Correlation between albuminuria and spontaneous platelet microaggregate formation in type 2 diabetic patients.
OBJECTIVE
Albuminuria in type 2 diabetic patients is a risk factor for cardiovascular disease. We investigated the correlation between albuminuria and spontaneous microaggregation of platelets (SMAP) formed under shear stress.


METHODS
The study subjects were 401 type 2 diabetic individuals (252 with normoalbuminuria and 149 with albuminuria) who were examined for SMAP under conditions of shear stress only (no agonist stimulation) and the reversibility of platelet microaggregation after stimulation with 1 mumol/l ADP, measured by a laser light-cattering method. Active glycoprotein IIb/IIIa (GPIIb/IIIa) and P-selectin expression levels on platelets as an index of platelet activation were measured by whole-blood flow cytometry.


RESULTS
SMAP formation was noted in 53% of diabetic patients. All patients with SMAP showed an irreversible pattern of platelet microaggregates by a low dose of ADP. SMAP was observed in 75% of diabetic subjects with albuminuria and in 39% of those with normoalbuminuria. Multivariate logistic regression analysis identified urinary albumin excretion rate and brachial-ankle pulse-wave velocity as independent factors associated with SMAP. The degree of SMAP correlated with active GPIIb/IIIa (gamma = 0.59, P < 0.001) and P-selectin (gamma = 0.55, P < 0.001) expression levels. These early-activated platelet profiles were significantly inhibited in albuminuric patients with aspirin intake, although the effect was incomplete.


CONCLUSIONS
Our study demonstrated an independent association between albuminuria and early changes in activated platelet profiles of type 2 diabetic patients. Further follow-up and intervention studies are needed to establish whether the inhibition of SMAP affects the course of cardiovascular disease in type 2 diabetic patients.
Araki
Shin-ichi
S
Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan. araki@belle.shiga-med.ac.jp
Matsuno
Hiroyuki
H
Haneda
Masakazu
M
Koya
Daisuke
D
Kanno
Yosuke
Y
Itho
Junko
J
Kishi
Akio
A
Isshiki
Keiji
K
Sugimoto
Toshiro
T
Maegawa
Hiroshi
H
Kashiwagi
Atsunori
A
Uzu
Takashi
T
D000244:Adenosine Diphosphate / Q000494:pharmacology; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology*; D001783:Blood Flow Velocity; D001792:Blood Platelets / Q000502:physiology; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000235:genetics / Q000652:urine*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000235:genetics; D015539:Platelet Activation; D010974:Platelet Aggregation / Q000187:drug effects; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000235:genetics; D012307:Risk Factors; D013314:Stress, Mechanical; D049629:Waist-Hip Ratio
D000244:Adenosine Diphosphate; D006442:Glycated Hemoglobin; D019007:P-Selectin; D019039:Platelet Glycoprotein GPIIb-IIIa Complex
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