Alev ALTİNOVA, Mujde AKTURK, Cigdem OZKAN, Ozlem IYİDİR TURHAN, Fusun TORUNER BALOS, Isilay KALAN, Ethem Turgay CERİT, Metin ARSLAN

The Relationship between Inflammatory Markers and Mean Platelet Volume in Patients with Diabetic Foot Infection

Amaç: Diyabetik ayak infeksiyonu (DAİ), diabetes mellitus ile izlenen hastalarda en sık karşılaşılan, ciddi ve maliyeti yüksek komplikasyonlarından biridir. Tam kan sayımında rutin olarak rapor edilen ortalama trombosit hacminin (MPV) diyabetik hastalarda arttığı rapor edilmiştir. Ayrıca yüksek MPV değerlerinin artmış kardiyovasküler risk ve tromboz ile ilişkili olduğu belirtilmiştir. Bu çalışmada diyabetik ayak osteomyeliti olan hastalarda akut dönemde ve tedavi sonrasında MPV değerlerinin inflamatuar belirteçler ile ilişkisini belirlemeyi amaçladık. Gereç ve Yöntem: Çalışmamızda 2004-2012 yılları arasında Gazi Üniversitesi Endokrinoloji ve Metabolizma Hastalıkları Kliniğinde izlenen ve kayıtlarına ulaşılabilen diyabetik ayak osteomyeliti ile izlenmiş olan kırk-yedi hastanın tedavi öncesinde ve sonrasında eritrosit sedimentasyon hızı (ESR), C- reaktif protein (CRP) değerleri, beyaz küre sayısı, trombosit sayısı ve MPV değerleri retrospektif olarak değerlendirildi. Bulgular: Hastaların ortalama yaşı 59.4 ± 10.0 yıl olarak tespit edildi. Otuz-bir hasta (%66) erkekti. Ortanca DM süresi 15 yıl , ortanca glikolize hemoglobin (HbA1c) değeri %7.9 olarak bulundu. Tedavi sonrasında ESR, CRP değerlerinde , beyaz küre sayısı, trombosit sayısında istatiksel olarak anlamlı düşüş tespit edildi (p < 0.001, p < 0.001, p < 0.001, p= 0.01). Tedavi sonrasında MPV değerlerinde 8.58 ± 1.38 fl'dan 8.68 ± 1.74 fl'a artış izlendi ancak bu artış istatistiksel olarak anlamlı bulunmadı (p= 0.60). MPV değeri ile tedavi öncesinde ve sonrasında ESR, CRP değerleri ve beyaz küre sayısı arasında bir korelasyon tespit edilmedi. Sonuç: Çalışmamız sonuçları MPV değerlerinin DAİ izleminde bir belirteç olarak kullanılmasını desteklememektedir. Ancak MPV değerlerinin DAİ izleminde rolünün belirlenmesi için daha geniş sayıda hasta ile yapılacak prospektif çalışmalara ihtiyaç vardır.

Diyabetik Ayak İnfeksiyonu ile İzlenen Hastalarda İnflamatuar Belirteçler ile MPV İlişkisinin Değerlendirilmesi

Objective: Diabetic foot infections (DFI) is one of the most common and debilitating complications of diabetes. Mean platelet volume (MPV), which is reported routinely in complete blood count has been shown to be increased in patients with diabetes. Higher MPV values have also been shown to be related with increased risk of cardiovascular events and thrombosis. In this study we aimed to study MPV values in DFI during the acute stage and after treatment, and its relationship between inflammatory markers. Patients and Methods: Data of all diabetic patients with DFI followed up in the Endocrinology and Metabolism Unit of Gazi University Hospital between 2004-2012 were reviewed. Forty-seven patients with diabetic foot osteomyelitis were included into the study. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell (WBC) count, platelet count, and MPV levels were recorded at baseline and after treatment from the computerized patient registry database. Results: The mean age of the patients included in the study was 59.4 ± 10.0 years. Thirty-one (66%) patients were male. Median duration of diabetes was 15 years. Median HbA1c was 7.9% . ESR, CRP, WBC and platelet counts were significantly decreased after treatment when compared to the baseline (p < 0.05). Following the treatment, we found an increase in MPV values from 8.58 ± 1.38 to 8.68 ± 1.74 (fl), but this was not statistically significant (p>0.05). MPV did not correlate with ESR, CRP and WBC counts before and after treatment in diabetic foot osteomyelitis. Conclusion: The results of our study suggest that values of MPV might not be used as a marker in DFI. Prospective studies with larger number of patients are needed to evaluate the role of MPV in diabetic foot infections.

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