Elevated Platelet Activation in Type I Diabetics with Chronic Complications under Long-Term Near-Normoglycemic Control

Tschöepe, Diethelm; Ostermann, Helmut; Huebinger, A.; Ziegler, Dan; Wiefels, K; Gries, F. A.

doi:10.1159/000216113

Cited by 12 publications

(13 citation statements)

References 22 publications

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“…The HbA 1c levels indicate that the patients were in good long‐term glycemic control. The present data are in accordance with previous findings [14,31] that platelet and leukocyte hyperactivity takes place in Type 1 DM patients even under good metabolic control. Thus, platelet and leukocyte reactivity did not appear to be related to glycemic control among our DM patients.…”

Section: Discussionsupporting

confidence: 94%

“…However, little is known about platelet–leukocyte cross‐talk in DM. It has been reported that diabetic microangiopathy is associated with increased platelet [13,14] and leukocyte [15] activation and increased heterotypic aggregation [11,16]. Thus, we compared platelet and leukocyte activation and platelet–leukocyte interactions among Type 1 DM patients without and with microangiopathy, and age‐ and gender‐matched healthy subjects, to clarify if there is enhanced platelet–leukocyte cross‐talk, and if this may contribute to platelet and leukocyte hyperreactivity in Type 1 DM.…”

Section: Introductionmentioning

confidence: 99%

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Enhanced leukocyte–platelet cross‐talk in Type 1 diabetes mellitus: relationship to microangiopathy

H¹,

N²,

Yngen³

et al. 2004

Journal of Thrombosis and Haemostasis

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Summary. Background: Platelets and leukocytes may in¯u-ence each others' function, i.e. platelet±leukocyte cross-talk. Diabetes mellitus (DM) is associated with platelet and leukocyte dysfunction. Objective: To evaluate platelet±leukocyte cross-talk, and if this might contribute to platelet and leukocyte dysfunction and microangiopathy in DM patients. Patients and methods: We evaluated platelet and leukocyte function, and cross-talk between these cells in Type 1 DM patients without (n 19) and with (n 20) microangiopathy, and healthy subjects (n 27), using whole blood¯ow cytometry. Platelet± leukocyte cross-talk was studied in hirudinized whole blood incubated at 37 8C with stirring. Results: Basal single platelet P-selectin and leukocyte CD11b expression were similar in DM patients and healthy subjects, whilst circulating platelet±leu-kocyte aggregates and plasma elastase levels were elevated in DM patients. The thromboxane A 2 analog U46619 (3 Â 10 À7 M) induced more marked increases of platelet P-selectin expression and platelet±leukocyte aggregation in DM patients than in healthy subjects. The leukocyte-speci®c agonist N-formylmethionyl-leucyl-phenylalanine (fMLP) (10 À7 M) induced more marked CD11b expression in DM patients with microangiopathy, compared with healthy subjects. Platelet±leukocyte cross-talk induced by U46619 (10 À6 M) showed no difference between DM patients and healthy subjects. fMLP (10 À6 M) evoked marked leukocyte activation, which subsequently caused mild platelet P-selectin expression. This leukocyte± platelet cross-talk was more pronounced in DM patients than in healthy subjects. Furthermore, enhanced leukocyte±platelet cross-talk was correlated to platelet hyperreactivity among DM patients with microangiopathy only. Conclusions: Type 1 DM is associated with platelet and leukocyte hyperactivity, and enhanced leukocyte±platelet cross-talk, which may contribute to platelet hyperactivity and the microvascular complications seen in Type 1 DM.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Enhanced leukocyte–platelet cross‐talk in Type 1 diabetes mellitus: relationship to microangiopathy

H¹,

N²,

Yngen³

et al. 2004

Journal of Thrombosis and Haemostasis

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“…39 Thus, hyperglycemia alone potentially accounts for at least part of the altered platelet response in patients with diabetes mellitus. This hypothesis is consistent with the observation that patients with type 1 diabetes mellitus have an increased risk of cardiovascular disease without concomitant dysipidemia and hypertension.…”

Section: Aspirin Resistancementioning

confidence: 99%

Aspirin for primary prevention of cardiovascular disease in diabetes mellitus

Pignone

Williams

2010

Nat Rev Endocrinol

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Aspirin is effective for the prevention of cardiovascular events in patients with a history of vascular disease, as so-called secondary prevention. In general populations with no history of previous myocardial infarction or stroke, aspirin also seems useful for primary prevention of cardiovascular events, although the absolute benefits are smaller than those seen in patients with previous cardiovascular disease. Patients with diabetes mellitus are at an increased risk of cardiovascular events, but new trials have raised questions about the benefit of aspirin for primary prevention in patients with this disorder. This Review comprehensively examines the basic pharmacology of aspirin and provides an overview of the randomized, controlled trials of aspirin therapy that have included patients with diabetes mellitus. On the basis of currently available evidence from primary prevention trials, aspirin is estimated to reduce the relative risk of myocardial infarction and stroke by about 10% in patients with diabetes mellitus; however, aspirin also increases the risk of gastrointestinal bleeding. As such, low-dose aspirin therapy (75–162 mg) is reasonable for patients with diabetes mellitus and a 10-year risk of cardiovascular events >10%. Results from upcoming large trials will help clarify the effects of aspirin with greater precision, including whether the benefits differ between men and women.

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“…Leukozyten von Patienten mit Diabetes mellitus, vor allem Neutrophile, weisen abnorme Strukturen und eine erhöhte Chemotaxis auf. Diabetische Mikroangiopathie ist assoziiert mit erhöhter Aktivierung von Thrombozyten und Leukozyten sowie einer verstärkten Bildung von Thrombozyten-LeukozytenAggregaten [10,28,29].…”

Section: Gesteigerte Gerinnungsneigung Bei Diabetes Mellitusunclassified

Glykierungsprodukte als Gerinnungsaktivatoren

Gawlowski

2008

Diabetologe

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Elevated Platelet Activation in Type I Diabetics with Chronic Complications under Long-Term Near-Normoglycemic Control

Cited by 12 publications

References 22 publications

Enhanced leukocyte–platelet cross‐talk in Type 1 diabetes mellitus: relationship to microangiopathy

Enhanced leukocyte–platelet cross‐talk in Type 1 diabetes mellitus: relationship to microangiopathy

Aspirin for primary prevention of cardiovascular disease in diabetes mellitus

Glykierungsprodukte als Gerinnungsaktivatoren

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