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Response: Clinical Marker of Platelet Hyperreactivity in Diabetes Mellitus (Diabetes Metab J 2013;37:423-8)
Jin Hwa Kim, Hak Yeon Bae, Sang Yong Kim
Diabetes & Metabolism Journal 2014;38(2):160-161.
Published online: April 18, 2014
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Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea.

Corresponding author: Sang Yong Kim. Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, 365 Pilmun-daero, Dong-gu, Gwangju 501-717, Korea.

Copyright © 2014 Korean Diabetes Association

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

We truly appreciate the interest and comments regarding our article, "Clinical marker of platelet hyperreactivity in diabetes mellitus," which was published in Diabetes & Metabolism Journal [1]. Our responses to the comments by Drs. Cengiz Beyan and Esin Beyan's are as follows:
We suggested that mean platelet volume (MPV), which is used to measure platelet size, is a potential marker of platelet hyperreactivity in diabetes. Although some uncertainty remain, previous studies have also shown that MPV is a potential predictive marker of platelet hyperreactivity in diabetes [2,3,4,5]. Furthermore, Shah et al. [6] reported a significant correlation between MPV and the degree of glycemic control only in diabetic patients. They suggested that the positive relationship between an increased glucose level and increased MPV is a unique phenomenon of diabetes. Recent data from our group supports this possibility. We found a contrasting relationship between MPV and fasting plasma glucose in the presence and absence of diabetes in a general Korean population [7]. Nevertheless, we think that further large prospective studies should be conducted to confirm the clinical utility of this marker and to clarify the association between MPV and platelet hyperreactivity in diabetes.
We agree with you about the correct measurement of MPV. There is a need for careful measurements and interpretation. However, current various methods that are used to measure platelet function are mostly complex and are not easily applicable in real clinical practice. On the other hand, although there are controversies about the most exact methodology for measuring MPV, it is easily accessible in the inpatient and outpatient settings at a relatively low cost. For this reason we believe that bolstering the strengths to make up for the weaknesses may provide an alternative route for better diagnosis, but further studies are still required.
Thank you for your interest in this article and for your thoughtful comments.

No potential conflict of interest relevant to this article was reported.

  • 1. Kim JH, Bae HY, Kim SY. Clinical marker of platelet hyperreactivity in diabetes mellitus. Diabetes Metab J 2013;37:423-428. ArticlePubMedPMC
  • 2. Unubol M, Ayhan M, Guney E. The relationship between mean platelet volume with microalbuminuria and glycemic control in patients with type II diabetes mellitus. Platelets 2012;23:475-480. ArticlePubMed
  • 3. Tavil Y, Sen N, Yazici H, Turfan M, Hizal F, Cengel A, Abaci A. Coronary heart disease is associated with mean platelet volume in type 2 diabetic patients. Platelets 2010;21:368-372. ArticlePubMed
  • 4. Park BJ, Shim JY, Lee HR, Jung DH, Lee JH, Lee YJ. The relationship of platelet count, mean platelet volume with metabolic syndrome according to the criteria of the American Association of Clinical Endocrinologists: a focus on gender differences. Platelets 2012;23:45-50. ArticlePubMed
  • 5. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011;17:47-58. ArticlePubMed
  • 6. Shah B, Sha D, Xie D, Mohler ER 3rd, Berger JS. The relationship between diabetes, metabolic syndrome, and platelet activity as measured by mean platelet volume: the National Health and Nutrition Examination Survey, 1999-2004. Diabetes Care 2012;35:1074-1078. PubMedPMC
  • 7. Kim JH, Kang SB, Kang JI, Kim JW, Kim SY, Bae HY. The relationship between mean platelet volume and fasting plasma glucose differs with glucose tolerance status in a Korean general population: gender differences. Platelets 2013;24:469-473. ArticlePubMed

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      Response: Clinical Marker of Platelet Hyperreactivity in Diabetes Mellitus (Diabetes Metab J 2013;37:423-8)
      Diabetes Metab J. 2014;38(2):160-161.   Published online April 18, 2014
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