LETTER TO THE EDITOR
Letter to the Editor: Mean Platelet Volume May Not Be Increased After
Laparoscopic Sleeve Gastrectomy
Cengiz Beyan1
&Esin Beyan2 Published online: 6 July 2018
# Springer Science+Business Media, LLC, part of Springer Nature 2018
Dear Editor,
We read with a great interest the retrospective study of Kutluturk et al. about the effect of laparoscopic sleeve gas-trectomy on values of mean platelet volume (MPV) [1]. They found that MPV levels were increased significantly after laparoscopic sleeve gastrectomy. We would like to comment about this paper because we think that there were different factors affecting the results of this study.
Firstly, the authors suggested that higher MPV level was associated with increased platelet reactivity and hyperaggregability. They explained that the relationship between MPV and obesity as a chronic proinflammatory and prothrombotic state was based on this mechanism. Nowadays, that is true because the platelet parameters including MPV are not accepted as the tests of the platelet function [2]. The gold standard test for platelet function is the light transmission platelet aggregometry at the present time and three different studies showed that platelet
indices including MPV had not any correlation with plate-let aggregation responses usage with light transmission platelet aggregometry [3–5]. Actually, MPV shows only platelet production not platelet function.
In real world, the wide variability of MPV as well as the very poor standardization of the methodologies used for MPV measurement makes it impossible to decide whether an individual patient has normal or slightly in-creased MPV [6]. Despite many decades have passed since MPV can be easily obtained with electronic coun-ters, measurement of this parameter still lacks standardi-zation. Because ethylenediaminetetraacetic acid (EDTA) induced variations over time, MPV level may increase up to 30% within 5 min of exposure and then increase by another 10–15% over the next 2 h [7]. MPV is not a very reliable index with the use of EDTA as the antico-agulant in complete blood count. Because several authors reported anticoagulant and time dependency, Lance et al. aimed the standardization of the MPV measurement [8]. They reported that timing was important when measuring MPV and optimal measuring time with EDTA should be 120 min after venipuncture. Also, a meta-analysis study that was performed in published MPV studies indexed PubMed showed that the measurement times between 15 min and 2 h were significantly different from the mea-surement times of shorter than 15 min and longer than 2 h [9]. Because the measurement times for complete blood count were unknown in this study, the data reliability might not be accurate.
As a result, the MPV level may not be increased after laparoscopic sleeve gastrectomy.
* Cengiz Beyan
cengizbeyan@hotmail.com Esin Beyan
esinbeyan@hotmail.com
1
Faculty of Medicine, Department of Hematology, Ufuk University, Çankaya, Ankara, Turkey
2
Kecioren Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey Obesity Surgery(2018) 28:3621–3622
Compliance with Ethical Standards
Conflict of Interest The authors declare that they have no conflict of interest.
References
1. Kutluturk F, Ozsoy Z. Effect of sleeve gastrectomy on platelet counts and mean platelet volumes. Obes Surg. 2018;https://doi.org/10. 1007/s11695-018-3287-8.
2. Israels SJ. Laboratory testing for platelet function disorders. Int J Lab Hematol. 2015;37 Suppl 1:18–24.
3. Ho CH, Chan IH. The influence of time of storage, temperature of storage, platelet number in platelet-rich plasma, packed cell, mean platelet volume, hemoglobin concentration, age, and sex on platelet aggregation test. Ann Hematol. 1995;71(3):129–33.
4. Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with op-tical platelet aggregation responses in healthy volunteers. J Thromb Thrombolysis. 2006;22(3):161–4.
5. De Luca G, Verdoia M, Cassetti E, et al. Mean platelet volume is not associated with platelet reactivity and the extent of coronary artery disease in diabetic patients. Blood Coagul Fibrinolysis. 2013;24(6): 619–24.
6. Noris P, Melazzini F, Balduini CL. New roles for mean platelet volume measurement in the clinical practice? Platelets. 2016;27(7):607–12.
7. Jackson SR, Carter JM. Platelet volume: laboratory measurement and clinical application. Blood Rev. 1993;7(2):104–13.
8. Lancé MD, van Oerle R, Henskens YM, et al. Do we need time adjusted mean platelet volume measurements? Lab Hematol. 2010;16(3):28–31.
9. Beyan C, Beyan E. Were the measurements standardized sufficiently in published studies about mean platelet volume? Blood Coagul Fibrinolysis. 2017;28(3):234–6.
