title: Increased CD40 ligand and platelet-monocyte aggregates in patients with type 1 diabetes mellitus.
abstract: BACKGROUND
  Diabetes mellitus is a major risk factor for cardiovascular disease and is associated with a proinflammatory and prothrombotic state. We investigated whether CD40 ligand (L) expression and platelet-monocyte aggregation are increased in patients with type 1 diabetes.
  
  
  METHODS
  Serum C-reactive protein (CRP) and soluble (s) CD40L concentrations, platelet surface CD40L expression and platelet-monocyte aggregates were measured in 22 patients with uncomplicated type 1 diabetes and 22 age- and sex-matched non-diabetic control subjects.
  
  
  RESULTS
  In comparison to controls, patients with type 1 diabetes had higher serum CRP concentrations (3.29 +/- 0.9 mg/L versus 0.99 +/- 0.2mg/L, P = 0.01), serum sCD40L concentrations (10.0 +/- 1.4 ng/mL versus 4.6 +/- 0.6 ng/mL, P = 0.006), and platelet surface expression of CD40L (13.8 +/- 0.9% versus 8.5 +/- 1.1%, P < 0.001). Platelet-monocyte aggregates were also significantly elevated in type 1 diabetes (35.9 +/- 3.3% versus 26.4 +/- 2.9%, P = 0.005; n = 10). We also observed a significant correlation between plasma glucose and serum CRP (r = 0.53, P = 0.01) as well as platelet-monocyte aggregates (r = 0.69, P = 0.03).
  
  
  CONCLUSIONS
  Type 1 diabetes is associated with increased CD40L expression and platelet-monocyte aggregation, which may contribute to the proinflammatory and prothrombotic state as well as the accelerated atherogenesis associated with this disorder.
authors.affiliation: Cardiovascular Research Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SB, Scotland, UK.
authors.forename: S A
authors.initials: SA
authors.lastname: Harding
authors.forename: A J
authors.initials: AJ
authors.lastname: Sommerfield
authors.forename: J
authors.initials: J
authors.lastname: Sarma
authors.forename: P J
authors.initials: PJ
authors.lastname: Twomey
authors.forename: D E
authors.initials: DE
authors.lastname: Newby
authors.forename: B M
authors.initials: BM
authors.lastname: Frier
authors.forename: K A A
authors.initials: KA
authors.lastname: Fox
mesh_terms: D000328:Adult; D001786:Blood Glucose; D002097:C-Reactive Protein / Q000032:analysis; D023201:CD40 Ligand / Q000097:blood*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology*; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D009000:Monocytes / Q000502:physiology*; D010974:Platelet Aggregation
chemical_list: D001786:Blood Glucose; D023201:CD40 Ligand; D002097:C-Reactive Protein