Significance of platelet counts in health and disease: Insights from a population study using data from the National Health and Nutrition Examination Survey

Abstract

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 10^th and 90^th percentiles were calculated, and logistic regression was used to predict likelihood (Odds ratio [OR]) of being in categories with TPC < 10^th percentile or > 90^th 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 10^th percentile 170 × 10³/µL and the 90^th percentile 311 × 10³/µL. Hispanics (other than Mexican Americans) and obese individuals had lower odds of a TPC < 10^th percentile. Males, Blacks, adults aged ≥ 45 years, and those with a recent (last 12 months) hospital stay were more likely to have a TPC < 10^th percentile. Obese individuals and Mexican Americans had higher odds of having TPC > 90^th 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 <10^th percentile. Individuals with an emphysema or asthma diagnosis were more likely to have TPC > 90^th 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 < 10^th percentile, and those with emphysema and asthma were more likely to have TPC > 90^th percentile.

Keywords: platelet count, NHANES, obesity, coronary heart disease, emphysema, asthma