Key result
Higher mean platelet volume was independently associated with a central non-dipping blood pressure pattern in adults with type 1 diabetes (OR 3.74).
Why the study?
Hypertensive non-dippers have higher mean platelet volume than dippers, but the relationship between central dipping pattern and platelet morphology had never been investigated in type 1 diabetes.
Does a central non-dipping blood pressure pattern associate with altered platelet morphology (MPV and PDW) in adults with type 1 diabetes without cardiovascular disease?
Cross-Sectional (n=62)
No
Does a central non-dipping blood pressure pattern associate with altered platelet morphology (MPV and PDW) in adults with type 1 diabetes without cardiovascular disease?
In adults with type 1 diabetes without cardiovascular disease, a central non-dipping blood pressure pattern is independently associated with increased platelet activation markers (MPV and PDW), suggesting a potential mechanism for elevated cardiovascular risk.
Should not yet change practice in type 1 diabetes; hypothesis-generating for mean platelet volume and BP patterns.
Background People with type 1 diabetes mellitus (T1DM) have higher cardiovascular risk (CVR) compared to those from the general population. One of the markers of elevated CVR is a non-dipping pattern. Mean platelet volume (MPV) and platelet distribution width (PDW) are related to platelets' activation. Aortic systolic blood pressure (SBP Ao) has a better predictive value for cardiovascular disease than brachial systolic blood pressure (SBP Br). Hypertensives with non-dipping pattern have higher MPV than dippers. However, this relationship was never investigated among people with T1DM. This study aimed to investigate the association between central dipping pattern and platelets morphology in subjects with T1DM. Methods We measured SBPAo and SBPBr with a validated non-invasive brachial oscillometric device - Arteriograph 24 (TensioMed Ltd., Budapest, Hungary) - during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The non-dipping pattern was defined as a nocturnal SBP Ao fall of less than 10%. We collected medical history, anthropometrical features, and laboratory results. The group was divided based on the dipping pattern for dippers and non-dippers. Results From total 62 subjects (32 males) aged 30.1 (25.7-37) years with T1DM duration 15.0 (9.0-20) years, 36 were non-dippers based on SBP Ao. Non-dipper group had significantly higher MPV (10.4 [10-10.7] fl vs 10.9 [10.3-11.5] fl; p = 0.03) and PDW (12.3 [11.7-12.8] fl vs 13.95 [11.7-15.1] fl; p=0.02) than dipper group. The groups did not differ in classic risk factors. Multivariate logistic regression revealed that MPV (OR: 3.74; 95% CI =1.48-9.45; p = 0.005) and daily insulin intake (OR: 445.11; 95% CI = 4.25 - 46597.42; p = 0.01) were independently positively associated with non-dipping pattern based on SBP Ao. PDW was also independently positively related to central non-dipping pattern (OR: 1.91; 95% CI = 1.22 - 3.00; p = 0.005). Conclusions T1DM subjects with central non-dipping pattern have higher values of MPV and PDW than dippers. MPV and PDW are independently positively associated with SBP Ao non-dipping pattern among people with T1DM.
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Kulecki et al. (2021) conducted a cross-sectional in Type 1 diabetes mellitus without cardiovascular disease (n=62). Mean platelet volume (MPV) vs. Reference MPV was evaluated on Central non-dipping pattern (nocturnal aortic systolic blood pressure fall <10%) (OR 3.74, 95% CI 1.48-9.45, p=0.005). Higher mean platelet volume was independently associated with a central non-dipping blood pressure pattern in adults with type 1 diabetes (OR 3.74).
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