title: Younger age, higher body mass index and lower adiponectin concentration predict higher serum thromboxane B2 level in aspirin-treated patients with type 2 diabetes: an observational study.
abstract: BACKGROUND
  Evidence from the literature suggests diminished acetylsalicylic acid (ASA) treatment efficacy in type 2 diabetes (DM2). High on-aspirin platelet reactivity (HAPR) in DM2 has been linked to poor glycemic and lipid control. However, there are no consistent data on the association between HAPR and insulin resistance or adipose tissue metabolic activity. The aim of this study was to assess the relationship between laboratory response to ASA and metabolic control, insulin resistance and adipokines in DM2.
  
  
  METHODS
  A total of 186 DM2 patients treated with oral antidiabetic drugs and receiving 75 mg ASA daily were included in the analysis. Response to ASA was assessed by measuring serum thromboxane B2 (TXB2) concentration and expressed as quartiles of TXB2 level. The achievement of treatment targets in terms of glycemic and lipid control, insulin resistance parameters (including Homeostatic Model Assessment-Insulin Resistance, HOMA-IR, index), and serum concentrations of high-molecular weight (HMW) adiponectin, leptin and resistin, were evaluated in all patients. Univariate and multivariate logistic regression analyses were performed to determine the predictive factors of serum TXB2 concentration above the upper quartile and above the median.
  
  
  RESULTS
  Significant trends in age, body mass index (BMI), HOMA-IR, HMW adiponectin concentration, C-reactive protein concentration and the frequency of achieving target triglyceride levels were observed across increasing quartiles of TXB2. In a multivariate analysis, only younger age and higher BMI were independent predictors of TXB2 concentration above the upper quartile, while younger age and lower HMW adiponectin concentration were predictors of TXB2 concentration above the median.
  
  
  CONCLUSIONS
  These results suggest that in DM2, the most important predictor of HAPR is younger age. Younger DM2 patients may therefore require total daily ASA doses higher than 75 mg, preferably as a twice-daily regimen, to achieve full therapeutic effect. Higher BMI and lower HMW adiponectin concentration were also associated with less potent ASA effect. This is the first study to demonstrate an association of lower adiponectin concentration with higher serum TXB2 level in patients treated with ASA.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kaplon-Cieslicka
authors.forename: Marek
authors.initials: M
authors.lastname: Postula
authors.forename: Marek
authors.initials: M
authors.lastname: Rosiak
authors.forename: Michal
authors.initials: M
authors.lastname: Peller
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kondracka
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Serafin
authors.forename: Ewa
authors.initials: E
authors.lastname: Trzepla
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052242:Adiponectin / Q000097:blood; D000367:Age Factors; D001241:Aspirin / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013929:Thromboxane B2 / Q000097:blood; D016896:Treatment Outcome
chemical_list: D052242:Adiponectin; D001241:Aspirin; D015415:Biomarkers; D013929:Thromboxane B2