Study of Fibrinogen Level and Platelets Indices in Type 2 Diabetes Mellitus and their Relation with Microvascular Complications

Background: Type 2 DM (T2DM), represents about 90% of all cases of diabetes mellitus (DM) and this is because of obesity and lack of exercise. It is marked by insulin resistance, high blood glucose, and a relative lack of insulin. The aim of this work was to assess the mean platelet volume, platelet distribution width, and platelet large cell ratio: (MPV, PDW, PL-cR) and fibrinogen in T2DM and their correlation with microvascular complications. 
Methods: This case control study was carried out on 90 subjects who classified into three equal groups: Group (1) with type 2 diabetes mellitus without microvascular complications, group (2) with type 2 diabetes mellitus with microvascular complications. These complications are retinopathy, nephropathy and neuropathy, and group (3) as control group. All participants were subjected to serum fibrinogen evaluation, routine laboratory investigations and fundus examination. 
Results: Fibrinogen was higher significantly in the complicated group compared to the other studied groups (p < 0.001). Regarding fibrinogen, at cut off level (301.5 mg/dL) the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were (73.3%, 93.3%,77.8% and 91.6%), respectively. Concerning platelet distribution width (PDW), at cut off level 17.65%, the sensitivity, specificity, NPV, and PPV of Platelet distribution width were (76.7%, 100%, 81.1%, and 100%), respectively. Additionally, platelet large cell ratio (PL-cR), at cut off level 0.338%, the sensitivity, specificity, PPV and NPV of Platelet distribution width were (76.7%, 100%, 100% and 81.1%), respectively. 
Conclusions: Serum fibrinogen, platelet distribution width and platelet large cell ratio can be used as simple parameters to detect micro vascular complications in type 2 diabetes mellitus than mean platelet volume.