Platelet entropy is increased in familial hypercholesterolemia and in type 2 diabetic patients

A plethora of abnormalities in platelet function have been described in diabetic patientsas well in familial hypercholesterolemia. This paper investigates the use of computerized fractal analysis for objective characterization of the entropy of the platelet surface of circulating platelets collected from healthy individuals, from type 2 diabetic patients and from familial hypercholesterolemic subjects, in order to search a structural biomarker to distinguish between them.

Circulating platelets were collected from 11 type 2 diabetic patients, from 6 familial hypercholesterolemic patients and 5 healthy subjects as platelet rich plasma. Platelet boundaries were observed by transmission electron microscopy and extracted by means of automatically image processing. The information dimension (entropy of the platelet contour) was automatically calculated.

Platelet boundary observed by electron microscopy is fractal. Entropy of the platelet surface in the circulating platelets is significantly increased in the diabetic patients in comparison to healthy subjects (P<0.001), as well in familial hypercholesterolemic patients (P<0.01), with 100% correct classification in selected subjects. In vitro activated platelets from healthy subjects show an analogous increase of platelet entropy.

Computerized shape analysis of circulating platelets observed by transmission electron microscopy provides accurate, quantitative, data to study platelet activation at morphological level in atherosclerosis-linked condition, as diabetes mellitus and familial hypercholesterolemia, able to distinguish the activated platelets of the patients from the platelets of healthy subjects. This method may be promising to follow the platelet activation in the circulating blood at morphological level in pathophysiological condition linked to platelet activation and after administration of drugs or other therapeutic procedures.