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Licensed Unlicensed Requires Authentication Published by De Gruyter December 1, 2017

Effect of preanalytical and analytical variables on the clinical utility of mean platelet volume

  • Mauro Buttarello EMAIL logo , Giacomo Mezzapelle and Mario Plebani

Abstract

Background:

The study endpoint was to analyze the effect of preanalytical (time, temperature, anticoagulant) and analytical (imprecision, correlation between volume and platelet concentration) variables on mean platelet volume (MPV). A further aim was to calculate in an adult population the reference intervals using the Sysmex XE-5000 analyzer. A critical evaluation was also made of the clinical utility of these parameters.

Methods:

Analyses of the above values were performed in duplicate in 170 healthy adults of both sexes: (1) within 30 min from collection, and (2) after 4 h. To evaluate stability over time, the value of the platelet parameters of 20 subjects were determined, a re-analysis being performed for a period of up to 24 h on samples maintained at room temperature and 4°C using either K2-EDTA or Na-citrate as anticoagulants.

Results:

The stability over time of MPV closely depends on the anticoagulant used, storage temperature and time interval between venipuncture and analysis. An inverse, non-linear correlation between MPV and platelet count was also found.

Conclusions:

In view of their effect on MPV and other related indices, the preanalytical and analytical variables make them, little more than experimental.


Corresponding author: Mauro Buttarello, MD, Department of Laboratory Medicine, University-Hospital, Padova, Italy

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Martin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B-2 production and megakariocyte nuclear DNA concentration. Thromb Res 1983;32:443–60.10.1016/0049-3848(83)90255-4Search in Google Scholar

2. Bessman JD, Williams LJ, Gilmer PR. Mean platelet volume: the inverse relation of platelet size and count in normal subjects, and an artifact of other particles. Am J Clin Pathol 1981;76:289–93.10.1093/ajcp/76.3.289Search in Google Scholar PubMed

3. Verdoia M, Schaffer A, Barbieri L, Bellomo G, MarinoP, Sinigaglia F, et al. Impact of age on mean platelet volume and its relationship with coronary artery disease: a single-centre cohort study. Exp Gerontol 2015;62:32–6.10.1016/j.exger.2014.12.019Search in Google Scholar PubMed

4. Lippi G, Meschi T, Borghi L. Mean platelet volume increases with aging in a large population study. Thromb Res 2012;129: e159–60.10.1016/j.thromres.2011.12.031Search in Google Scholar PubMed

5. Panova-Noeva M, Schulz A, Hermanns MI, Grossmann V, Pefani E, Spronk HM, et al. Sex-specific differences in genetic and nongenetic determinants of mean platelet volume: results from the Gutemberg Health Study. Blood 2016;127:251–9.10.1182/blood-2015-07-660308Search in Google Scholar PubMed

6. Hoffmann JJ, van den Broek NM, Curvers J. Reference intervals of reticulated platelets and other platelet parameters and their associations. Arch Pathol Lab Med 2013;137:1635–40.10.5858/arpa.2012-0624-OASearch in Google Scholar PubMed

7. Thompson CB, Jakubowski JA, Quinn PG, Deykin D, Valeri CR. Platelet size and age determine platelet function independently. Blood 1984;63:1372–5.10.1182/blood.V63.6.1372.1372Search in Google Scholar

8. Balduini CL, Noris P, Spedini P, Belletti S, Zambelli A, Da Prada GA. Relationship between size and thiazole orange fluorescence of platelets in patient undergoing high-dose chemotherapy. Br J Haematol 1999;106:202–7.10.1046/j.1365-2141.1999.01475.xSearch in Google Scholar PubMed

9. Kaito K, Otsubo H, Usui N, Yoshida M, Tanno J, Kurihara E. Platelet size deviation width, platelet large cell ratio, and mean platelet volume have sufficient sensitivity and specificity in the diagnosis of immune thrombocytopenia. Br J Haematol 2005;128:698–702.10.1111/j.1365-2141.2004.05357.xSearch in Google Scholar PubMed

10. Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta- analysis. J Thromb Haemost 2010;8:148–56.10.1111/j.1538-7836.2009.03584.xSearch in Google Scholar PubMed PubMed Central

11. Klovaite J, Benn M, Yazdanyar S, Nordestgaard BG. High platelet volume and increased risk of myocardial infarction: 39531 participants from the general population. J Thromb Haemost 2011;9:49–56.10.1111/j.1538-7836.2010.04110.xSearch in Google Scholar PubMed

12. Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke 2004;35:1688–91.10.1161/01.STR.0000130512.81212.a2Search in Google Scholar PubMed

13. Papanas N, Symeonidis E, Maltezos G, Mavridis G, Karavageli E, Vosnakidis T, et al. Mean platelet volume in patients with type 2 diabetes mellitus. Platelets 2004;15:475–8.10.1080/0953710042000267707Search in Google Scholar PubMed

14. Bilici S, Sekemli T, Goksu M, Melek M, Auci V. Mean platelet volume in diagnosis of acute appendicitis in children. Afr Health Sci 2011;11:427–32.Search in Google Scholar

15. Gunebakmaz O, Kaya MG, Kaya EG, Ardic I, Yarloglues M, Dogdu O, et al. Mean platelet volume predicts embolic complications and prognosis in infective endocarditis. Int J Infect Dis 2010;14:e982–5.10.1016/j.ijid.2010.05.019Search in Google Scholar PubMed

16. Gao Y, Li Y, Yu XI, Guo S, Ji X, Son T, et al. The impact of various platelet indices as prognostic markers of septic shock. PLoS One 2014;9:e103761.10.1371/journal.pone.0103761Search in Google Scholar PubMed PubMed Central

17. Kim CH, Kim SJ, Lee MJ, Kwon YE, Kim YL, Park KS, et al. An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. PLoS One 2015;10:e0119437.10.1371/journal.pone.0119437Search in Google Scholar PubMed PubMed Central

18. Riedl J, Kaider A, Reitter EM, Marosi C, Jager U, Schwarzinger I, et al. Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. Results from the Vienna Cancer and Thrombosis Study. Thromb Haemost 2014;111:670–8.10.1160/TH13-07-0603Search in Google Scholar PubMed

19. Ferroni P, Guadagni F, Riondino C, Portarena I, Mariotti S, La Farina F, et al. Evaluation of mean platelet volume as a predictive marker for cancer-associated venous thromboembolism during chemotherapy. Haematologica 2014;99:1638–44.10.3324/haematol.2014.109470Search in Google Scholar PubMed PubMed Central

20. International Council for Standardization in Haematology (ICSH). Recommendation of the International Council for Standardization in Haematology for Ethylenediamine-tetra-acetic Acid Anticoagulation of Blood for Blood Cell Counting and Sizing. Am J Clin Pathol 1993;100:371–2.10.1093/ajcp/100.4.371Search in Google Scholar PubMed

21. Dastjerdi MS, Emami T, Najafian A, Amini M. Mean platelet volume measurement, EDTA or citrate? Hematology 2006;11:317–9.10.1080/10245330600954163Search in Google Scholar PubMed

22. Shah B, Valdes V, Nardi MA, Hu L, Schrem E, Berger JS. Mean platelet volume reproducibility and association with platelet activity and anti-platelet therapy. Platelets 2014;25:188–92.10.3109/09537104.2013.793794Search in Google Scholar PubMed PubMed Central

23. Lippi G, Pavesi F, Pipitone S. Evaluation of mean platelet volume with four hematological analyzers: harmonization is still an unresolved issue. Blood Coag Fibrinolysis 2015;26:235–7.10.1097/MBC.0000000000000220Search in Google Scholar PubMed

24. Noris P, Klersy C, Gresele P, Giona F, Giordano P, Minuz P, et al. Platelet size for distinguishing between inherited thrombocytopenias and immune thrombocytopenia: a multicentric, real life study. Br J Haematol 2013;162:112–9.10.1111/bjh.12349Search in Google Scholar PubMed PubMed Central

25. Latger-Cannard V, Hoarau M, Salignac S, Baumgart D, Nurden P, Lecomte T. Mean platelet volume: comparison of three analysers towards standardization of platelet morphological phenotype. Int J Lab Hematol 2012;34:300–10.10.1111/j.1751-553X.2011.01396.xSearch in Google Scholar PubMed

26. Beyan C, Beyan E. Pre-analytical standardization should be mandatory before reference ranges for mean platelet volume are determined (letter). Scand J Clin Lab Invest 2016;76:588.10.1080/00365513.2016.1203015Search in Google Scholar PubMed

27. Clinical and Laboratory Standard Institute (CLSI). Defining, establishing, and verifying reference intervals in the clinical laboratory; approved guideline-third edition. Wayne, PA: C28-A3, 2008.Search in Google Scholar

28. Pekelharing JM, Hauss O, De Jonge R, Lokhoff J, Sodikromo J, Spaans M, et al. Haematology reference intervals for established and novel parameters in healthy adults. Sysmex J International 2010;20:1–9.Search in Google Scholar

29. Biino G, Santimone I, Minelli G, Sorice R, Frongia B, Traglia M, et al. Age and sex-related variations in platelet count in Italy: a proposal of referece ranges based on 40987 subjects’ data. PLoS One 2013;8:e54289.10.1371/journal.pone.0054289Search in Google Scholar PubMed PubMed Central

30. Joergensen MK, Bathum L. Reference intervals for mean platelet volume and immature platelet fraction determined on a Sysmex XE 5000 Hematology Analyzer. Scand J Clin Lab Invest 2016;76:172–6.10.3109/00365513.2015.1124448Search in Google Scholar PubMed

31. Wakeman L, Munro R, Russell C, Benton A, Hartnell S, Al-ismail S. New reference ranges in haematology for healthy adults using the modern Sysmex XE-2100 Automated Analyser. Blood (ASH Annual Meeting Abstracts) 2005;106:abstract 3740.10.1182/blood.V106.11.3740.3740Search in Google Scholar

32. Maluf CB, Barreto SM, Vidigal PG. Standardization and reference intervals of platelet volume indices: insight from the Brazilian longitudinal study of adult health (ELSA-BRASIL). Platelets 2015;26:413–20.10.3109/09537104.2014.942620Search in Google Scholar PubMed

33. Hong J, Min Z, Bai-Shen P, Jie Z, Ming-Ting P, Xian-Zhang H, et al. Investigation on reference intervals and regional differences of platelet indices in healthy Chinese Han adults. J Clin Lab Anal 2015;29:21–7.10.1002/jcla.21721Search in Google Scholar PubMed PubMed Central

34. Lippi G, Targher G, Neri G, Cattabiani C, Pipitone S, Cervellin G. Diagnostic significance of haematological testing in patients presenting at the emergency department. Emergency Care J 2012;8:7–12.10.4081/ecj.2012.1.7Search in Google Scholar

35. Sachdev R, Tiwari AK, Goel S, Raina V, Sethi M. Establishing biological reference intervals for novel platelet parameters (immature platelet fraction, high immature platelet fraction, platelet distribution width, platelet large cell ratio, platelet-X, plateletcrit) and their correlations among each other. Indian J Pathol Microbiol 2014;57:231–5.10.4103/0377-4929.134676Search in Google Scholar PubMed

36. Shimodaira M, Niwa T, Nakajima K, Kobayashi M, Hanyu N, Nakayama T. Correlation between mean platelet volume and fasting plasma glucose levels in prediabetic and normoglycemic individuals. Cardiovasc Diabetol 2013;12:14.10.1186/1475-2840-12-14Search in Google Scholar PubMed PubMed Central

37. Islamoglu Y, Ertas F, Acet H, Elbey MA, Evliyaogllu O, Tekbas E, et al. The association between mean platelet volume and coronary collateral circulation. Eur Rev Med Pharmacol Sci 2013;17:276–9.Search in Google Scholar

38. Xu XF, Jiang FL, Ou MJ, Zhang ZH. The association between mean platelet volume and chronic atrial fibrillation and the presence of thrombotic events. Biomed Rep 2015;3:388–94.10.3892/br.2015.418Search in Google Scholar PubMed PubMed Central

39. Yang SW, Cho SH, Kwon HS, Sohn IS, Hwang HS. Significance of the platelet distribution width as a severity marker for the development of preeclampsia. Eur J Obst Gynecol Reprod Biol 2014;175:107–11.10.1016/j.ejogrb.2013.12.036Search in Google Scholar PubMed

40. Shameer K, Denny JC, Ding K, Jouni H, Crosslin DR, De Andrade M, et al. A genome and phenome-wide association study to identify genetic variants influencing platelet count and volume and their pleiotropic effect. Hum Genet 2014;133:95–109.10.1007/s00439-013-1355-7Search in Google Scholar PubMed PubMed Central

41. Chu H, Chen WL, Huang CC, Chang HY, Kuo HY, Gau CM, et al. Diagnostic performance of mean platelet volume for patients with acute coronary syndrome visiting an emergency department with acute chest pain: the Chinese scenario. Emerg Med J 2011;28:569–74.10.1136/emj.2010.093096Search in Google Scholar PubMed

42. Grove EL, Hvas AM, Mortensen SB, Larsen SB, Kristensen SD. Effect of platelet turnover on whole blood platelet aggregation in patients with coronary artery disease. J Thromb Haemost 2011;9:185–91.10.1111/j.1538-7836.2010.04115.xSearch in Google Scholar PubMed

43. Zampieri FG, Ranzani OT, Sabatoski V, Possolo de Souza H, Babeiro H, Montero Cruz da Neto L, et al. An increase in mean platelet volume after admission is associated with higher mortality in critically ill patients. Ann Intensive Care 2014;4:20.10.1186/s13613-014-0020-1Search in Google Scholar PubMed PubMed Central

44. Buoro S, Seghezzi M, Manenti B, Pacioni A, Carobene A, Ceriotti F, et al. Biological variation of platelet parameters determined by the Sysmex XN hematology analyzer. Clin Chim Acta 2017;470:125–32.10.1016/j.cca.2017.05.004Search in Google Scholar PubMed

45. Lacher DA, Barletta J, Hughes JP. Biological variation of hematology tests based on the 1999–2002 National Health and Nutrition Examination Survey. Natl Health Stat Report 2012;54:1–11.Search in Google Scholar

46. Ricos C, Alvarez V, Cava F, Garcia-Lario JV, Hernandez A, Jimenez CV, et al. Current database on biological variation: pros, cons and progress. Scand J Lab Invest 1999;59:491–500.10.1080/00365519950185229Search in Google Scholar PubMed

47. Slavka G, Perkmann T, Haslacher H, Greisenegger S, Marsik C, Wagner OF, et al. Mean platelet volume may represent a predictive parameter for overall vascular mortality and ischemic heart disease. Arterioscler Thromb Vasc Biol 2011;31:1215–18.10.1161/ATVBAHA.110.221788Search in Google Scholar PubMed

Received: 2017-8-17
Accepted: 2017-10-20
Published Online: 2017-12-1
Published in Print: 2018-4-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

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