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Endothelial and platelet markers in diabetes mellitus type 2
Peter Kubisz1, Lucia Stančiaková1, Ján Staško1
1Peter Kubisz, Lucia Stančiaková, Ján Staško, National Centre of Haemostasis and Thrombosis, Clinic of Haematology and Transfusiology, Comenius University in Bratislava, Jessenius Faculty of Medicine and University Hospital in Martin, 03659 Martin, Slovak Republic.
Abstract:
Diabetes mellitus (DM) is an extremely common disorder which carries a risk of vascular impairment. DM type 2 (DM2) can be characterized by the dysfunction of haemostasis manifesting by stimulated coagulation process, disorder of platelet function and decreased fibrinolytic activity. These all are the reasons why DM2 is the most common acquired thrombophilia. Endothelial dysfunction along with platelet hyperactivity are unquestionably involved in the hyperactivation of platelets and clotting factors in DM. As a natural consequence of continuous investigation, many markers of endothelial dysfunction and diabetic thrombocytopathy have been identified and considered for implementation in clinical practice. Endothelial function can be assessed by the evaluation of endothelial markers, circulating molecules synthesised in various amounts by the endothelium. These markers precede the signs of evident microangiopathy. Platelets have an ethiopathogenic relation to the microangiopathy in DM. Their increased activity was confirmed in both types of DM. Predictors of endothelial and platelet disorder could improve the screening of individuals at increased risk, thus leading to the early diagnosis, appropriate treatment, as well as to the effective prevention of the complications of DM2. In the article we deal with the mechanisms involved in the pathogenesis of endothelial and platelet functional abnormalities, endothelial and platelet markers of DM2 considered for implementation in clinical practice and possibilities of their detection.
Insights
Type 2 diabetes (DM2) significantly increases vascular impairment risk due to hemostasis dysfunction, making it a leading cause of acquired thrombophilia. Identifying endothelial and platelet markers aids early detection and prevention of DM2 complications.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Hematology
Background:
- Diabetes mellitus (DM) is a prevalent condition associated with vascular complications.
- Type 2 diabetes (DM2) involves hemostatic dysfunction, including hypercoagulation, platelet disorders, and reduced fibrinolysis, classifying it as a common acquired thrombophilia.
- Endothelial dysfunction and platelet hyperactivity are key factors in DM-related hypercoagulation.
Purpose of the Study:
- To explore the mechanisms behind endothelial and platelet functional abnormalities in DM2.
- To review endothelial and platelet markers for DM2, considering their clinical implementation.
- To discuss the detection methods for these markers.
Main Methods:
- Review of existing literature on DM2 pathogenesis, endothelial dysfunction, and platelet abnormalities.
- Identification and analysis of endothelial and platelet markers relevant to DM2.
- Discussion of diagnostic and prognostic implications of identified markers.
Main Results:
- DM2 is characterized by stimulated coagulation, impaired platelet function, and reduced fibrinolysis, contributing to thrombophilia.
- Endothelial dysfunction and platelet hyperactivity are central to the hypercoagulation observed in DM.
- Numerous markers for endothelial dysfunction and diabetic thrombocytopathy have been identified, with potential for clinical application.
Conclusions:
- Endothelial and platelet markers can precede microangiopathy, offering early diagnostic potential.
- Increased platelet activity is a confirmed feature in all types of DM.
- Predictive markers for endothelial and platelet disorders can enhance screening, leading to timely diagnosis, treatment, and prevention of DM2 complications.
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