Correlation between albuminuria and spontaneous platelet micro-aggregate formation in type 2 diabetic patients
- Shin-ichi Araki, MD, PHD (araki{at}belle.shiga-med.ac.jp)1,
- Hiroyuki Matsuno, PHD2,
- Masakazu Haneda, MD, PHD3,
- Daisuke Koya, MD, PHD4,
- Yosuke Kanno, PHD2,
- Junko Itho2,
- Akio Kishi, MD, PHD1,
- Keiji Isshiki, MD, PHD1,
- Toshiro Sugimoto, MD, PHD1,
- Hiroshi Maegawa, MD, PHD1,
- Atsunori Kashiwagi, MD, PHD1 and
- Takashi Uzu, MD, PHD1
- From the 1Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan
- 2Department of Clinical Pathological Biochemistry, Doshisha Women's Collage Liberal Arts, Kyotanabe, Kyoto
- 3Division of Metabolism and Biosystemic Science, Department of Medicine, Asahikawa Medical College, Asahikawa, Hokkaido, Japan; and
- 4Division of Endocrinology & Metabolism, Department of Medicine, Kanazawa Medical University, Kahoku-gun, Ishikawa, Japan
Abstract
Objective. Albuminuria in type 2 diabetic patients is a risk factor for cardiovascular disease. We investigated the correlation between albuminuria and spontaneous micro-aggregation of platelets (SMAP) formed under shear stress.
Research Design and Methods. The study subjects were 401 type 2 diabetics (252 with normoalbuminuria, 149 with albuminuria) who were examined for SMAP under conditions of shear stress only (no agonist stimulation) and the reversibility of platelet micro-aggregation after stimulation with 1 μM adenosine diphosphate (ADP), measured by a laser-light scattering method. Active GPIIb/IIIa and P-selectin expression levels on platelets as 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 irreversible pattern of platelet micro-aggregates by a low dose of ADP. SMAP was observed in 75% of diabetics 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 (γ=0.59, P<0.001) and P-selectin (γ=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 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.
Footnotes
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- Received March 25, 2009.
- Accepted July 30, 2009.
- Copyright © American Diabetes Association
