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

BackgroundPlatelet 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.MethodsA 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.ResultsThe 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%).ConclusionsCompared 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 registrationPROSPERO CRD42023493848. center dot It is known that inflammatory bowel disease (IBD) is related to various alterations in platelets, but there are variations in reported results of platelet parameters in the IBD population in clinical studies.center dot To elucidate the diagnostic and prognostic value of platelet parameters in IBD, we conducted a meta-analysis of 79 studies to provide more comprehensive conclusions on changes in platelet parameters in IBD.center dot This meta-analysis reveals that individuals with IBD exhibit significantly elevated platelet count (PLT) and plateletcrit (PCT), alongside a significant decrease in mean platelet volume (MPV) compared to healthy individuals.center dot The platelet parameters can offer reliable insights for assessing the severity of IBD and understanding potential pathophysiological mechanisms.