Platelet Distribution Width and Mean Platelet Volume Are Not Correlated with the Disease Activity Indices of Ankylosing Spondylitis

Sejin Byun; Seung Min Jung; Jason Jungsik Song; Yong-Beom Park; Sang-Won Lee

doi:10.4078/jrd.2017.24.3.143

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Byun, Jung, Song, Park, and Lee: Platelet Distribution Width and Mean Platelet Volume Are Not Correlated with the Disease Activity Indices of Ankylosing Spondylitis

Original Article

J Rheum Dis 2017;24(3):143-148.

Published online: 31 October 2017

DOI: https://doi.org/10.4078/jrd.2017.24.3.143

Platelet Distribution Width and Mean Platelet Volume Are Not Correlated with the Disease Activity Indices of Ankylosing Spondylitis

Sejin Byun, Seung Min Jung, Jason Jungsik Song, Yong-Beom Park, Sang-Won Lee

Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

Corresponding to: Sang-Won Lee, Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. E-mail: sangwonlee@yuhs.ac

Received 14 March 20171 May 2017 Accepted 10 May 2017

This is a Open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

We investigated the association of platelet distribution width (PDW) and mean platelet volume (MPV) with disease activity indices of ankylosing spondylitis (AS) in patients whose laboratory results or medical conditions would not affect PDW and MPV levels.

Methods

We analysed demographic and laboratory data of 88 patients with AS. On the same day as the laboratory tests were done, we assessed AS disease activity using the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Patients Global Score and Ankylosing Spondylitis Disease Activity Score (ASDAS), including erythrocyte sedimentation rate (ESR) (ASDAS-ESR) and C-reactive protein (CRP) (ASDAS-CRP). The association was analyzed by linear regression.

Results

The median age of 88 patients was 38.0 years and the median length of observation was 5.5 years. The median platelet count was 266,500.0/μ L, the median PDW was 10.7 fL and the median MPV 9.6 fL. The median ESR was 19.0 mm/hr and CRP was 2.5 mg/L. Among acute reactants, only CRP was negatively correlated with MPV, but not PDW (r=−0.218, p<0.041). However, both PDW and MPV were not significantly correlated with any disease activity index of AS. On multivariate linear regression analysis, only the length of observation was significantly correlated with MPV (β=0.224, p<0.044).

Conclusion

PDW and MPV were not potent surrogate markers to reflect AS activity, with potential confounding strictly controlled, to affect MPV and PDW levels.

Keywords: Mean platelet volume, Platelt count, Ankylosing spondylitis

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Figure 1.

Selection of the study population. HbA1c: haemoglobin A1c, INR: international normalized ratio.

Table 1.

Baseline characteristics of patients with ankylosing spondylitis (n=88)

Variable	Value
Demographic data
Age (yr)	38.0 (15.8)
Male gender	68 (77.3)
Follow-up duration (yr)	5.5 (8.5)
Smoking	36 (40.9)
BMI (kg/m²)	24.0 (5.0)
Platelet information
Platelet×10³ (/mm³)	266.5 (70.3)
PDW (fL)	10.7 (1.9)
MPV (fL)	9.6 (1.0)
Other laboratory results
White blood cell (/mm³)	7,495.0 (2,650.0)
Haemoglobin (g/dL)	14.9 (2.3)
Prothrombin time (INR)	0.9 (0.1)
Fasting glucose (mg/dL)	95.5 (12.8)
HbA1c	5.5 (0.4)
Blood urea nitrogen (mg/dL)	13.9 (4.5)
Creatinine (mg/dL)	0.8 (0.2)
Albumin (mg/dL)	4.5 (0.5)
Alkaline phosphatase (IU/L)	70.0 (26.0)
Aspartate aminotransferase (IU/L)	20.0 (9.0)
Alanine aminotransferase (IU/L)	18.0 (17.0)
Total cholesterol (mg/dL)	192.0 (40.3)
High density cholesterol (mg/dL)	49.0 (16.0)
Low density cholesterol (mg/dL)	105.0 (23.2)
Triglyceride (mg/dL)	179.0 (184.3)
Acute reactants and disease activity indices
ESR (mm/h)	19.0 (25.0)
CRP (mg/L)	2.5 (5.3)
ASDAS-ESR	2.3 (1.5)
ASDAS-CRP	2.0 (1.5)
BASDAI	3.6 (2.4)
BAS-G	3.0 (4.0)
BASFI	1.7 (3.3)

Values are expressed as median (interquartile range, IQR) and number (%). BMI: body mass index, PDW: platelet distribution width, MPV: mean platelet volume, INR: international normalized ratio, HbA1c: haemoglobin A1c, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein, ASDAS: ankylosing spondylitis disease activity score, BASDAI: bath ankylosing spondylitis disease activity index, BAS-G: bath ankylosing spondylitis patient global score, BASFI: bath ankylosing spondylitis disease activity functional index.

Table 2.

Univariate and multivariate analysis of either PDW or MPV and other continuous variables

Variable	Univariate analysis			Multivariate analysis			VIF
Variable	Regression coefficient (Crude B)	Correlation coefficient (R=β)	p-value	Standardized β^*	95% confidential interval	p-value	VIF
Analysis of PDW
Demographic data
Age (yr)	0.031	0.205	0.056	0.098	−0.015, 0.044	0.326	1.093
Follow-up duration (yr	r) 0.045	0.179	0.095	-	-	-	-
BMI (kg/m²)	0.053	0.096	0.893	-	-	-	-
Platelet information
Platelet×10³ (/mm³)	−0.011	−0.369	<0.001	-	-	-	-
MPV (fL)	0.920	0.463	<0.001	-	-	-	-
Acute reactants and the disease activity indices
ESR (mm/h)	−0.008	−0.078	0.470	-	-	-	-
CRP (mg/L)	−0.034	−0.170	0.114	-	-	-	-
ASDAS-ESR	0.091	0.051	0.635	-	-	-	-
ASDAS-CRP	0.165	0.094	0.382	−0.200	−0.902, 0.204	0.213	2.797
BASDAI	0.193	0.200	0.062	0.284	−0.032, 0.581	0.079	2.818
BAS-G	0.058	0.079	0.467	-	-	-	-
BASFI	−0.003	−0.008	0.948	-	-	-	-
Analysis of MPV
Demographic data
Age (yr)	0.021	0.274	0.010	0.129	−0.006, 0.025	0.209	1.176
Follow-up duration (yr)	0.037	0.293	0.006	0.175	−0.003, 0.048	0.089	1.170
BMI (kg/m²)	0.032	0.114	0.290	-	-	-	-
Platelet information
Platelet×10³ (/mm³)	−0.003	−0.236	0.027	-	-	-	-
PDW (fL)	0.233	0.463	<0.001	-	-	-	-
Acute reactants and the disease activity indices
ESR (mm/h)	0.001	0.018	0.869	-	-	-	-
CRP (mg/L)	−0.022	−0.218	0.041	-	-	-	-
ASDAS-ESR	0.075	0.083	0.440	-	-	-	-
ASDAS-CRP	0.123	0.140	0.193	0.020	−0.261, 0.296	0.901	2.882
BASDAI	0.084	0.173	0.108	0.068	−0.122, 0.189	0.672	2.947
BAS-G	0.051	0.039	0.198	-	-	-	-
BASFI	0.018	0.084	0.491	-	-	-	-

Multivariate analyses for PDW were adjusted for age, ASDAS-CRP and BASDAI. We did not include MPV in multivariate analysis in order not to confound the interpretation of statistical results, because MPV is a variable closely correlated with PDW. Multivariate analyses for MPV were adjusted for age, disease duration, ASDAS-CRP and BASDAI. We did not include PDW in multivariate analysis in order not to confound the interpretation of statistical results, because PDW is a variable closely correlated with MPV. PDW: platelet distribution width, MPV: mean platelet volume, VIF: variance inflation factor, BMI: body mass index, ESR: erythrocyte sedimentation rate, CRP: C-reactive protein, ASDAS: ankylosing spondylitis disease activity score, BASDAI: bath ankylosing spondylitis disease activity index, BAS-G: bath ankylosing spondylitis patient global score, BASFI: bath ankylosing spondylitis disease activity functional index, −: not applicable.

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