Abstract
I read the article with great interest by Ntolios et al. 1 They investigated the role of the mean platelet volume (MPV) and platelet distribution width (PDW) in patients with recently diagnosed idiopathic pulmonary fibrosis. They found that MPV was higher in patients than controls, whereas there was no difference in PDW between the groups. This is an interesting and well-written study. However, I want to make criticism of this study from methodological aspect.
As many previous studies reported, there are significant relations of MPV with blood pressure, smoking, obesity, hyperlipidemia, cardiovascular diseases, stroke, diabetes mellitus, metabolic syndrome, inflammatory and malignant diseases, thyroid disorders, and some cardiovascular drugs. 2 –6 The authors excluded the potential confounding factors including antiplatelet and anticoagulant drugs that affect MPV. However, they didn’t mention about the blood pressure levels, blood glucose and cholesterol levels, and incidence of metabolic syndrome. It has been reported that hypertension, hypercholesterolemia, diabetes mellitus, and metabolic syndrome increase MPV values. 2,3 In addition, there is no information regarding antihypertensive drugs and statins. It has been shown that some antihypertensive drugs such as calcium antagonists and β-blockers and statins decrease MPV values. 4 –6 I believe that it would be useful if the authors provided data about these confounding factors on MPV.
Mean platelet volume can be measured with routine complete blood counts and a simple method of evaluating platelet function. It has been reported that thrombotic potential of larger ones is higher than smaller ones. 2,7 When compared with smaller ones, larger platelets have more granules, have higher thromboxane A2 level, express more glycoprotein Ib and IIb/IIIa receptors, and aggregate more rapidly with collagen. 2,7 Mean platelet volume can be affected by many inflammatory and cardiovascular risk factors. Because of that, all confounding factors must be taken into account.