Significance of platelet counts in health and disease: Insights from a population study using data from the National Health and Nutrition Examination Survey
Background: Platelets are important mediators of coagulation, inflammation, and
atherosclerosis. We conducted a large population study with National Health and Nutrition
Examination Survey (NHANES) data to understand the relationship of total platelet count
(TPC) with health and disease in humans.
Methods: NHANES is a cross-sectional survey of non-institutionalized United States adults,
administered every 2 years by the Centers for Disease Control and Prevention. Participants
answer a questionnaire, receive a physical examination, and undergo laboratory tests. TPC
values were analyzed for a six-year period of NHANES (2011–2016). Weighted 10th and 90th
percentiles were calculated, and logistic regression was used to predict likelihood (Odds ratio
[OR]) of being in categories with TPC < 10th percentile or > 90th percentile. Statistical analysis
was performed using Stata/SE 15.1, using population weights for complex survey design.
Results: The mean TPC for our sample (N = 17,969) was 236 × 103/μL (SD = 59 × 103)
with the 10th percentile 170 × 103/μL and the 90th percentile 311 × 103/μL. Hispanics (other
than Mexican Americans) and obese individuals had lower odds of a TPC < 10th percentile.
Males, Blacks, adults aged ≥ 45 years, and those with a recent (last 12 months) hospital stay
were more likely to have a TPC < 10th percentile. Obese individuals and Mexican Americans
had higher odds of having TPC > 90th percentile. Individuals with a congestive heart failure
(CHF) or coronary heart disease (CHD) diagnosis had over twice the odds (OR 2.06, 95% CI:
1.50-2.82, p =< 0.001, and 2.11, 95% CI: 1.48-3.01, p =< 0.001, respectively) of having TPC
<10th percentile. Individuals with an emphysema or asthma diagnosis were more likely to have
TPC > 90th percentile (OR 1.84, 95% CI: 1.08-3.13, p = 0.026, and 1.25, 95% CI: 1.00-1.56,
p = 0.046, respectively). A diagnosis of chronic obstructive pulmonary disease and cancer did
not have significant associations with TPC.
Conclusions: Our study showed that obese individuals are more likely to have
higher TPC. Individuals with CHF and CHD had higher odds of having TPC < 10th
percentile, and those with emphysema and asthma were more likely to have TPC > 90th
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