Elsevier

Joint Bone Spine

Volume 75, Issue 3, May 2008, Pages 291-294
Joint Bone Spine

Original article
Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis

https://doi.org/10.1016/j.jbspin.2007.06.016Get rights and content

Abstract

Aims

The aim of this retrospective study was to investigate the correlation between MPV and the clinical disease activity indices of rheumatoid arthritis and ankylosing spondylitis.

Methods

The study consisted of 32 active RA patients (males/females: 7/25, mean age: 49 ± 13) and 30 active AS patients (males/females: 15/15, mean age: 36 ± 12) along with 26 osteoarthritis (OA) patients (males/females: 4/22, mean age: 52 ± 8) and 29 age-matched healthy subjects (males/females: 5/24, mean age: 41 ± 7) as control groups for RA and AS, respectively.

Results

MPV was significantly lower in both AS patients and RA patients with active disease as compared to controls (RA vs OA p < 0.001, AS vs healthy subjects p < 0.001). After treatment MPV values significantly increased in AS and RA (p < 0.001 for all). However, MPV values remained somewhat lower in RA patients than OA patients (p = 0.019). There was a negative correlation between MPV values and BASDAI scores in AS patients after two months of treatment (r = −0.507; p = 0.004).

Conclusion

Our results suggest that assessment of MPV may provide additional information about inflammation in AS and RA.

Introduction

C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are the most widely used assays for measuring acute phase response due to their reliability, reproducibility and cost effectiveness [1], [2], [3], [4]. On the other hand, ESR is influenced by several factors unrelated to inflammation such as age, sex, anemia and renal failure [2], [3], [4]. Rapid serum level changes reflecting the rate of inflammation are one of the major advantages of CRP compared to ESR although it shares some of the disadvantages of ESR [2], [4], [5].

ESR and CRP correlate closely with clinical disease activity in patients with rheumatoid arthritis (RA) and to a lesser extent with ankylosing spondylitis (AS) [3], [4], [5], [6], [7]. However, certain studies revealed a discordance between ESR or CRP levels and the disease activity in RA [2], [5], [8], [9].

Mean platelet volume (MPV) is a parameter generated by full blood count analyzers as part of the routine complete blood count (CBC) test cycle which is usually overlooked by clinicians [10]. MPV correlates with the platelet function and activation [11], [12], [13], [14]. MPV is influenced inversely by inflammation as shown in ulcerative colitis and Crohn's disease [14]. An association between RA activity and MPV has been demonstrated in two studies previously [15], [16]. However, its correlation with disease activity indices was not investigated.

The present study aimed to investigate the correlation of MPV and clinical activity indices, namely Bath ankylosing spondylitis disease activity index (BASDAI) and Disease activity score (DAS28), in AS and RA, respectively.

Section snippets

Patients and controls

Thirty-two RA patients and 30 AS patients were enrolled retrospectively into the study. Age-matched 26 osteoarthritis (OA) patients and 29 healthy subjects were used as control groups for RA and AS patients, respectively. All RA patients fulfilled the 1987 ACR criteria for RA [17] and AS patients fulfilled the modified New York criteria [18]. Disease activity was determined by DAS28 score [19] in RA patients and by BASDAI score [20] in AS patients. All patients had active disease (DAS28 score

Results

Demographic features, clinical activity scores and laboratory findings of RA and AS patients and control groups are given in Table 1. As expected acute phase reactant (APR) levels were significantly higher in active RA and AS patients (Table 1). After treatment, levels of these markers decreased significantly (Table 2). BASDAI scores in AS patients (6.3 ± 1.6 vs 2.1 ± 1.0; p = <0.001) and DAS28 scores in RA patients (5.7 ± 0.8 vs 3.4 ± 1.3; p = <0.001) decreased significantly after two months.

Initial

Discussion

Our study revealed that MPV decreased in active RA and AS patients as compared to controls. Furthermore, MPV increased after treatment of RA and AS. A negative correlation between MPV and BASDAI scores was observed in AS patients after two months of treatment modification. Our data did not disclose a correlation between MPV values and the disease activity index assessed by DAS28 in RA patients.

Although ESR and CRP mirror disease activity in RA and AS [3], [4], [5], [6], [7] they may present

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