Mean platelet volume as a Low-Cost discriminatory marker for thrombotic risk assessment in Yemeni type 2 diabetic patients: A proposal for Resource-Limited settings.

BACKGROUND

Thrombotic complications are a leading cause of mortality in type 2 diabetes mellitus (T2DM). In resource-limited settings, identifying affordable and accessible predictive biomarkers is paramount for risk stratification. However, population-specific Mean Platelet Volume (MPV) thresholds and their cost-effectiveness in conflict settings remain unknown, hindering its implementation in guidelines.

OBJECTIVES

This study aimed to evaluate the discriminatory value of mean platelet volume (MPV) for thrombotic risk and propose a low-cost screening strategy for patients with type 2 diabetes mellitus (T2DM) in Yemen, a resource-limited conflict setting.

DESIGN

A cross-sectional study.

SETTING

Major hospitals in Aden Governorate, Yemen.

PARTICIPANTS

140 adult Yemeni patients with clinically diagnosed T2DM.

INTERVENTIONS: Not applicable.

PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the predictive performance (sensitivity, specificity, area under the curve) of MPV for a composite thrombotic risk endpoint. The secondary outcome was the strength of correlation between MPV and glycemic control (HbA1c).

RESULTS

MPV was significantly elevated in patients with poor glycemic control (HbA1c ≥ 7%). ROC analysis identified an MPV value of 11.5 fL as a robust predictor of thrombotic risk, with a sensitivity of 78% and a specificity of 85% (AUC = 0.82, 95% CI: 0.74-0.89). A strong positive correlation was found between HbA1c and MPV (r = 0.52, p < 0.001), demonstrating a dose-response relationship across glycemic strata.

CONCLUSION

MPV ≥ 11.5 fL shows promise as a highly discriminatory, low-cost marker of thrombotic risk in Yemeni T2DM patients. We propose that routine MPV testing should be considered for integration into national diabetic guidelines in Yemen and similar conflict-affected settings. This evidence-based, low-cost strategy could contribute to improved preventive care and reduce the burden of thrombosis where resources are most scarce.