Platelet indices independently predict microvascular complications in type 2 diabetes mellitus: Findings from a tertiary care cross-sectional study

Objectives: Platelet dysfunction is increasingly implicated in the pathogenesis of diabetic microvascular complications. This study aimed to evaluate platelet indices, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet large cell ratio (P-LCR), as potential markers of microvascular complications in patients with type 2 diabetes mellitus (T2DM). Material and Methods: A hospital-based cross-sectional study was conducted on 150 adult T2DM patients and 75 age- and sex-matched non-diabetic controls over 18 months at a tertiary care center. Diabetic patients were categorized as those with (Group A, n = 90) and without (Group B, n = 60) microvascular complications. Platelet indices were measured using a standardized automated hematology analyzer (electrical impedance method). Glycated hemoglobin (HbA1c), fasting and postprandial plasma glucose, serum creatinine, estimated glomerular filtration rate (eGFR), and urine albumin-to-creatinine ratio were recorded. Statistical analysis employed Student’s t -test, one-way analysis of variance, Pearson correlation, and binary logistic regression with statistical significance at p < 0.05. A sensitivity analysis was conducted, restricting comparisons to patients with a single complication only. Results: MPV, PDW, and P-LCR were significantly elevated in diabetics compared to controls ( p < 0.001 each). Among diabetics, MPV (12.68 ± 1.42 fL vs. 10.21 ± 1.18 fL; p < 0.001) and PDW (16.84 ± 2.91 fL vs. 14.20 ± 2.54 fL; p < 0.001) were significantly higher in those with microvascular complications. On binary logistic regression, MPV (odds ratios [OR] 2.84; 95% confidence intervals [CI] 1.92–4.21; p < 0.001) and PDW (OR 1.68; 95% CI 1.28–2.20; p < 0.001) were independent predictors of microvascular complications, persisting after additional adjustment for eGFR. Positive correlations were observed between MPV and HbA1c (r = 0.52; p < 0.001) and disease duration (r = 0.44; p < 0.001). Conclusion: Platelet indices, particularly MPV and PDW, are significantly elevated in T2DM patients with microvascular complications and are independent predictors of their occurrence. These routinely available, zero-incremental-cost parameters hold promise as accessible adjunctive biomarkers for early microvascular risk stratification in clinical practice.