Platelet hyper- and hypoaggregability in different microangiopathic complications of diabetes mellitus

Abstract

In vitro platelet aggregometry was performed in 201 patients with diabetes mellitus, and in 106 controls. The complication-free and retinopathic patients showed hyperaggregability to collagen and arachidonic acid, and also to epinephrine and adenosine diphosphate when neuropathy occurred. Patients with nephropathy, both with and without azotemia, had diminished in vitro platelet responses to each of the four stimuli as compared to age- and sex-matched controls. These characteristics were independent of the type of diabetes. It is concluded that diabetic nephropathy is characterized by reduced platelet in vitro reactivity. Further research is necessary to explain in vitro hypoaggregability in contrast to the numerous proofs of in vivo hyperfunction of platelets in diabetes.

Elevated Levels of Plasma and Urine Beta-Thromboglobulin or Thromboxane-B₂ as Markers of Real Platelet Hyperactivation in Diabetic Nephropathy

“…That is why multifactorial thrombocyte dysfunction must be supposed. Our group proved that in vitro hyperaggregability can be detected in patients suffering from diabetic nephropathy even before the stage of azotaemia [20]. How ever, in some of these cases increased in vivo stimulation of platelets can be suspected.…”