Abnormal platelet parameters in inflammatory bowel disease: a systematic review and meta-analysis

Abstract

Background: Platelet dysfunction plays a critical role in the pathogenesis of inflammatory bowel disease (IBD). Despite clinical observations indicating abnormalities in platelet parameters among IBD patients, inconsistencies persist, and these parameters lack standardization for diagnosis or clinical assessment.

Methods: A comprehensive search was conducted in the PubMed, Embase, Web of Science, and Cochrane Library databases for relevant articles published up to December 16th, 2023. A random-effects model was employed to pool the weighted mean difference (WMD) and 95% confidence interval (95% CI) of platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) between IBD patients and healthy controls, and subgroup analyses were performed.

Results: The meta-analysis included 79 articles with 8,350 IBD patients and 13,181 healthy individuals. The results revealed significantly increased PLT and PCT levels (WMD: 69.910, 95% CI: 62.177, 77.643 10⁹/L; WMD: 0.046%, 95% CI: 0.031%, 0.061%), and decreased MPV levels (WMD: -0.912, 95% CI: -1.086, -0.739 fL) in IBD patients compared to healthy individuals. No significant difference was found in PDW between the IBD and control groups (WMD: -0.207%, 95% CI: -0.655%, 0.241%). Subgroup analysis by disease type and disease activity showed no change in the differences for PLT, PCT, and MPV in the ulcerative colitis and Crohn's disease groups, as well as the active and inactive groups. Notably, the active group exhibited significantly lower PDW levels than the control group (WMD: -1.138%, 95% CI: -1.535%, -0.741%).

Conclusions: Compared with healthy individuals, IBD patients display significantly higher PLT and PCT and significantly lower MPV. Monitoring the clinical manifestations of platelet abnormalities serves as a valuable means to obtain diagnostic and prognostic information. Conversely, proactive measures should be taken to prevent the consequences of platelet abnormalities in individuals with IBD.

Systematic review registration: PROSPERO CRD42023493848.

Keywords: Inflammatory bowel disease; Mean platelet volume; Meta-analysis; Platelet count; Platelet distribution width; Platelet parameters; Plateletcrit; Systematic review.

Fig. 1

Flow diagram of study selection

Fig. 2

Weighted Mean Difference in PLT between the IBD Group and the Control Group. PLT measurements are reported in 10⁹/L. Abbreviations: IBD: inflammatory bowel disease; UC: ulcerative colitis; CD: Crohn’s disease; PLT: platelet count; WMD: weighted mean difference; 95% CI: 95% confidence interval

Fig. 3

Weighted Mean Difference in MPV between the IBD Group and the Control Group. MPV measurements are reported in femtoliters (fL). Abbreviations: IBD: inflammatory bowel disease; UC: ulcerative colitis; CD: Crohn’s disease; MPV: mean platelet volume; WMD: weighted mean difference; 95% CI: 95% confidence interval

Fig. 4

Weighted Mean Difference in PDW between the IBD Group and the Control Group. PDW measurements are reported in percentage (%). Abbreviations: IBD: inflammatory bowel disease; UC: ulcerative colitis; CD: Crohn’s disease; PDW: platelet distribution width; WMD: weighted mean difference; 95% CI: 95% confidence interval

Fig. 5

Weighted Mean Difference in PCT between the IBD Group and the Control Group. PCT measurements are reported in percentage (%). Abbreviations: IBD: inflammatory bowel disease; UC: ulcerative colitis; CD: Crohn’s disease; PCT: plateletcrit; WMD: weighted mean difference; 95% CI: 95% confidence interval