Food Intake Enhances Thromboxane Receptor–Mediated Platelet Activation in Type 2 Diabetic Patients but Not in Healthy Subjects
- Masoud Razmara, LIC1,
- Paul Hjemdahl, MD, PHD1,
- Marianne Yngen, MD, PHD1,
- Claes-Göran Östenson, MD, PHD2,
- N. Håkan Wallén, MD, PHD13 and
- Nailin Li, MD, PHD1
- 1Department of Medicine, Clinical Pharmacology Unit, Karolinska University Hospital (Solina)/Karolinska Institute, Stockholm, Sweden
- 2Department of Molecular Medicine and Surgery, Endocrinology and Diabetes Unit, Karolinska University Hospital (Solna), Stockholm, Sweden
- 3Department of Clinical Sciences, Division of Internal Medicine, Danderyd Hospital, Stockholm, Sweden
- Address correspondence and reprint requests to Nailin Li, MD, PhD, Department of Medicine, Clinical Pharmacology Unit, Karolinska University Hospital (Solna), SE-171 76 Stockholm, Sweden. E-mail: nailin.li{at}ki.se
Diabetes is associated with platelet hyperactivity (1,2), increases in circulating activated platelets and platelet-leukocyte aggregates (PLAs), and platelet hyperreactivity to in vitro stimulation (2,3). Thromboxane-mediated platelet activation is of special interest since diabetes is associated with increased platelet-dependent thromboxane A2 (TxA2) production (2), and diabetic patients appear to benefit less from prevention with aspirin than nondiabetic patients (4,5).
Insufficient insulin production and/or insulin resistance in diabetes leads to hyperglycemia, especially after food intake. Accumulating evidence indicates that postprandial hyperglycemia contributes to diabetes cardiovascular complications and may even predict complications more closely than fasting glucose levels (6). We recently reported (7) the effects of food intake and oral antidiabetes treatment on platelet function in type 2 diabetic patients. We found that food intake augmented platelet activation stimulated by ADP but not by thrombin (7). Responses to the TxA2 analog U46619 were also studied but have not been reported. Healthy control subjects were only studied in the fasting state in the original study design (7). We therefore recalled them to test if the meal causes similar enhancement of platelet activation in subjects with normal blood glucose regulation, and we currently focus on the responsiveness to U46619.
RESEARCH DESIGN AND METHODS—
Fifteen patients with fairly well-controlled type 2 diabetes (mean ± SE age 53 ± 6 years, 11 male and 4 female, BMI 28.1 ± 3.8 kg/m2, A1C 6.8 ± 1.7% [reference <5.2%]). The study originally recruited 15 matched healthy control subjects, but only 10 (age 51 …
