Acute hyperglycemia increases soluble P-selectin in male patients with mild diabetes mellitus

Abstract

The aim of this study was to examine if acute hyperglycemia (an oral glucose tolerance test) activates platelet function, endothelial cells or thrombin generation in diabetic patients and healthy controls. Eleven males with mild type II diabetes mellitus and 11 healthy male volunteers, matched for age and body mass index, were investigated before and after the glucose load. Soluble P-selectin, von Willebrand factor antigen and markers of thrombin generation in plasma were determined by immunoassays, and platelet P-selectin expression (unstimulated and agonist-stimulated) by flow cytometry in whole blood. Acute hyperglycemia elevated plasma soluble P-selectin from 32.5 to 50.9 ng/ml in the diabetic group (P = 0.05) but not in the controls (from 27.3 to 28.8 ng/ml; P = 0.6). Also, soluble P-selectin levels were higher in patients with diabetes than in healthy controls during hyperglycemia, but not in the fasting state. Adenosine diphosphate- and thrombin-induced platelet P-selectin expression was slightly, but significantly, decreased by the glucose load, whereas platelet P-selectin expression in unstimulated samples was not affected. Plasma levels of von Willebrand factor and thrombin generation were similar in patients and controls, and were not altered by hyperglycemia. In conclusion, we found that acute hyperglycemia elevates soluble P-selectin in plasma in males with mild type II diabetes mellitus. Our observation of unaltered plasma levels of the endothelial marker von Willebrand factor is in agreement with platelets being the main source of P-selectin released into plasma following hyperglycemia. Thus, platelets in individuals with type II diabetes may be more susceptible to hyperglycemia than platelets in non-diabetic individuals.

Platelet abnormalities in diabetes mellitus

“…It mediates platelet-leukocyte interaction in inflammatory and thrombotic reactions [25]. Diabetic patients have increased soluble P-selectin levels, especially when exposed to acute hyperglycemia [26]. Increased expression of P-selectin on the platelet surface was also suspected [27] and confirmed by more recent data [21,28].…”

Soluble P-selectin and CD40L levels in subjects with prediabetes, diabetes mellitus, and metabolic syndrome—the Chennai Urban Rural Epidemiology Study

“…Harding et al [33] showed that platelet-monocyte aggregates and CD40L levels were significantly elevated in type 1 diabetic subjects. Yngen et al [34] showed that acute hyperglycemia induced by oral glucose tolerance test led to elevated levels of sP-selectin in males with type 2 diabetes mellitus. Thus, among the several reasons for excess CAD in subjects with diabetes, increased platelet activation could be one.…”

A study to find correlation of platelet indices with HbA1c in diabetic patients with absence/presence of vascular complications

“…In addition, studies of the effect of acute hyperglycemia on platelet function in patients with DM are sparse. 13 The increased platelet activity is emphasized to play a role in the development of vascular complications of the metabolic disorder. Large platelets are hemostatically more active and are a risk factor for developing coronary thrombosis, leading to myocardial infarction.…”