Mean platelet volume (MPV) is associated with leukoaraiosis in the apparently healthy elderly
Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.Archives of gerontology and geriatrics (Impact Factor: 1.85). 11/2011; 54(2):e118-21. DOI: 10.1016/j.archger.2011.10.010
Leukoaraiosis refers to diffuse white matter abnormalities on MR brain scans, which have been suggested to be associated with cerebral microangiopathy and geriatric syndromes such as cognitive impairment, depressive mood and gait disturbance. MPV is a simple indicator of platelet size and has been known to be a marker of platelet activity. MPV is now considered a link between inflammation and thrombosis in multiple cardiovascular and cerebrovascular disorders including hypertension, peripheral artery disease, and stroke. This cross-sectional study aims to evaluate the association between MPV and leukoaraiosis for 223 healthy elderly subjects (142 men, 81 women; mean age 66.0±5.2 years) in a health examination program including brain magnetic resonance imaging (MRI) scans. The overall prevalence rate of leukoaraiosis was 15.3%. The mean MPV was significantly higher in the leukoaraiosis group than control group: 8.4±0.8 and 8.1±1.0, respectively (p=0.036). A higher value of MPV was independently associated with an increased risk of leukoaraiosis. In the multivariate logistic analysis, the odds ratio (OR) (95% confidence interval (CI)) for leukoaraiosis was 1.61 (1.02-2.53) with 1 fL of MPV increment after adjusting for confounding variables. In conclusion, MPV was found to be independently and positively associated with leukoaraiosis. This finding indicates that MPV values may be a useful additional measure in assessing the risk of leukoaraiosis in the clinical setting.
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ABSTRACT: Elderly patients represent a high risk category among subjects with atherosclerosis, due to the presence of comorbidities and suboptimal response to antiplatelet drugs. Mean platelet volume (MPV) has been indicated as a marker of platelet reactivity, with contrasting data on its role on coronary artery disease. The aim of the present study was to evaluate the impact of age on the MPV and its role on the extent of coronary artery disease (CAD). Our population is represented by a cohort of 3750 patients undergoing coronary angiography. Elderly were defined according to age≥75years. MPV was measured at admission. Significant coronary artery disease was defined as a stenosis >50% in at least 1 coronary vessel, while severe CAD was defined as the left main and/or three-vessel disease. A total of 1170 out of 3750 (31.2%) patients were ≥75years old. Advanced age was associated with female gender (p<0.001), hypertension (p<0.001), renal failure (p<0.001), previous myocardial infarction (p=0.03) coronary artery bypass grafting (p<0.001) indication to angiography (p<0.001), therapy with angiotension-receptor blockers, (p=0.003), nitrates, diuretics and calcium-antagonists (p<0.001), serum creatinine (p<0.001), fibrinogen (p<0.001) and C reactive protein (p=0.02), but inversely to percutaneous coronary interventions (p=0.02), dyslipidemia, family history of CAD and smoking (p<0.001, respectively), use of statins (p=0.02) and beta blockers (p=0.003), haemoglobin, total cholesterol and triglycerides (p<0.001, respectively), white blood cells (p=0.009) and platelet count (p=0.006). Elderly patients displayed a significantly larger platelet volume (p<0.001), with a direct linear relationship between age and the MPV (r=0.08, p<0.001), with age being confirmed as an independent predictor of larger MPV (≥10.85fl) at multivariate analysis (adjusted OR [95% CI]=1.18 [1.01-1.40], p=0.04). Among the elderly, MPV value above the median (≥10.85fl) was not associated with a higher prevalence of coronary artery disease (77.3 vs. 79.4%, p=0.39, adjusted OR [95% CI]=0.94 [0.66-1.33], p=0.71), or higher prevalence of severe CAD (35.2 vs. 32.4%, p=0.28, adjusted OR [95% CI]=1.34 [0.99-1.82], p=0.06). Advanced age was directly associated with larger mean platelet volume that, however, did not contribute to explain the higher prevalence and extent of coronary artery disease observed in elderly patients. Copyright © 2014. Published by Elsevier Inc.
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ABSTRACT: Bilirubin, the principal tetrapyrrole, bile pigment and catabolite of haem, is an emerging biomarker of disease resistance, which may be related to several recently documented biological functions. Initially believed to be toxic in infants, the perception of bilirubin has undergone a transformation: it is now considered to be a molecule that may promote health in adults. Data from the last decade demonstrate that mildly elevated serum bilirubin levels are strongly associated with reduced prevalence of chronic diseases, particularly cardiovascular diseases (CVDs), as well as CVD-related mortality and risk factors. Recent data also link bilirubin to other chronic diseases, including cancer and Type 2 diabetes mellitus, and to all-cause mortality. Therefore, there is evidence to suggest that bilirubin is a biomarker for reduced chronic disease prevalence and a predictor of all-cause mortality, which is of important clinical significance. In the present review, detailed information on the association between bilirubin and all-cause mortality, as well as the pathological conditions of CVD, cancer, diabetes and neurodegenerative diseases, is provided. The mechanistic background concerning how bilirubin and its metabolism may influence disease prevention and its clinical relevance is also discussed. Given that the search for novel biomarkers of these diseases, as well as for novel therapeutic modalities, is a key research objective for the near future, bilirubin represents a promising candidate, meeting the criteria of a biomarker, and should be considered more carefully in clinical practice as a molecule that might provide insights into disease resistance. Clearly, however, greater molecular insight is warranted to support and strengthen the conclusion that bilirubin can prevent disease, with future research directions also proposed.
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