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[Thrombocyte function in children with Type I diabetes mellitus. Cross-sectional study]
U Nowak-Göttl1, W D Kreuz, E Besier
1Zentrum der Kinderheilkunde, Johann-Wolfgang-Goethe-Universität, Frankfurt/Main.
Insights
Diabetic children without angiopathy show enhanced platelet aggregation and adhesion. These platelet function changes may precede diabetic vasculopathy.
Area of Science:
- Hematology
- Pediatric Endocrinology
- Vascular Biology
Context:
- Type 1 diabetes mellitus (T1DM) is a chronic metabolic disorder affecting children.
- Diabetic microvascular complications, such as retinopathy and nephropathy, are well-documented.
- Platelet activation and function alterations are implicated in the pathogenesis of diabetic vascular disease.
Purpose:
- To investigate platelet function in children with T1DM and no clinical signs of diabetic angiopathy.
- To assess spontaneous and stimulated platelet aggregation, adhesion, and related markers.
- To explore correlations between glycemic control (HbA1c), diabetes duration, and platelet parameters.
Summary:
- Fifty-one children with T1DM were compared to age-matched healthy controls.
- Diabetic children exhibited significantly enhanced spontaneous platelet aggregation, elevated von-Willebrand-factor, increased platelet shape change, and adhesion.
- No significant differences were observed in ADP- and collagen-induced platelet aggregation or beta-thromboglobulin levels.
Impact:
- Demonstrates subclinical platelet function abnormalities in children with T1DM.
- Suggests that these platelet changes, potentially linked to metabolic control, may precede the development of diabetic vasculopathy.
- Highlights the importance of monitoring platelet function in pediatric diabetes management.
Abstract:
Platelet count, spontaneous platelet aggregation, ADP- and collagen-induced platelet aggregation platelet adhesion, platelet volume, shape change, beta-thromboglobulin and von-Willebrand-factor have been investigated in 51 insulin dependent diabetic children without clinical signs of diabetic angiopathy. Compared to an age matched healthy control group diabetic children showed a significant enhancement of spontaneous platelet aggregation, elevated plasma levels of von-Willebrand-factor, increased platelet shape change and adhesion. No alterations could be found in ADP--and collagen--induced platelet aggregation and in beta-thromboglobulin levels. Significant correlations could be found between the total glycosylated haemoglobin concentrations (Hb A1) and spontaneous platelet aggregation, as well as between duration of diabetes Hb A1, and platelet volume. In this study we could demonstrate changes in platelet function in diabetic children without clinical signs of diabetic angiopathy. However these changes could be due to metabolic adjustment and may precede diabetic vasculopathy.