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How important are mean platelet volume and neutrophil values in diabetic foot amputation decision?



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.

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Corresponding author

Correspondence to Burak Keklikcioglu.

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Conflict of interest

Rana Kapuyakaya, Ahmet Kapukaya, Burak Keklikcioglu, and Asena Ayça Özdemir declare that they have no conflict of interest

Ethical approval

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).

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Informed consent was obtained from all individual participants included in the study.

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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).

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  • Diabetic foot
  • Amputation
  • MPV
  • Neutrophil