Association between mean platelet volume and kidney events in patients with type 2 diabetes mellitus.

INTRODUCTION: Mean platelet volume (MPV), which reflects platelet size and activity, is known to be elevated in patients with type 2 diabetes mellitus. Although increased MPV has been linked to poor glycemic control and diabetic vascular complications, evidence regarding its association with hard kidney outcomes remains limited. We aimed to investigate the relationship between MPV and kidney events in patients with type 2 diabetes mellitus. MATERIALS AND METHODS: We retrospectively analyzed longitudinal data from 1,076 Japanese patients with type 2 diabetes mellitus enrolled in the Fukushima Cohort Study. Participants were categorized into quartiles based on baseline MPV levels. The primary endpoint was kidney events, defined as a ≥50% decline in estimated glomerular filtration rate (eGFR) from baseline or progression to end-stage kidney disease requiring kidney replacement therapy. The secondary endpoint was new-onset cardiovascular events. RESULTS: During a median follow-up of 5.3 years, 97 patients experienced kidney events. The second quartile (Q2) had the lowest incidence of kidney events. Compared with Q2 as the reference, patients in the highest quartile (Q4) had a significantly increased risk of kidney events (adjusted hazard ratio 2.05, 95% confidence interval 1.13-3.72). Higher MPV levels were also significantly associated with an increased risk of cardiovascular events. CONCLUSION: Elevated MPV was independently associated with both kidney and cardiovascular events in Japanese patients with type 2 diabetes mellitus. MPV may serve as a simple and useful biomarker for predicting kidney disease progression in this high-risk population.