Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima–Media Thickness and Arterial Stiffness in Prediabetes

Marco, Maurizio Di; Urbano, Francesca; Filippello, Agnese; Mauro, Stefania Di; Scamporrino, Alessandra; Miano, Nicoletta; Coppolino, Giuseppe; Leggio, Stefano; Purrello, Francesco; Piro, Salvatore; Pino, Antonino Di

doi:10.3390/jcm11102870

Cited by 4 publications

(4 citation statements)

References 50 publications

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“…Despite the aforementioned limitations, our study was relatively successful in demonstrating a correlation between subtle changes in platelet count and the development of microalbuminuria in prediabetes. Our study results are particularly meaningful given that the literature on platelet dynamics in prediabetes is rare [34,35]. Previous studies on platelets in diabetes have revealed various pathological changes, such as changes in platelet hematocrit, platelet indices, increased intracellular calcium concentration, increased activation, adhesion, reactivity, and turnover of platelets, and increased reticular platelets [36][37][38].…”

Section: Discussionsupporting

confidence: 53%

Association between Relative Thrombocytosis and Microalbuminuria in Adults with Mild Fasting Hyperglycemia

Choi,

Kim,

Park

et al. 2024

JPM

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An elevated platelet count may contribute to significant thrombotic events and pose a risk for diabetic microvascular complications. Albuminuria, one of the hallmarks of diabetes, is thought to be a risk factor for endothelial dysfunction. In this study, we investigated the association between relative thrombocytosis and an increased urine albumin-to-creatinine ratio in healthy adult participants. Using multivariate analyses on data from the Korea National Health and Nutrition Examination Survey V–VI, 12,525 eligible native Koreans aged ≥ 20 were categorized into platelet count quintiles by sex. The highest platelet count quintile included younger, more obese participants with elevated white blood cell counts, poor lipid profiles, and a better estimated glomerular filtration rate. Restricted cubic spline regression analysis revealed significant associations between platelet count and fasting blood glucose, glycated hemoglobin, and urine albumin-to-creatinine ratio. Adjusted logistic regression models indicated that heightened fasting blood glucose and platelet count were linked to risk of microalbuminuria (fasting blood glucose, odds ratio = 1.026, 95%CI = 1.011–1.042; platelet count, odds ratio = 1.004, 95%CI = 1.002–1.006). Particularly, an increased platelet count was notably associated with microalbuminuria progression in subjects with impaired fasting glucose. These findings suggest that an elevated platelet count, even below diagnostic thrombocytosis levels, independently correlates with an increased risk of vascular endothelial dysfunction in patients with impaired fasting glucose.

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Section: Discussionsupporting

confidence: 53%

Association between Relative Thrombocytosis and Microalbuminuria in Adults with Mild Fasting Hyperglycemia

Choi,

Kim,

Park

et al. 2024

JPM

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“…Although aspirin has been comprehensively used in populations, comparatively, its clinical reports about arterial stiffness are not too many [ 19 , 61 , 62 ], and none of them involve mechanism explanation. It is taken for granted anti-platelet effect duo to direct correlation of platelet activation with arterial stiffness [ 63 , 64 , 65 ]. Recently, several studies propose that the effect of aspirin on improving arterial stiffness is independent of anti-platelet.…”

Section: Discussionmentioning

confidence: 99%

Effects of Long-Term Intervention with Losartan, Aspirin and Atorvastatin on Vascular Remodeling in Juvenile Spontaneously Hypertensive Rats

et al. 2023

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Hypertension in adolescents is associated with adverse cardiac and vascular events. In addition to lowering blood pressure, it is not clear whether pharmacological therapy in early life can improve vascular remodeling. This study aimed to evaluate the effects of long-term administration of losartan, aspirin, and atorvastatin on vascular remodeling in juvenile spontaneously hypertensive rats (SHRs). Losartan, aspirin, and atorvastatin were administered via gavage at doses of 20, 10, and 10 mg/kg/day, respectively, on SHRs aged 6–22 weeks. Paraffin sections of the blood vessels were stained with hematoxylin-eosin (H&E) and Sirius Red to evaluate the changes in the vascular structure and the accumulation of different types of collagen. The plasma levels of renin, angiotensin II (Ang II), aldosterone (ALD), endothelin-1 (ET-1), interleukin-6 (IL-6), and neutrophil elastase (NE) were determined using ELISA kits. After the 16-week treatment with losartan, aspirin, and atorvastatin, the wall thickness of the thoracic aorta and carotid artery decreased. The integrity of the elastic fibers in the tunica media was maintained in an orderly manner, and collagen deposition in the adventitia was retarded. The plasma levels of renin, ALD, ET-1, IL-6, and NE in the SHRs also decreased. These findings suggest that losartan, aspirin, and atorvastatin could improve vascular remodeling beyond their antihypertensive, anti-inflammatory, and lipid-lowering effects. Many aspects of the protection provided by pharmacological therapy are important for the prevention of cardiovascular diseases in adults and older adults.

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“…The more severe the renal impairment, or the higher the albuminuria, the greater the risk of cardiovascular as well as other complications. Patients with alteration of glucose homeostasis and type 2 diabetes have higher cardiovascular (CV) risk [39]. However, the question of which of the two phenotypes is associated with a higher cardiovascular risk is the focus of this review.…”

Section: Cardiovascular Risk Profile In Dkd Phenotypesmentioning

confidence: 99%

Update on Diabetic Kidney Disease (DKD): Focus on Non-Albuminuric DKD and Cardiovascular Risk

et al. 2023

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The classic description of diabetic kidney disease (DKD) involves progressive stages of glomerular hyperfiltration, microalbuminuria, proteinuria, and a decline in the estimated glomerular filtration rate (eGFR), leading to dialysis. In recent years, this concept has been increasingly challenged as evidence suggests that DKD presents more heterogeneously. Large studies have revealed that eGFR decline may also occur independently from the development of albuminuria. This concept led to the identification of a new DKD phenotype: non-albuminuric DKD (eGFR < 60 mL/min/1.73 m2, absence of albuminuria), whose pathogenesis is still unknown. However, various hypotheses have been formulated, the most likely of which is the acute kidney injury-to-chronic kidney disease (CKD) transition, with prevalent tubular, rather than glomerular, damage (typically described in albuminuric DKD). Moreover, it is still debated which phenotype is associated with a higher cardiovascular risk, due to contrasting results available in the literature. Finally, much evidence has accumulated on the various classes of drugs with beneficial effects on DKD; however, there is a lack of studies analyzing the different effects of drugs on the various phenotypes of DKD. For this reason, there are still no specific guidelines for therapy in one phenotype rather than the other, generically referring to diabetic patients with CKD.

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Increased Platelet Reactivity and Proinflammatory Profile Are Associated with Intima–Media Thickness and Arterial Stiffness in Prediabetes

Cited by 4 publications

References 50 publications

Association between Relative Thrombocytosis and Microalbuminuria in Adults with Mild Fasting Hyperglycemia

Association between Relative Thrombocytosis and Microalbuminuria in Adults with Mild Fasting Hyperglycemia

Effects of Long-Term Intervention with Losartan, Aspirin and Atorvastatin on Vascular Remodeling in Juvenile Spontaneously Hypertensive Rats

Update on Diabetic Kidney Disease (DKD): Focus on Non-Albuminuric DKD and Cardiovascular Risk

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