Pınar AKHANLI, Sema HEPŞEN, Muhammed KİZİLGUL, Sevgi BİLEN AYHAN, Hakan DÜĞER, Hayri BOSTAN, Muhammed Erkam SENCAR, Bekir UCAN, Erman ÇAKAL

The impact of SGLT2-inhibitor therapy on platelet function in type 2 Diabetes mellitus

Anahtar Kelimeler:

SGLT2 inhibitors, mean platelet volume, hematocrit

The impact of SGLT2-inhibitor therapy on platelet function in type 2 Diabetes mellitus

Aim: We consider mean platelet volume (MPV), a pointer of platelet activity related to type 2 diabetes mellitus (T2DM) and vascular complications, may have a role in patients using Sodium-Glucose Co-Transporter 2 inhibitors (SGLT2i). Therefore, we aimed to evaluate the MPV change after SGLT2i use in diabetic patients.Matherial and Method: Hemogram parameters such as hemoglobin, hematocrit, and MPV in the 0th and 24th weeks of 102 patients with T2DM that received SGLT2i treatment added to their existing medications and of the control group in which participants are compatible in terms of age and gender factor were compared.Results: A significant increase was observed in the values of MPV and hemoglobin in the 0th and 24th weeks (9.3 (8.2-10.3) to 10.1±1.3, p<0.001, 13.9±1.42 to 14.4±1.5 p<0.001, respectively). Similarly, the hematocrit value increased (42±3.7 to 44.2±3.8, p<0.001). There was also a significant increase in both red blood cell (RBC) and platelet counts (5±0.42 to 5.2±0.47, p<0.001, 252,000 (209,000-304,000) to 262,000 (221,000-322,000), p=0.007, respectively). No correlation was identified in patients with T2DM between MPV and age and gender factors, diabetes duration, body mass index (BMI), fasting and postprandial blood glucose, and insulin use.Conclusion: Contrary to the studies analyzing the relation between MPV and T2DM and its complications, we detected that a 24-week SGLT2i treatment led to an increase in MPV value.

Keywords:

SGLT2 inhibitors, mean platelet volume, hematocrit,

PDF

___

Kakouros N, Rade JJ, Kourliouros A, Resar JR. Platelet function in patients with diabetes mellitus: from a theoretical to a practical perspective. Int J Endocrinol 2011; 2011: 742719.
Yamagishi S-I, Matsui T, Ueda S-I, Nakamura K, Imaizumi T. Advanced glycation end products (AGEs) and cardiovascular disease (CVD) in diabetes. Cardiovasc Hematol Agents Med Chem 2007; 5: 236–40.
Fujita Y, Inagaki N. Renal sodium glucose cotransporter 2 inhibitors as a novel therapeutic approach to treatment of type 2 diabetes: Clinical data and mechanism of action. J Diabetes Investig 2014; 5: 265–75.
Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015; 373: 2117–28.
Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2019; 380: 347–57.
Davì G, Patrono C. Platelet activation and atherothrombosis. N Engl J Med 2007; 357: 2482–94.
van der Loo B, Martin JF. A role for changes in platelet production in the cause of acute coronary syndromes. Arterioscler Thromb Vasc Biol 1999; 19: 672–79.
Berger JS, Eraso LH, Xie D, Sha D, Mohler ER. Mean platelet volume and prevalence of peripheral artery disease, the National Health and Nutrition Examination Survey, 1999-2004. Atherosclerosis 2010; 213: 586–91.
Inoue H, Saito M, Kouchi K, Asahara S-I, Nakamura F, Kido Y. Association between mean platelet volume in the pathogenesis of type 2 diabetes mellitus and diabetic macrovascular complications in Japanese patients. J Diabetes Investig 2020; 11: 938–45.
Sertbas Y, Sertbas M, Okuroglu N, Ozturk MA, Abacar KY, Ozdemir A. Mean platelet volume changes before and after glycated hemoglobin (HbA1c) improvement in a large study population. Arch Med Sci. 2017; 13: 711–15.
Ji S, Zhang J, Fan X, et al. The relationship between mean platelet volume and diabetic retinopathy: a systematic review and meta-analysis. Diabetol Metab Syndr 2019; 11: 25.
Buch A, Kaur S, Nair R, Jain A. Platelet volume indices as predictive biomarkers for diabetic complications in Type 2 diabetic patients. J Lab Physicians 2017; 9: 84–8.
Verdoia M, Schaffer A, Barbieri L, et al. Diabetes, glucose control and mean platelet volume: a single-centre cohort study. Diabetes Res Clin Pract 2014; 104: 288–94.
Coban E, Bostan F, Ozdogan M. The mean platelet volume in subjects with impaired fasting glucose. Platelets 2006; 17: 67–9.
Shah B, Sha D, Xie D, Mohler ER, Berger JS. The relationship between diabetes, metabolic syndrome, and platelet activity as measured by mean platelet volume: the National Health And Nutrition Examination Survey, 1999-2004. Diabetes Care 2012; 35: 1074–78.
Demirtunc R, Duman D, Basar M, Bilgi M, Teomete M, Garip T. The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications 2009; 23: 89–94.
Dolasık I, Sener SY, Celebı K, Aydın ZM, Korkmaz U, Canturk Z. The effect of metformin on mean platelet volume in dıabetıc patients. Platelets 2013; 24: 118–21.
Sano M, Goto S. Possible Mechanism of Hematocrit Elevation by Sodium Glucose Cotransporter 2 Inhibitors and Associated Beneficial Renal and Cardiovascular Effects. Circulation 2019; 139: 1985–87.
Lambers Heerspink HJ, de Zeeuw D, Wie L, Leslie B, List J. Dapagliflozin a glucose-regulating drug with diuretic properties in subjects with type 2 diabetes. Diabetes Obes Metab 2013; 15: 853–62.