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      The Correlation Between RDW, MPV and Weight Indices After Metabolic Surgery in Patients with Obesity and DM/IGR: Follow-Up Observation at 12 Months

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          Abstract

          Introduction

          Red blood cell distribution width (RDW) and mean platelet volume (MPV) are both new biomarkers for the prognosis of many diseases. This study aimed to observe the predictive values of RDW and MPV for weight loss after different metabolic surgeries in patients with obesity and abnormal glucose metabolism [diabetes mellitus or impaired glucose regulation (DM/IGR)].

          Methods

          We retrospectively analyzed the body weight (BW), body mass index (BMI) and blood routine index of 98 patients with obesity and DM/IGR who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).

          Results

          Levels of RDW and MPV in both groups were significantly higher than before 1 month after surgery and then gradually decreased. Twelve months after surgery, the RDW level in the RYGB group was significantly lower than that before surgery. In the RYGB group, the RDW level of patients in the high-level percentage weight loss (%BW) (≥ 31.90) at 6 and 12 months after surgery decreased significantly compared to those in the corresponding low level. %BW and change in BW and BMI (ΔBW and ΔBMI) at 6 and 12 months after surgery in the high-level RDW (≥ 12.90) before surgery were significantly higher than those in the low level in the RYGB group. No significant difference in weight index was found in the high and low levels of the MPV before surgery in either group at other follow-up time points.

          Conclusions

          Preoperative baseline RDW and postoperative RDW levels can preliminarily predict the effect of different metabolic surgeries in patients with obesity and DM/IGR.

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          Most cited references21

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          Neutrophil-Lymphocyte ratio and Platelet-Lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus.

          Cuma Mertoglu, Murat Günay (2017)
          Chronic inflammation plays a central role in the development and progression of diabetes, and in the pathogenesis of its complications. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are indicators of subclinical inflammation. Mean platelet volume (MPV) is one of the platelet function indices. We investigated the association of NLR, PLR and MPV with prediabetes and type 2 diabetes mellitus and determine whether or not these are reliable markers for diagnosis.
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            Mean platelet volume in patients with type 2 diabetes mellitus.

            G Symeonidis, E. Maltezos, T Vosnakidis … (2004)
            To evaluate mean platelet volume (MPV) in type 2 diabetic versus non-diabetic patients, as well as to investigate the associations between MPV and diabetic complications. This study included 416 patients divided into two groups. Group A comprised 265 type 2 diabetic patients (131 men) with a mean age of 67.4 +/- 9.5 years and a mean diabetes duration of 14.5 +/- 5.7 years. Group B comprised 151 non-diabetic patients (74 men) with a mean age of 68.6 +/- 9.1 years. MPV (blood samples anticoagulated with sodium citrate) was measured in two blood cell counters (Sysmex SF 3000 and Cell-Dyn 3700). MPV was significantly higher (P = 0.01) in group A (14.2 +/- 2.2 fl) than in group B (7.1 +/- 1.2 fl). In group A MPV was significantly higher (P = 0.043) in patients with retinopathy (15.8 +/- 1.3 fl) than in patients without retinopathy (10.9 +/- 1.1 fl) and also significantly higher (P = 0.044) in patients with microalbuminuria (15.6 +/- 1.2 fl) than in patients without microalbuminuria (10.1 +/- 1.2 fl). No association, however, was found in group A between MPV and age, gender, duration of diabetes, insulin dependency, BMI, HbA1c, coronary artery disease or dyslipidaemia. MPV is higher in type 2 diabetic patients than in non-diabetic patients. Among type 2 diabetic patients MPV is higher in those who have microvascular complications (retinopathy or microalbuminuria).
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              New roles for mean platelet volume measurement in the clinical practice?

              Patrizia Noris, Federica Melazzini, Carlo L. Balduini (2016)
              Several hundreds of studies recently investigated mean platelet volume (MPV) as measured by electronic cell counters in a wide variety of acquired diseases, and most of them found that platelet size was significantly increased with respect to healthy subjects. On this basis, it has been suggested that MPV can be used for diagnostic purposes. Moreover, investigation of subjects with arterial thrombosis not only revealed that their platelets were larger than those of controls, but also found that a high MPV predicted poor prognosis. Despite the large amount of available data, the pathogenesis of increased platelet size in these conditions is unclear. In particular, we do not know whether the increased platelet size is the cause or the consequence of thrombosis. Differences in MPV between patients and controls are usually very small and they reach the statistical significance because of the large number of investigated patients and the standardized methodology for MPV measurement. In real life, the wide variability of MPV possibly due to platelet count, sex, age, and ethnicity, as well as the very poor standardization of the methodologies used for MPV measurement, makes it impossible to decide whether an individual patient has normal or instead slightly increased MPV. So, MPV has presently no role in making diagnosis and defining prognosis in any acquired illness.
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                Author and article information

                Contributors
                Hui Liang: drhuiliang@126.com
                Hongwen Zhou: drhongwenzhou@njmu.edu.cn
                Journal
                Journal ID (nlm-ta): Diabetes Ther
                Journal ID (iso-abbrev): Diabetes Ther
                Title: Diabetes Therapy
                Publisher: Springer Healthcare (Cheshire )
                ISSN (Print): 1869-6953
                ISSN (Electronic): 1869-6961
                Publication date (Electronic): 13 August 2020
                Publication date PMC-release: 13 August 2020
                Publication date (Print): October 2020
                Volume: 11
                Issue: 10
                Pages: 2269-2281
                Affiliations
                [1 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Department of Endocrinology and Metabolism, , The First Affiliated Hospital of Nanjing Medical University, ; 300 Guangzhou Road, Nanjing, 210029 Jiangsu China
                [2 ]GRID grid.89957.3a, ISNI 0000 0000 9255 8984, Department of Endocrinology and Metabolism, , The Affiliated Huai’an No.1 People’s Hospital of Nanjing Medical University, ; 1 Huanghe West Road, Huai’an, 223300 Jiangsu China
                [3 ]GRID grid.412676.0, ISNI 0000 0004 1799 0784, Department of General Surgery, , The First Affiliated Hospital of Nanjing Medical University, ; 300 Guangzhou Road, Nanjing, 210029 Jiangsu China
                Article
                Publisher ID: 897
                DOI: 10.1007/s13300-020-00897-9
                PMC ID: 7509025
                PubMed ID: 32789779
                SO-VID: 3499467c-186a-4b21-bb67-08e9abc267e4
                Copyright © © The Author(s) 2020
                License:

                Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 19 June 2020
                Funding
                Funded by: the National Key R&D Program of China
                Award ID: 2018YFA0506904
                Award Recipient :
                Funded by: major Research plan of the National Natural Science Foundation of China
                Award ID: 91854122
                Funded by: the National Natural Sciences Foundation of China
                Award ID: 81670723
                Funded by: Revitalize and Defend the Key Talent's Subsidy Project in Science and Education of the Department of Public Health of Jiangsu Province
                Award ID: ZDRCA2016017
                Categories
                Subject: Original Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: diabetes mellitus,impaired glucose regulation,mean platelet volume,metabolic surgery,obesity,red blood cell distribution width
                Data availability:
                ScienceOpen disciplines: Endocrinology & Diabetes
                Keywords: diabetes mellitus, impaired glucose regulation, mean platelet volume, metabolic surgery, obesity, red blood cell distribution width

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