title: Platelets microparticles as a link between micro- and macro-angiopathy in young patients with type 1 diabetes.
abstract: The development of vasculopathies in diabetes involves multifactorial processes. Increased levels of platelets-derived microparticles (PMPs) have been reported in diseases associated with thrombotic risk, but few data are available in diabetes. We explored the level of PMPs in young patients with type 1 diabetes in relation to inflammation, glycemic control, micro-vascular complications and carotid intima media thickness (CIMT). Eighty children and adolescents with type 1 diabetes were divided into two groups according to the presence of micro-vascular complications and compared with 40 healthy controls. Patients were subjected to medical history, clinical examination and assessment of high-sensitivity C-reactive protein (hs-CRP), HbA1c, urinary albumin creatinine ratio (UACR), flow cytometric analysis for PMPs using anti-CD41b and CIMT. PMP levels were significantly increased in all patients with type 1 diabetes (2.92 ± 1.3%) whether with micro-vascular complications (3.46 ± 1.11%) or those without complications (2.37 ± 1.28%) compared with healthy controls (1.28 ± 0.64%; p < 0.001). CIMT was significantly elevated in all patients, and the highest levels were among those with micro-vascular complications (p < 0.001). Significant positive correlations were found between PMPs and body mass index, HbA1c, serum creatinine, total cholesterol, UACR, hs-CRP and CIMT (p < 0.05). Multiple linear regression analysis showed that HbA1c, UACR, hs-CRP and CIMT were independently related to PMPs levels in type 1 diabetes. According to Receiver operating characteristic curve analysis, the cutoff value of PMPs at 2.48% could differentiate patients with and without micro-vascular complications with a sensitivity of 80% and specificity of 73.3%. PMPs are elevated in patients with type 1 diabetes and can be considered as an early marker of micro-vascular complications and subclinical atherosclerosis.
authors: a Department of Pediatrics and.
authors: Mona Abd El Kader
authors: MA
authors: Salem
authors: Amira Abdel Moneam
authors: AA
authors: Adly
authors: Eman Abdel Rahman
authors: EA
authors: Ismail
authors: Yasser Wagih
authors: YW
authors: Darwish
authors: Hosam Adly
authors: HA
authors: Kamel
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers; D001792:Blood Platelets / Q000378:metabolism*; D059168:Carotid Intima-Media Thickness; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D012372:ROC Curve
chemical_list: D015415:Biomarkers
keywords: Carotid intima media thickness; micro-vascular complications; platelets microparticles; type 1 diabetes