High mean platelet volume is associated with cerebral white matter hyperintensities in non-stroke individuals

Background: Mean platelet volume (MPV) is regarded as a marker for thrombosis, atherosclerosis, and inflammation in various vascular diseases including stroke. However, it is still unclear whether plasma MPV is associated with cerebral white matter hyperintensities (WMH) and cerebral microvascular pathology in the elderly. Methods: We examined whether MPV level is associated with the presence of cerebral WMH on brain magnetic resonance imaging (MRI) from 870 non-stroke outpatient subjects. The subjects were divided into three groups according to the consecutive level of MPV (low T1, middle T2, and high T3 MPV tertile groups). Demographic data and laboratory data for vascular risk factors were evaluated.Results: Univariate analysis disclosed that old age, hypertension, diabetes mellitus, and low renal function were more prevalent in subjects with higher MPV level. In addition, cerebral WMH were more prevalent in subjects with higher MPV level. After adjusting confounding factors, moderate to severe cerebral WMH were significantly associated with high MPV tertile level. This association remained significant after adjusting for other cerebral vascular pathologies such as large artery atherosclerosis of cerebral arteries, displaying that subjects with middle MPV level (odds ratio (OR): 1.49, 95% confidence interval (95%CI): 1.03-2.15) and those with high MPV level (OR: 1.51, 95%CI: 1.04-2.20) had cerebral WMH lesions more than those with low MPV level. Subjects with more severe cerebral WMH had higher plasma MPV levels than those without (p = 0.02). Conclusions: We found that high MPV level is independently associated with cerebral WMH. This result suggests that platelet activation plays a role in the development of cerebral WMH.