Platelet aggregation. Adult-onset diabetes mellitus and coronary artery disease

Davis, James W.

doi:10.1001/jama.239.8.732

Cited by 18 publications

(13 citation statements)

References 7 publications

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“…Many recognized atherogenic factors have been associated with both uncontrolled and controlled diabetes mellitus; e.g., increased O j production by monocytes (15), enhanced aggregation of platelets (22,23), and increased adhesion of erythrocytes (24) have been associated with poorly controlled diabetes, and hyperinsulinemia, consequent to the control of the diabetic state, may itself be atherogenic (25) and induce hyperproliferation of arterial smooth muscle cells (26) despite well-controlled diabetes. Hence, regardless of whether the diabetes is controlled, these patients have a tendency to develop atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Increased Superoxide Production by Mononuclear Cells of Patients With Hypertriglyceridemia and Diabetes

Hiramatsu

Arimori²

1988

Diabetes

113

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Diabetic patients with hypertriglyceridemia frequently develop atherosclerosis. Because superoxide (O2-) is suspected to play an important role in the initiation of atherosclerosis, we investigated whether an abnormal amount of O2- was produced by circulating mononuclear cells of patients with both diabetes mellitus and hypertriglyceridemia. The rate of production of superoxide dismutase-inhibitable O2- was measured when cells were stimulated by either 4 beta-phorbol 12 beta-myristate 13 alpha-acetate (PMA) or by opsonized zymosan (OZ). In addition, the rates of O2- production by mononuclear cells drawn from three other groups (normal, solely diabetic, and solely hypertriglyceridemic) were determined. We found that the rate of O2- production by mononuclear cells from the diabetic hypertriglyceridemic group was significantly higher than that from normal, diabetic, and hypertriglyceridemic groups. When the rates of O2- production by mononuclear cells were plotted against the levels of plasma triglyceride for all individuals tested, they correlated positively (r = .73 in PMA stimulation and r = .79 in OZ stimulation, P less than .01). However, the rate of O2- production did not relate to other parameters, i.e., plasma cholesterol level, hemoglobin A1 level in erythrocytes, and the molar ratio of free cholesterol to phospholipid in mononuclear cells. Thus, we concluded that the observed elevated rate of O2- production in the diabetic hypertriglyceridemic mononuclear cells was a reflection of a hypertriglyceridemic condition and was not unique to the diabetic hypertriglyceridemic condition. Also, O2- may be involved in the pathogenesis of atherosclerosis in diabetic hypertriglyceridemic patients when atherogenic factors specific to diabetes are concomitantly present.

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Section: Discussionmentioning

confidence: 99%

Increased Superoxide Production by Mononuclear Cells of Patients With Hypertriglyceridemia and Diabetes

Hiramatsu

Arimori²

1988

Diabetes

113

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“…Hyperaggregation of platelets of diabetic patients has been found to be associated with age, 15 blood glucose control, 7 and the presence or absence of various vascular changes. 16 " 18 Hyperaggregation has also been reported with a number of circulating substances, including lipids, prothrombin, and von Willebrand factor. 1 -2 Each of these factors has been reported to be altered in diabetes and may contribute to the observations related to in vitro platelet changes seen in blood from diabetic .patients.…”

Section: Discussionmentioning

confidence: 99%

Platelet Survival in Patients with Diabetes Mellitus

Jones¹,

Paradise

1981

Diabetes

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Platelet survival by 51chromium labeling was determined in six normal control subjects and in twelve patients with diabetes mellitus, before and after improved glucose control (mean HbA1c 10.5 +/- 2.2% and 7.1 +/- 1.8%, respectively). Mean platelet survival was 9.47 +/- 0.85 days for the normal subjects and 9.04 +/- 1.40 and 9.90 +/- 1.05 for the diabetic subjects in hyperglycemic and improved glycemic states, respectively. The differences between these values were not statistically significant. However, platelet survivals performed in three diabetic patients who had severe retinal disease requiring photocoagulation were significantly shortened compared with nonsmoking control subjects (P less than 0.05) or to patients without severe retinopathy (P less than 0.01). These observations imply that measurable changes in in vivo platelet survival occur after the development of small vessel disease. It remains to be determined whether abnormalities described for diabetic platelets in vitro or changes in in vivo platelet physiology contribute to the initiation or propagation of vascular disease in the hyperglycemic individual.

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“…Despite the persuasive evidence of abnormal platelet function in the diabetic patients, 151 it must be pointed out that others found no appreciable differences in platelet aggregation in diabetes with coronary artery disease compared with the nondiabetic controls with coronary artery disease. 155 Such studies underscore the need for well matched controls with comparable vascular disease in the nondiabetic population. Furthermore, it should be recalled that enhanced platelet sensitivity in the diabetic may result from other concomitants well known to be associated with this phenomenon, e.g., hyperbetalipoproteinemia, hypertension' and smoking.…”

Section: Factors Unique To Diabetic Vascular Diseasementioning

confidence: 99%