Authors' reply: ‘Mean platelet volume could be a promising biomarker to monitor dietary compliance in celiac disease'

We thank Dr Varol for his interest in our article (1). First of all, we agree with Dr Varol regarding the methodological concern of mean platelet volume (MPV) assessments (2). Blood samples must be studied within 2 hours, as in our study, to avoid falsely elevated results. Also, when commenting MPV values in different studies, one must be cautious about the analyzer device. Different analyzer devices might produce different MPV results, and this fact should be taken into account before generalization of the results. Therefore, we tried to use the same analyzer device (Beckman Coulter analyzer) as in our previous studies (3,4).

Secondly, Dr Varol mentions in great detail variables which affect MPV. Currently, almost all diseases may influence MPV. Excluding MPV-related diseases is practically impossible, but to some extent, however, researchers might take appropriate measures to avoid fluctuations of MPV. Moreover, our main driving force behind this study was to find a useful marker for dietary compliance of celiac patients other than the change in MPV.

Finally, we find Dr Varol's hypothesis very intriguing regarding a relationship between celiac disease and cardiovascular disease. Hitherto, with respect to cardiovascular mortality among celiac patients, studies have yielded conflicting results. However, in a recent study performed in a large group of patients, it was concluded that celiac patients have more favorable cardiac profiles compared with controls (5). As a result of that, our current knowledge about celiac disease is evolving, and all clues including Dr Varol's hypothesis will broaden our horizon.