Mean platelet volume in Korean patients with hepatic diseases

Mean platelet volume (MPV) is a parameter generated by fully automated blood count analyzers as a part of routine complete blood count, and a useful platelet function index that can show platelet activation and its production rate in bone marrow [1]. MPV has been studied in various disease groups other than hematologic disease such as cardiovascular and rheumatic diseases [2–5]. It has been also investigated in several hepatic diseases and showed significant differences in these disease entities [1], [6–10]. Recently, we read a series of interesting articles about MPV in various hepatic diseases [6], [8], [10]. In this study, we planned to investigate this platelet index in Korean patients with chronic hepatitis B (CHB) and hepatocellular carcinoma (HCC) accompanying increased alpha-fetoprotein (AFP).

The study included 115 with CHB and HCC for patients group, and 311 subjects for medical check-ups for control group, at Kyung Hee Medical Center, a tertiary teaching hospital, between November 2010 and August 2011. Mean age of patient group was 61.13 (range 16–89 years), and male to female ratio was 127:67. Blood sampling was performed through venepuncture and MPV was measured using EDTA-containing tubes in Advia 2120 (Bayer Diagnostics, Tarrytown, NY, USA) within 2 h. AFP was tested using Modular Analytics E170 (Roche Diagnostics, Mannheim, Germany). Analysis of variance followed by post hoc analysis were used to compare means in our study. Pearson correlation analysis was used to examine the relationships between variables. The statistical analyses were performed with MedCalc v11.6 (MedCalc Software, Mariakerke, Belgium) and Excel 2007 (Microsoft Corporation, Redmond, WA, USA). Statistical significance was set at p = 0.05.

Mean of MPV levels showed the significant difference, which was 8.70 fl (range 7.2–13.0 fl) in patients group and 8.02 fl in control group (range 6.7–11.0 fl), respectively. Moreover, when patients group was subdivided into CHB and HCC groups, the significant difference was also observed among these two patient groups and control group (p < 0.001; Figure 1). However, there was no correlation between AFP and MPV.

Figure 1. When patients group was subdivided into CHB and HCC groups, the significant difference was observed among these two patient groups and control group (p < 0.001).

Thrombopoietin (TPO), which is synthesized in the liver, could play a relevant role to increase MPV in hepatic diseases. Moreover, in addition to TPO, several cytokines, inflammatory mediators, and growth factors may affect MPV, with subsequent production of larger and more reactive platelets [2–5]. These mechanisms could be involved in several hepatic diseases, such as CHB and HCC. The limitation of our study was relatively long study durations about 2 years. The further study with more patients should be followed to investigate the reason of this increase, relations with other hepatic enzyme such as gamma-glutamyl transpeptidase and alanine aminotransferase, and possibility to use as a biomarker in MPV.

Declaration of interest: The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.