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.

Viscoelasticity as a measurement of clot structure in poorly controlled type 2 diabetes patients: towards a precision and personalized medicine approach

“…In type 2 diabetes, this hypercoagulability is also mediated by enhanced erythrocyte pathology, which in turn, could promote thrombosis and hypercoagulation [7, 23, 24, 45]. Platelets are also known to play important roles in hypercoagulation and thrombosis [46, 47]; and are changed in diabetes [19, 48, 49]. Either hypercoagulability [25–27, 50–54]; or reduced clot permeability; or decreased susceptibility of clots to undergo (fibrino)lysis, have previously been reported [21, 26, 28–31, 51, 54–58].…”

Influence of hyperinsulinemic – hypoglycemic clamp on induced platelet aggregation, activity of physiological anticoagulants and von Willebrand factor in patients with type I diabetes

“…Характерны также изменения тромбоцитарного гемостаза [11]. В целом на-блюдается прокоагулянтный сдвиг [5], что проявляется наличием в крови микрочастиц (фрагментов мембран) активированных тромбоцитов [12,13], увеличением дис-персии среднего объема и гетерогенности тромбоцитов и количества тромбоцитов больших размеров [14].…”

“…Характерны также изменения тромбоцитарного гемостаза [11]. В целом на-блюдается прокоагулянтный сдвиг [5], что проявляется наличием в крови микрочастиц (фрагментов мембран) активированных тромбоцитов [12,13], увеличением дис-персии среднего объема и гетерогенности тромбоцитов и количества тромбоцитов больших размеров [14].Эпизоды гипогликемии могут сопутствовать интен-сифицированной инсулинотерапии у больных СД1. По-вторные эпизоды гипогликемии приводят к ухудшению эндотелий-зависимого расширения сосудов и к более быстрому нарастанию изменений комплекса интима-ме-диа, что позволяет рассматривать повторяющуюся ги-погликемию как возможный фактор ускоренного раз-вития атеросклеротического поражения сосудистого русла [15].…”

Microvesicles and exosome granules and their role in macroorganism.

“…By spełnić to zadanie, na powierzchni MV musi dojść do ekspresji miRNA-126, który wzbudza produkcję chemokinowego ligandu CXCL (chemokine C-X-C motif ligand 1), powodując, że mikropęcherzyki zachowują się jak elementy parakrynne -chroniąc komórki endotelialne (3). Uważa się, że mikropęcherzyki bardzo dobrze spełniają rolę transporterów międzykomórkowych (10,25), co może w przyszłości znaleźć swoiste zastosowanie w diagnostyce chorób tła zapalnego, szczególnie układu krążenia (29), chorób autoimmunologicznych (5, 29, 30) oraz cukrzycy typu 1 (27).…”