Are mean platelet volume (MPV), platelet distribution width (PDW), and platetelet counts associated with markers of vitamin B12, folate, and iron status?

16.03.2013 / Risch C, Stanga Z, Medina Escobar P, Nydegger UE, Risch M, Risch L
Are mean platelet volume (MPV), platelet distribution width (PDW), and platetelet counts associated with markers of vitamin B12, folate, and iron status?

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Es ist unbekannt, ob gewisse Eigenschaften der Blutplättchen (Anzahl, mittleres Volumen, Verteilung der Volumina) allenfalls auf Mangelzustände für gewisse Vitamine (Folsäure und Vitamin B12) und Spurenelemente (Eisen) hinweisen könnten. Diese Zusammenhänge wurden bei Senioren untersucht. Es konnte gezeigt werden, dass diese Eigenschaften nicht geeignet sind, um auf einen Vitaminmangel hinzuweisen. Auch bezüglich Hinweis auf einen Eisenmangel sind die untersuchten Parameter nur von begrenztem Nutzen. Die Resultate dieser Analyse wurden am internationalen IFCC-Euromedlab Kongress für Labormedizin, welcher vom 19. – 23. Mai 2013 in Milano stattgefunden hat, vorgestellt. In der Folge ist daraus die Originalarbeit 1.) entstanden.

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Background:

Mean volume and distribution widths of red blood cells and leukocyte subpopulations have been shown to be associated with iron deficiency and/or vitamin B12 and folate deficiency. It would be interesting whether platelets as other cellular components of peripheral blood also display morphological characteristics linked to these nutritional deficiencies.

Aim:

To investigate, whether platelet counts, mean platelet volume and platelet distribution width are associated with markers of nutritional deficiencies.

Methods:

This cross-sectional analysis was performed within the framework of the ongoing www.seniorlabor.ch study, which includes subjectively healthy individuals aged >60 years. Vitamin B12 status was investigated by holotranscobalamin and total cobalamin, folate status was assessed with red cell folate and serum folate, whereas iron status was assessed with ferritin and reticulocyte hemoglobin content. In a multivariate linear regression model, the association of these markers with platelet markers was controlled for age and gender.

Results:

A total of 1230 participants (697 females; 533 males; mean age 72 + 8 years) were included in the study. Platelet counts were inversely associated with markers of iron status (ferritin and reticulocyte hemoglobin; both P <0.001), folate status (serum folate P=0.02; RBC folate P <0.001) and B12 status (total B12 P=0.02; HoloTc P <0.01). Ferritin was associated with both mean platelet volume (MPV) and platelet distribution width (PDW) (P <0.01), whereas reticulocyte hemoglobin was only associated with PDW (P <0.01). Neither MPV nor PDW was associated with markers of vitamin B12 and folate status.

Conclusions:

Whereas quantitative platelet counts are associated with markers of iron, vitamin B12 and folate status, qualitative platelet characteristics (MPV and PDW) are only associated with markers of iron status. Morphological platelet markers are unrelated to vitamin B12 and folate status.