Platelet aggregation responses in type 2 diabetic patients

Abstract

Diabetes mellitus (DM) is associated with platelet dysfunction. In diabetic patients, alterations in platelet functions, especially increased platelet agregation, have been suggested to cause increasing in cardiovascular morbidity and mortality or in accelaretion of athersclerotic process. In this study, we aimed to investigate the platelet aggregation response alterations and the effects of DM duration, HbA1c, treatment options among the patients with Type 2 DM. Fortyfive patients (case group; 21 male, 24 female) with Type 2 DM and forty-eight healthy individuals (control group; 22 male, 26 female) were included in this study. Platelet aggregation was determinated with Chorono-log 500 (USA) named device by using Chorono-log/ADP, Chorono-log/ collagen and Chorono-log/epinephrine kits. ADP-induced platelet aggregation was significantly higher in the case group compared with control group (p < 0.05). Epinephrine induced platelet aggregation were significant in negatively correlation with the diabetes duration (P < 0.05). Platelet aggregation responses did not differ according to their treatment type (sulphonylurea or insulin) was statistically insignificiant among the case groups (p > 0.05). In conclusion, our findings supported that type 2 diabetes may interfere with platelet functions without any relationship age, gender, the treatment types and the regulation levels. These findings supports that existence potential new factors or mechanism affecting platelet agregation. The subject requires more detailed studies in the future.

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Güven, F. , Yilmaz, A. , Aydin, H. and Korkmaz, I. (2010) Platelet aggregation responses in type 2 diabetic patients. Health, 2, 708-712. doi: 10.4236/health.2010.27108.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Knobler, H., Savion, N., Shenkman, B., Kotev-Emeth, S. and Varon, D. (1998) Shear-induced platelet adhesion and aggregation on subendothelium are increased in diabetic patients. Thrombosis Research, 90(4), 181-190.
[2] Li, Y., Woo, V. and Bose, R. (2001) Platelet hyperactivity and abnormal Ca2+ homeasis in diabetes mellitus. American Journal of Physiol Heart Circ Physiol, 280(4), 1480-1489.
[3] Ross, R. (1986) The pathogenesis of atherosclerosis. The New England Journal of Medicine, 314(8), 488-500.
[4] Sinzinger, H. (1986) Role of platelets in atherosclerosis. Semin Thromb Haemostasis, 2(12), 124-133.
[5] Bern, M.M. (1978) Platelet functions in diabetes mellitus. Diabetes, 27(3), 342-350.
[6] Colwell, J.A., Lopes-Virella, M. and Halushka, P.V. (1981) Pathogenesis of atherosclerosis in diabetes mellitus. Diabetes Care, 4(1), 121-133.
[7] Vinik, A.I., Erbas, T., Park, T.S., Nolan, R. and Pittenger, G.L. (2001) Platelet Dysfunction in Type 2 Diabetes. Diabetes Care, 24(8), 1476-1485.
[8] Davi, G., Gresele, P., Violi, F., Basili, S., Catalano, M., Giammarresi, C., Volpato, R., Nenci, G. G., Ciabattoni, G. and Patrono, C. (1997) Diabetes mellitus, hypercholesterolemia, and hypertension but not vascular disease per se are associated with persistent platelet activation in vivo. Evidence derived from the study of peripheral arterial disease. Circulation, 96(1), 69-75.
[9] Colwell, J.A., Winocour, P.D. and Halushka, P.V. (1983) Do platelets have anything to do with diabetic microvascular disease? Diabetes, 32(2), 14-19.
[10] Natarajan, A., Zaman, A.G. and Sally, M.M. (2008) Platelet hyperactivity in type 2 diabetes: Role of antiplatelet agents. Diabetes and Vascular Disease Research, 5(2), 138-144.
[11] Tóth, L., Szénási, P., Jámbor, G., Kammerer, L. and Romics, L. (1992) Platelet Function in Male Diabetic With and Without Macrovascular Complications. Diabetes Res Clin Pract, 15(2), 143-148.
[12] Hajek, A.S. and Joist, J.H. (1992) Platelet insulin receptor. Methods Enzymol, 215, 399-403.
[13] Trovati, M., Anfossi, G., Cavalot, F., Massucco, P., Mularoni E. and Emanuelli, G. (1988) Insulin directly reduces platelet sensivity to aggregating agents. Diabetes, 37(6), 780-786.
[14] DeFronzo, R.A. (1992) Insulin resistance, hyperinsulinemia and coronary artery disease. A complex metabolic web. Journal of Cardiovascular Pharmacology, 20(11), 1-16.
[15] Terres, W., Weber, K., Kupper, W. and Bleifeld, W. (1991) Age, cardiovascular risk factors and coronary heart disease as determinants of platelet function in men. A multivariate approach. Thrombosis Research, 62(6), 649661.
[16] O’Donnell, C.J., Larson, M.G., Feng, D., Sutherland, P. A., Lindpaintner, K., Myers R.H., D’Agostino, R.A., Levy, D. and Tofler, G.H. (2001) Genetic and Environmental Contributions to Platelet Aggregation: Framingham Heart Study. Circulation, 103(25), 3051-3056.
[17] Bath,, P.M. and Butterworth, R.J. (1996) Platelet size: Measurement, physiology and vascular disease. Blood Coagulation and Fibrinolysis, 7(2), 157-161.
[18] Kim, S.W., Ryu, G.H., Lee, I., Koh, J.J., Min, B.G. and Lee, H.K. (1995) Adhered platelet morphology in diabetes mellitus. Diabetes and Metabolism, 21(1), 50-53.
[19] Mazzanfi, L. and Mutus, B. (1997) Diabetes-induced alterations in platelet metabolism. Clinical Biochemistry, 30(7), 509-515.
[20] Srivastava, S., Joshi, C.S., Sethi , P.P., Agrawal, A.K., Srivastava, S.K. and Seth, P.K. (1994) Altered platelet functions in non-insulin-dependent diabetes mellitus (NIDDM). Thrombosis Research, 76(5), 451-461.
[21] Demirtunc, R., Duman, D., Basar, M., Bilgi, M., Teomete, M. and Garip, T. (2009) The relationship between glycemic control and platelet activity in type 2 diabetes mellitus. Journal of Diabetes and its Complications, 23(2), 89-94.
[22] Hekimsoy, Z., Payzin, B., Ornek, T. and Kando?an, G. (2004) Mean platelet volume in Type 2 diabetic patients. Journal of Diabetes and its Complications, 18(3), 173176.
[23] Mandal, S., Sarode, R., Dash, S. and Dash, R.J. (1993) Hyperaggregation of platelets detected by whole blood platelet aggregometry in newly diagnosed noninsulindependent diabetes mellitus. American Journal of Clinical Pathology, 100(2), 103-107.
[24] Hughes, A., McVerry, B.A., Wilkinson, L., Goldstone, A. H., Lewis, D. and Bloom, A. (1983) Diabetes, a hypercoagulable state? Hemostatic variables in newly diagnosed type 2 diabetic patients. Acta Haematol, 69(4), 254259.
[25] Konya, H., Hasegawa, Y., Hamaguchi, T., Satani, K., Umehara, A., Katsuno, T., Ishikawa, T., Miuchi, M., Kohri, K., Suehiro, A., Kakishita, E., Miyagawa, J.I. and Namba, M. (2010) Effects of gliclazide on platelet aggregation and the plasminogen activator inhibitor type 1 level in patients with type 2 diabetes mellitus. Metabolism, Epub ahead of print.
[26] Larkins, R.G., Jerums, G., Taft, J.L., Godfrey, H., Smith, I. L. and Martin, T.J. (1988) Lack of effect of gliclazide on platelet aggregation in insulin-treated and non-insulintreated diabetes: A two-year controlled study. Diabetes Research and Clinical Practice, 4(2), 81-87.
[27] Losert, V.W., Scholz, C. and Hoder, A. (1975) Mechanisms of platelet aggregation inhibition caused by sulfonylurea compounds. Arzneimittelforschung, 25(4), 547-560.
[28] Klaff, L.J., Vinik, A.I., Jackson, W.P., Malan, E., Kernoff, L. and Jacobs, P. (1979) Effects of the sulphonylurea drugs gliclazide and glibenclamide on blood glucose control and platelet function. South African Medical Journal, 56(7), 247-250.
[29] Siluk, D., Kaliszan, R., Haber, P., Petrusewicz, J., Brzozowski, Z. and Sut, G. (2002) Antiaggregatory activity of hypoglycaemic sulphonylureas. Diabetologia, 45(7), 1034-1037.
[30] Qi, R., Ozaki, Y., Satoh, K., Kurota, K., Asazuma, N., Yatomi, Y. and Kume S. (1995) Sulphonylurea agents inhibit platelet aggregation and [Ca2+]i elevation induced by arachidonic acid. Biochemical Pharmacology, 49(12), 1735-1739.
[31] Westerbacka, J., Yki-J?rvinen, H., Turpeinen, A., Rissanen, A., Vehkavaara, S., Syrj?l?, M. and Lassila, R. (2002) Inhibition of platelet-collagen interaction: An in vivo action of insulin abolished by insulin resistance in obesity. Arteriosclerosis, Thrombosis, and Vascular Biology, 22(1), 167-172.
[32] Trovati, M. and Anfossi, G. (1998) Insulin, insulin resistance and platelet function: Similarities with insulin effects on cultured vascular smooth muscle cells. Diabetologia, 41(6), 609-622.
[33] Murer, E.H., Gyda, M.A. and Martinez, N.J. (1994) Insulin increases the aggregation response of human platelets to ADP. Thrombosis Research, 73(1), 69-74.
[34] Anfossi, G., Massucco, P., Mattiello, L., Piretto, V., Mularoni, E., Cavalot, F., Paoletti, G. and Trovati, M. (1996) Insulin exerts opposite effects on platelet function at physiological and supraphysiological concentrations. Thrombosis Research, 82(1), 57-68.
[35] Hu, H., Hjemdahl, P. and Li, N. (2002) Effects of insulin on platelet and leukocyte activity in whole blood. Thrombosis Research, 107(5), 209-215.

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