title: A cross-sectional evaluation of spontaneous platelet aggregation in relation to complications in patients with type II diabetes mellitus.
abstract: To clarify the relationship between platelet function and diabetic complications, we investigated spontaneous platelet aggregation (SPA) and agonist-induced platelet aggregation by a particle counting method using light scattering (LS) and by a conventional light transmission method (LT) in 23 age- and sex-matched control subjects and 74 patients with type II diabetes mellitus. We also observed platelets using the FIC-2 (TOA Medical Electronics, Kobe, Japan) flow cytometer and imaging device. Observation by the FIC-2 device showed microaggregates of platelets in samples with increased SPA-LS. SPA-LS was significantly elevated in patients with type II diabetes mellitus as a whole compared with control subjects. SPA-LS also showed significant differences between control subjects and three diabetic patient subgroups with a varying severity of retinopathy, nephropathy, or neuropathy, and the mean values increased along with the increasing severity of complications. On the other hand, although SPA-LT also showed significant differences between these groups, the absolute values were all less than 10%, which we believe does not warrant quantitative analysis. Adenosine-5'-diphosphate (ADP)-induced platelet aggregation failed to show significant differences between controls and subjects with a varying severity of retinopathy by either LS or LT, which indicates that SPA is more sensitive than agonist-induced platelet aggregation in relation to diabetic complications. We observed significant correlations between SPA-LS and the patients' age, hemoglobin A1c (HbA1c) level, plasma fibrinogen level, or 6-keto-PGF1alpha (6KF) to 11-dehydro-thromboxane B2 (TXB2) ratio. Our study demonstrated a close relationship between platelet hyperaggregability and diabetic complications, and a longitudinal prospective study of SPA-LS in diabetic patients is warranted to clarify cause-and-effect relationships.
authors.affiliation: Third Department of Internal Medicine, Yamanashi Medical University, Tamaho, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Iwase
authors.forename: M
authors.initials: M
authors.lastname: Tawata
authors.forename: K
authors.initials: K
authors.lastname: Aida
authors.forename: Y
authors.initials: Y
authors.lastname: Ozaki
authors.forename: S
authors.initials: S
authors.lastname: Kume
authors.forename: K
authors.initials: K
authors.lastname: Satoh
authors.forename: R
authors.initials: R
authors.lastname: Qi
authors.forename: T
authors.initials: T
authors.lastname: Onaya
mesh_terms: D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood; D003929:Diabetic Neuropathies / Q000097:blood; D003930:Diabetic Retinopathy / Q000097:blood; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008722:Methods; D008875:Middle Aged; D010974:Platelet Aggregation / Q000502:physiology*; D012016:Reference Values; D012542:Scattering, Radiation