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Mean platelet volume in acute pancreatitis: a systematic review and meta-analysis
Vasileios P Papadopoulos1,2, Dimitrios K Filippou3, Konstantinos P Mimidis2
1Department of Internal Medicine, ENARGEIA Medical Ltd., Xanthi (Vasileios P. Papadopoulos).
Background:
Several studies have suggested there may be statistically significant differences in mean platelet volume (MPV) between the onset and remission of acute pancreatitis (AP). This systematic review and meta-analysis aimed to better characterize the correlation between MPV and AP by identifying all relevant studies and summarizing their results.
Methods:
A comprehensive literature review was conducted using EMBASE, PubMed/MEDLINE, Cochrane Library, ClinicalTrials.gov, and Google Scholar from January 2000 to December 2019 to identify all studies that reported MPV at the onset or remission of AP, or both. Effect estimates from each study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. The Newcastle-Ottawa quality assessment scale was used to appraise the quality of the included studies.
Results:
Ten observational studies, including 1019 patients and 363 controls, were included in the meta-analysis. MPV was smaller at the onset of AP than on remission (standardized mean difference= -0.33 fL, 95% confidence interval -0.54 to -0.12 fL; P=0.002); however, a moderate degree of heterogeneity (I 2=72%, P≤0.001) was observed. Subgroup analysis indicated comparable MPV in relation to the severity of AP. Similarly, no statistically significant difference was detected between AP patients and controls at either onset (P=0.760) or remission (P=0.700) of the disease. No statistically significant publication bias was detected (Eggers' regression P=0.938). Subgroup analysis suggested age (P<0.001) and sex (P=0.01) adjustment as potential sources of heterogeneity.
Conclusion:
MPV is smaller at the onset of AP. Further clinical evaluation is needed to assess its potential prognostic value.
Insights
Mean platelet volume (MPV) is significantly lower during acute pancreatitis (AP) onset compared to remission. This finding suggests MPV may have prognostic value in AP, warranting further clinical investigation.
Area of Science:
- Hematology
- Gastroenterology
- Internal Medicine
Background:
- Studies suggest mean platelet volume (MPV) differs between acute pancreatitis (AP) onset and remission.
- Characterizing the MPV-AP correlation requires further investigation.
Purpose of the Study:
- To systematically review and meta-analyze existing studies on MPV in acute pancreatitis.
- To determine the relationship between MPV and AP at different disease stages.
Main Methods:
- Comprehensive literature search of EMBASE, PubMed/MEDLINE, Cochrane Library, ClinicalTrials.gov, and Google Scholar (Jan 2000-Dec 2019).
- Inclusion of ten observational studies (1019 patients, 363 controls).
- Random-effect, generic inverse variance method for effect estimate combination; Newcastle-Ottawa scale for quality appraisal.
Main Results:
- MPV was significantly smaller at AP onset versus remission (SMD=-0.33 fL, P=0.002).
- Moderate heterogeneity (I²=72%) was observed; subgroup analysis showed comparable MPV regarding AP severity.
- No significant MPV difference between AP patients and controls at onset or remission; age and sex may influence heterogeneity.
Conclusions:
- Mean platelet volume is reduced at the onset of acute pancreatitis.
- MPV's potential prognostic value in AP requires further clinical evaluation.
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