristic (ROC) curve analysis, the value for MPV levels to detect stroke with a sensitivity of 63.5% and specificity of 64.4% was 9.4 fl. High MPV (>9.4 fl) was significantly associated with the occurrence of stroke [odds ratio (OR) 4.021, 95% confidence interval (CI) 1709-9464, P < 0.001]. Our study supports the hypothesis that a high MPV is associated with an increased risk of stroke in atrial fibrillation patients.

 


References

Archontogeorgis, K, et al. (2018), ‘Mean Platelet Volume and Platelet Distribution Width in Patients With Obstructive Sleep Apnea Syndrome and Concurrent Chronic Obstructive Pulmonary Disease.’, Clin Appl Thromb Hemost, 24 (8), 1216-22. PubMed: 30016881
Bolaman, Z, et al. (2003), ‘Oral versus intramuscular cobalamin treatment in megaloblastic anemia: a single-center, prospective, randomized, open-label study.’, Clin Ther, 25 (12), 3124-34. PubMed: 14749150
Cumhur Cure, M, et al. (2014), ‘Mean platelet volume and vitamin D level.’, Ann Lab Med, 34 (2), 98-103. PubMed: 24624344
Cure, E, et al. (2013), ‘Is the mean platelet volume predictive of hip fractures in the elderly’, Ann Lab Med, 33 (5), 367-70. PubMed: 24003430
Dolasık, I, et al. (2013), ‘The effect of metformin on mean platelet volume in dıabetıc patients.’, Platelets, 24 (2), 118-21. PubMed: 22494325
Du, J, et al. (2016), ‘Association of mean platelet volume and platelet count with the development and prognosis of ischemic and hemorrhagic stroke.’, Int J Lab Hematol, 38 (3), 233-39. PubMed: 26992440
Feng, C, et al. (2013), ‘Relationship between mean platelet volume and coronary blood flow in patients with atrial fibrillation.’, Heart Lung Circ, 22 (1), 43-49. PubMed: 22981758
Hansen, JB, et al. (1993), ‘Effects of cod liver oil on lipids and platelets in males and females.’, Eur J Clin Nutr, 47 (2), 123-31. PubMed: 8436090
Karabacak, M, et al. (2014), ‘Mean platelet volume is increased in patients with hypertensive crises.’, Platelets, 25 (6), 423-26. PubMed: 24102343
Karaer, IC (2020), ‘Mean Platelet Volume, Neutrophil-To-Lymphocyte Ratio, and Platelet-To-Lymphocyte Ratio as İnflammatory Markers in patients with Recurrent Aphthous Stomatitis.’, Eurasian J Med, 52 (1), 38-40. PubMed: 32158312
Liang, QC, et al. (2014), ‘Mean platelet volume and platelet distribution width in vascular dementia and Alzheimer’s disease.’, Platelets, 25 (6), 433-38. PubMed: 24175580
Park, BJ, et al. (2012), ‘The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences.’, Platelets, 23 (1), 45-50. PubMed: 21736420
Park, Y and W Harris (2002), ‘EPA, but not DHA, decreases mean platelet volume in normal subjects.’, Lipids, 37 (10), 941-46. PubMed: 12530552
Singh, I, et al. (2007), ‘Effects of gamma-tocopherol supplementation on thrombotic risk factors.’, Asia Pac J Clin Nutr, 16 (3), 422-28. PubMed: 17704022
Torun, AN, AK Uzum, and N Aksoy (2012), ‘Overt and mild subclinical hypothyroidism do not influence mean platelet volume in premenopausal women having low cardiac risk.’, Clin Appl Thromb Hemost, 18 (3), 312-15. PubMed: 21873361
Turfan, M, et al. (2013), ‘Usefulness of mean platelet volume for predicting stroke risk in atrial fibrillation patients.’, Blood Coagul Fibrinolysis, 24 (1), 55-58. PubMed: 23080368