title: Elevated levels of remnant lipoproteins are associated with plasma platelet microparticles in patients with type-2 diabetes mellitus without obstructive coronary artery disease.
abstract: OBJECTIVE
  Platelets participate in the pathogenesis of arterial thrombosis and it has been demonstrated that enhanced platelet activation occurs in patients with diabetes mellitus (DM). Dyslipidaemia is a common feature of diabetes. We investigated the association between certain lipid fractions and plasma platelet-derived microparticle (PMP) levels in patients with type-2 DM.
  
  
  RESULTS
  We measured fasting serum levels of remnant-like lipoprotein particles-cholesterol (RLP-cholesterol) and assessed in vivo platelet activation by quantifying the number of PMP in the plasma detected as CD42b-positive microparticles by flow cytometry in Japanese type-2 DM patients without obstructive coronary artery disease who were more slender when compared with Western diabetic patients. The levels of total cholesterol, triglycerides, RLP-cholesterol, and plasma glucose were significantly higher in patients with type-2 DM (n = 105) than in non-diabetic patients (n = 92). The plasma levels of PMP were elevated significantly in type-2 DM patients when compared with non-diabetic control subjects [7.41(5.39-10.50) x 10(6) vs. 3.44(2.43-4.41)x10(6), P < 0.001]. We found that RLP-cholesterol levels were the best predictor of PMP in multivariable linear regression analyses (beta = 0.375, P < 0.001). Lipid-lowering medication with bezafibrate successfully reduced levels of both RLP-cholesterol and PMP in patients with type-2 DM (P < 0.05).
  
  
  CONCLUSIONS
  RLP-cholesterol and platelet microparticles are both elevated in type-2 DM patients when compared with controls. RLP-cholesterol is the primary and only predictor of platelet microparticles in the multivariable analysis, which include several standard atherosclerosis risk factors. This suggested that reducing elevated RLP-cholesterol with lipid-lowering therapy may be an effective strategy to prevent thrombogenic vascular complications in type-2 DM.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences Kumamoto University, Kumamoto City, Japan.
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Koga
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kugiyama
authors.forename: Hironobu
authors.initials: H
authors.lastname: Fukushima
authors.forename: Keisuke
authors.initials: K
authors.lastname: Watanabe
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Jinnouchi
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000787:Angina Pectoris / Q000097:blood*; D001629:Bezafibrate / Q000627:therapeutic use; D001792:Blood Platelets / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D003925:Diabetic Angiopathies / Q000097:blood*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008074:Lipoproteins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000960:Hypolipidemic Agents; D008074:Lipoproteins; D001629:Bezafibrate