Previous studies have shown mean platelet volume (MPV) levels to be an important biomarker in the formation of foot ulcers in diabetic patients. The aim here was to show whether MPV, monocyte, platelet, and neutrophil levels could guide diabetic foot amputation.
Two groups of patients diagnosed with type 2 diabetes and homogeneous in terms of age, sex, diabetes duration, body mass index (BMI), and hemoglobulinA1C (HbA1C) levels were included. The first group consisted of 36 patients with amputation, and the second group consisted of 30 patients with ulceration but no indication for amputation. Besides overall demographic characteristics, preoperative HbA1C, MPV, platelet, monocyte, and neutrophil levels were determined in both groups.
The amputated group had higher MPV and neutrophil levels than the non-amputated control group (p = 0.028 and p < 0.001, respectively). Neutrophil levels could differentiate amputations at a rate of 69.44% and non-amputations at 76.67%. Platelet levels were not statistically significant in differentiating between amputated and non-amputated patients (p = 0.064). Neutrophil levels were 1.207 times higher, and platelet levels were 1.005 higher in the amputation group (p < 0.05).
The atherosclerotic process that occurs during the course of diabetes is thought to be associated with high MPV levels in patients with diabetic foot ulcers. However, the findings obtained here support the use of neutrophil and platelet levels as a marker to predict amputation in diabetic foot monitoring. Further prospective studies with larger numbers of patients are needed to determine the role of MPV levels in the follow-up of diabetic foot ulcers.
Level of evidence
Level III, risk/prognostic study.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD (2011) Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 17(1):47–58
Park Y, Schoene N, Harris W (2002) Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 13:301–306
Agrawal J, Singh VB, Meena B, Yadav R, Shareef M, Saini V (2017) Mean platelet volume (MPV) the neglected marker of cardiovascular risk and glycosylated hemoglobin in diabetic patient. Diabetes Metab Syndr 11(2):109–112
Armstrong DG, Wrobel J, Robbins JM (2007) Guest Editorial: are diabetes-related wounds and amputations worse than cancer? Int Wound J 4:286–287
Zingg M, Nicodème JD, Uçkay I, Ray A, Suva D (2014) Lower limb amputation: indication, preoperative workup and complications. Rev Med Suisse 17:2409–2413
Thompson CB, Jakubowski JA, Quinn PG et al (1983) Relation with mean platelet volume and diabetic foot ulcers 403 Valeri CR. Platelet size as a determinant of platelet function. J Lab Clin Med 101:205–213
Papanas N, Symeonidis G, Maltezos E et al (2004) Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 15:475–478
Unübol M, Ayhan M, Güney E (2012) The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus. Platelets 23:475–480
Xiao W, Huang Y, Dong J et al (2014) Relationship between platelet volume indices with macrovascular and peripheral neuropathy complications in type 2 diabetic patients. J Diabetes 6(4):298–303
Sansanayudh N, Anothaisintawee T, Muntham D, McEvoy M, Attia J, Thakkinstian A (2014) Mean platelet volüme and coronary artery disease: a systematic review and meta-analysis. Int J Cardiol 175(3):433–440
Yüksel Kalkan G, Gür M, Baykan AO et al (2014) Mean platelet volume is associated with aortic intimamedia thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease. Anadolu Kardiyol Derg. https://doi.org/10.5152/akd.2014.5576
Ozkan Ç, Kalan I, Turhan Ö et al (2016) The relationship between inflammatory markers and mean platelet volume in patients with diabetic foot infection. GMJ 27:149–151
Mardia A I, Gatot D, Lindarto D (2018) Comparison platelet indices in diabetic patients with and without diabetic foot ulcer. IOP Conf. Series: Earth and Environmental Science 125 012134
Yesil S, Akinci B, Yener S et al (2009) Predictors of amputation in diabetics with foot ulcer: Single center experience in a large Turkish cohort. Hormones 8(4):286–295
Günes AE, Eren MA, Karakas EY et al (2017) Relation with mean platelet volüme and diabetic foot ulcers. Acta Med Mediterr 33:401
Conflict of interest
Rana Kapuyakaya, Ahmet Kapukaya, Burak Keklikcioglu, and Asena Ayça Özdemir declare that they have no conflict of interest
All procedures were in accordance with the 1964 Helsinski Declaration and its later ammendments. The study was approved by the Clinical Research Ethics Committee of the Faculty of Medicine at the Training and Research Hospital (48/680).
Informed consent was obtained from all individual participants included in the study.
Patients signed informed consent regarding publishing their data.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Kapukaya, R., Kapukaya, A., Keklikcioglu, B. et al. How important are mean platelet volume and neutrophil values in diabetic foot amputation decision?. Eur J Plast Surg 44, 507–510 (2021). https://doi.org/10.1007/s00238-020-01773-2
- Diabetic foot