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Correlation between albuminuria and spontaneous platelet microaggregate formation in type 2 diabetic patients.
- Source :
-
Diabetes care [Diabetes Care] 2009 Nov; Vol. 32 (11), pp. 2062-7. Date of Electronic Publication: 2009 Aug 12. - Publication Year :
- 2009
-
Abstract
- Objective: Albuminuria in type 2 diabetic patients is a risk factor for cardiovascular disease. We investigated the correlation between albuminuria and spontaneous microaggregation of platelets (SMAP) formed under shear stress.<br />Research Design and Methods: The study subjects were 401 type 2 diabetic individuals (252 with normoalbuminuria and 149 with albuminuria) who were examined for SMAP under conditions of shear stress only (no agonist stimulation) and the reversibility of platelet microaggregation after stimulation with 1 mumol/l ADP, measured by a laser light-cattering method. Active glycoprotein IIb/IIIa (GPIIb/IIIa) and P-selectin expression levels on platelets as an index of platelet activation were measured by whole-blood flow cytometry.<br />Results: SMAP formation was noted in 53% of diabetic patients. All patients with SMAP showed an irreversible pattern of platelet microaggregates by a low dose of ADP. SMAP was observed in 75% of diabetic subjects with albuminuria and in 39% of those with normoalbuminuria. Multivariate logistic regression analysis identified urinary albumin excretion rate and brachial-ankle pulse-wave velocity as independent factors associated with SMAP. The degree of SMAP correlated with active GPIIb/IIIa (gamma = 0.59, P < 0.001) and P-selectin (gamma = 0.55, P < 0.001) expression levels. These early-activated platelet profiles were significantly inhibited in albuminuric patients with aspirin intake, although the effect was incomplete.<br />Conclusions: Our study demonstrated an independent association between albuminuria and early changes in activated platelet profiles of type 2 diabetic patients. Further follow-up and intervention studies are needed to establish whether the inhibition of SMAP affects the course of cardiovascular disease in type 2 diabetic patients.
- Subjects :
- Adenosine Diphosphate pharmacology
Aged
Blood Flow Velocity
Blood Platelets physiology
Body Mass Index
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 genetics
Diabetic Angiopathies epidemiology
Female
Glycated Hemoglobin metabolism
Humans
Male
Middle Aged
P-Selectin genetics
Platelet Activation
Platelet Glycoprotein GPIIb-IIIa Complex genetics
Risk Factors
Stress, Mechanical
Waist-Hip Ratio
Albuminuria epidemiology
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 urine
Platelet Aggregation drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1935-5548
- Volume :
- 32
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Diabetes care
- Publication Type :
- Academic Journal
- Accession number :
- 19675198
- Full Text :
- https://doi.org/10.2337/dc09-0584