Analysis of Platelet Large Cell Ratio (P-LCR) and its Correlation with Lipid Parameters in a Dyslipidemic Patient: A Retrospective Observational Study

Background: Platelet activation is among the key variables in atherothrombosis. The percentage of large, hyperreactive platelets can be measured using the Platelet Large Cell Ratio (P-LCR), a metric reported by automated hematology analyzers. More study is essential to determine the relationship with dyslipidemia, a major cardiovascular risk factor. For the hematological workup of the patients, we have the Erba Elite 580, a fully automated 5-part differential hematology analyzer designed for high-throughput complete blood count (CBC) and differential testing. The analyzer reports 26 key parameters, including: WBC, LYM (absolute and %), MON (absolute and %), NEU (absolute and %), EOS (absolute and %), BAS (absolute and %), RBC, HGB, hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW-CV and RDW-SD), PLT, platelet distribution width (PDW), mean platelet volume (MPV), plateletcrit (PCT), platelet-large cell ratio (P-LCR), and platelet-large cell count (P-LCC). Additional features include automatic floating discriminators for detecting immature or atypical cells and enhanced platelet parameters (e.g., PDW-SD, PDW-CV) for improved diagnostic accuracy. The goal of this research was to review the relationship between P-LCR and other platelet indices and standard lipid parameters by examining results in a diverse patient cohort. Material and Methods: One hundred patients were included in our retrospective analysis. This data included platelet indices (Platelet Count, MPV, PDW, P LCR, P-LCC) and lipid profiles (Total Cholesterol, TG, HDL, LDL, VLDL). This statistical analysis included descriptive statistics, group comparisons (t-tests and ANOVAs), and Pearson correlations. For the hematological workup of the patients, we have been using the hematological analysis Erba Elite 580. It is a fully automated 5-part differential hematology analyzer designed for high-throughput complete blood count (CBC) and differential testing. A cyanide-free reagent for hemoglobin (HGB) measurement and the impedance method for counting and sizing white blood cells (WBC), red blood cells (RBC), and platelets (PLT) have been used to guarantee operator safety and environmental compliance. It integrates chemical dye staining, flow cytometry (FCM) technology, a semiconductor laser scatter, and an independent basophil channel for WBC differential analysis. This allows for accurate 5-part differentiation (lymphocytes [LYM], monocytes [MON], neutrophils [NEU], eosinophils [EOS], and basophils [BAS]) and sophisticated 3D scatterplot visualization for morphological evaluation. The cohort's mean P-LCR was 41.79% (SD: 10.31). MPV (r=0.994, p<0.0001) and PDW-SD (r=0.926, p<0.0001) showed a significant, strong positive correlation with P-LCR. P-LCR showed a weak but significant positive correlation with HDL (r=0.261, p=0.009) and total cholesterol (r=0.199, p=0.047). P-LCR did not differ significantly between sexes (p=0.299) or between age groups (p=0.200). Platelet count was strongly negatively correlated with P-LCR (r=-0.518, p<0.0001). Conclusion: Elevated P-LCR is prevalent in this patient cohort and is significantly correlated with key lipid parameters. The inverse relationship between platelet count and MPV, and the strong association between MPV and platelet reactivity, suggest a state of increased platelet reactivity. P-LCR is a valuable, readily available hematological marker that may aid in assessing thrombotic risk in patients with dyslipidemia.