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Shear-induced platelet adhesion and aggregation on subendothelium are increased in diabetic patients
H Knobler1, N Savion, B Shenkman
1Division of Endocrinology, Kaplan Hospital, Rehovot, Israel.
Insights
Diabetic patients show increased platelet activation, including adhesion and aggregation, compared to healthy individuals. This platelet hyperactivity is linked to dyslipidemia, not diabetes duration or complications.
Area of Science:
- Cardiovascular Research
- Hematology
- Metabolic Disorders
Background:
- Accelerated atherosclerosis in diabetics is linked to platelet aggregation.
- Previous aggregation tests' physiological relevance is questioned.
- Understanding platelet activation in diabetes is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To determine platelet activation in noninsulin-dependent diabetes mellitus patients.
- To utilize a novel cone and plate(let) analyzer for measuring shear-induced platelet activity on extracellular matrix (ECM).
- To explore correlations between platelet activity and clinical/laboratory characteristics in diabetics.
Main Methods:
- Comparison of whole blood platelet adhesion and aggregation between diabetic patients (n=82) and nondiabetic controls (n=71).
- Measurement of shear-induced platelet adhesion and aggregation on ECM using a cone and plate(let) analyzer.
- Analysis of clinical and laboratory data for correlations with platelet activity parameters.
Main Results:
- Diabetic patients exhibited significantly increased platelet adhesion to ECM (23% vs. 19%) and larger ECM-bound aggregates (54 µm² vs. 47 µm²).
- Platelet adhesion correlated with triglyceride levels (r=0.36), hematocrit (r=0.31), and inversely with HDL cholesterol (r=0.30).
- No correlations were found between platelet reactivity and diabetes duration, vascular complications, or LDL levels.
Conclusions:
- Diabetic patients demonstrate heightened platelet adhesion and aggregation.
- Diabetic dyslipidemia may modulate platelet activity.
- Novel analyzer provides insights into shear-induced platelet behavior in diabetes.
Abstract:
Increased platelet aggregation has been suggested to play a role in the accelerated atherosclerosis of diabetics. However the physiological relevance of the aggregation tests has been questioned. The purpose of this study was to determine platelet activation in diabetic patients, using a novel device--the cone and plate(let) analyzer--to measure shear-induced platelet adhesion and aggregation on extracellular matrix (ECM). Whole blood platelet adhesion and aggregation in patients with noninsulin-dependent diabetes mellitus (n=82) and in nondiabetic controls (n=71) were compared. Clinical and laboratory characteristics of the diabetic patients were analyzed for possible correlation with parameters of platelet activity. Patients with diabetes had a significantly increased platelet activation compared to nondiabetic subjects, demonstrated by an increased adhesion to the ECM (surface coverage, 23% [95% confidence interval, 22-25%] vs. 19% [95% confidence interval, 18-20%], respectively) and an increased average size of the ECM-bound aggregates (54 microm2 [95% confidence interval, 51-57 microm2] vs. 47 microm2 [95% confidence interval, 43-51 microm2], respectively). Platelet adhesion in the diabetic group was found to correlate with triglyceride levels (r=0.36) and hematocrit values (r=0.31) and inversely with high-density lipoprotein cholesterol levels (r=0.30). There were no correlation, however, between parameters of platelet reactivity and duration of diabetes, vascular complications and low-density lipoprotein levels. Our data demonstrate an increased platelet adhesion and aggregation in diabetic patients and suggest a modulatory role of diabetic dyslipidemia.