title: Correlation between albuminuria and spontaneous platelet microaggregate formation in type 2 diabetic patients.
abstract: 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.
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan. araki@belle.shiga-med.ac.jp
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Araki
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsuno
authors.forename: Masakazu
authors.initials: M
authors.lastname: Haneda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Koya
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kanno
authors.forename: Junko
authors.initials: J
authors.lastname: Itho
authors.forename: Akio
authors.initials: A
authors.lastname: Kishi
authors.forename: Keiji
authors.initials: K
authors.lastname: Isshiki
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maegawa
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kashiwagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Uzu
mesh_terms: 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
chemical_list: D000244:Adenosine Diphosphate; D006442:Glycated Hemoglobin; D019007:P-Selectin; D019039:Platelet Glycoprotein GPIIb-IIIa Complex
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