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Alsharidah AS. Diabetes mellitus and diabetic nephropathy: a review of the literature on hemostatic changes in coagulation and thrombosis. Blood Res 2022; 57:101-105. [PMID: 35620906 PMCID: PMC9242838 DOI: 10.5045/br.2022.2021204] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/31/2022] [Accepted: 03/14/2022] [Indexed: 11/17/2022] Open
Abstract
Vascular complications lead to morbidity and mortality in patients with diabetes. Diabetic nephropathy (DN) is one of the main life-threatening problems for these patients, as it is the main cause of end-stage renal disease. This study aimed to measure the clinical effects of diabetes in patients with diabetes and in patients with diabetic nephropathy. Improved hypoglycemic control in patients with diabetes could impressively reduce platelet hyperreactivity, and oxidative stress alters the levels of many coagulation and thrombosis factors, resulting in an abnormal hemostasis and impaired levels of numerous serum markers. Most studies have revealed that coagulation factor levels are high in patients with diabetes and nephrodiabetes. Serum inflammatory factors, and coagulation and endothelial functions are good predictors of diabetic nephropathy. This literature review was conducted with access to scholarly databases and Google Scholar through Qassim University, and it analyzes studies from early 2010 until November 2020. Many studies have inferred that diabetes severely affects hemostasis and increases the risk of cardiovascular disease.
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Affiliation(s)
- Ashwag S Alsharidah
- Department of Physiology, College of Medicine, Qassim University, Buraidah, Saudi Arabia
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2
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Predictors of thrombosis in patients treated with bevacizumab. THROMBOSIS UPDATE 2022. [DOI: 10.1016/j.tru.2021.100095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Fan EY, Crawford AS, Nguyen T, Judelson D, Learned A, Chan J, Schanzer A, Simons JP, Jones DW. Hemoglobin A1C Monitoring Practices Prior to Lower Extremity Bypass in Patients with Diabetes Vary Broadly and Do Not Predict Outcomes. J Vasc Surg 2022; 76:255-264. [DOI: 10.1016/j.jvs.2022.02.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/14/2022] [Indexed: 02/07/2023]
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Muruganantham S, Krishnaswami V, Alagarsamy S, Kandasamy R. Anti-platelet Drug-loaded Targeted Technologies for the Effective Treatment of Atherothrombosis. Curr Drug Targets 2021; 22:399-419. [PMID: 33109044 DOI: 10.2174/1389450121666201027125303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/13/2020] [Accepted: 08/27/2020] [Indexed: 11/22/2022]
Abstract
Atherothrombosis results from direct interaction between atherosclerotic plaque and arterial thrombosis and is the most common type of cardiovascular disease. As a long term progressive disease, atherosclerosis frequently results in an acute atherothrombotic event through plaque rupture and platelet-rich thrombus formation. The pathophysiology of atherothrombosis involves cholesterol accumulation endothelial dysfunction, dyslipidemia, immuno-inflammatory, and apoptotic aspects. Platelet activation and aggregation is the major cause for stroke because of its roles, including thrombus, contributing to atherosclerotic plaque, and sealing off the bleeding vessel. Platelet aggregates are associated with arterial blood pressure and cardiovascular ischemic events. Under normal physiological conditions, when a blood vessel is damaged, the task of platelets within the circulation is to arrest the blood loss. Antiplatelet inhibits platelet function, thereby decreasing thrombus formation with complementary modes of action to prevent atherothrombosis. In the present scientific scenario, researchers throughout the world are focusing on the development of novel drug delivery systems to enhance patient's compliance. Immediate responding pharmaceutical formulations become an emerging trend in the pharmaceutical industries with better patient compliance. The proposed review provides details related to the molecular pathogenesis of atherothrombosis and recent novel formulation approaches to treat atherothrombosis with particular emphasis on commercial formulation and upcoming technologies.
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Affiliation(s)
- Selvakumar Muruganantham
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Venkateshwaran Krishnaswami
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Shanmugarathinam Alagarsamy
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
| | - Ruckmani Kandasamy
- Centre for Excellence in Nanobio Translational Research (CENTRE), Department of Pharmaceutical Technology, University College of Engineering, Anna University, BIT Campus, Tiruchirappalli, Tamil Nadu, India
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Barale C, Cavalot F, Frascaroli C, Bonomo K, Morotti A, Guerrasio A, Russo I. Association between High On-Aspirin Platelet Reactivity and Reduced Superoxide Dismutase Activity in Patients Affected by Type 2 Diabetes Mellitus or Primary Hypercholesterolemia. Int J Mol Sci 2020; 21:ijms21144983. [PMID: 32679712 PMCID: PMC7404318 DOI: 10.3390/ijms21144983] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 12/18/2022] Open
Abstract
Platelet hyperactivation is involved in the established prothrombotic condition of metabolic diseases such as Type 2 Diabetes Mellitus (T2DM) and familial hypercholesterolemia (HC), justifying the therapy with aspirin, a suppressor of thromboxane synthesis through the irreversible inhibition of cyclooxygenase-1 (COX-1), to prevent cardiovascular diseases. However, some patients on aspirin show a higher than expected platelet reactivity due, at least in part, to a pro-oxidant milieu. The aim of this study was to investigate platelet reactivity in T2DM (n = 103) or HC (n = 61) patients (aspirin, 100 mg/day) and its correlation with biomarkers of redox function including the superoxide anion scavenger superoxide dismutase (SOD) and the in vivo marker of oxidative stress urinary 8-iso-prostaglandin F2α. As results, in T2DM and HC subjects the prevalence of high on-aspirin platelet reactivity was comparable when both non-COX-1-dependent and COX-1-dependent assays were performed, and platelet reactivity is associated with a lower SOD activity that in a stepwise linear regression appears as the only predictor of platelet reactivity. To conclude, in T2DM and HC, similarly, the impairment of redox equilibrium associated with a decrease of SOD activity could contribute to a suboptimal response to aspirin.
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Affiliation(s)
- Cristina Barale
- Department of Clinical and Biological Sciences of Turin University, 10043 Orbassano, Turin, Italy; (C.B.); (A.M.); (A.G.)
| | - Franco Cavalot
- Metabolic Disease and Diabetes Unit, San Luigi Gonzaga Hospital, 10043 Orbassano, Turin, Italy; (F.C.); (C.F.); (K.B.)
| | - Chiara Frascaroli
- Metabolic Disease and Diabetes Unit, San Luigi Gonzaga Hospital, 10043 Orbassano, Turin, Italy; (F.C.); (C.F.); (K.B.)
| | - Katia Bonomo
- Metabolic Disease and Diabetes Unit, San Luigi Gonzaga Hospital, 10043 Orbassano, Turin, Italy; (F.C.); (C.F.); (K.B.)
| | - Alessandro Morotti
- Department of Clinical and Biological Sciences of Turin University, 10043 Orbassano, Turin, Italy; (C.B.); (A.M.); (A.G.)
| | - Angelo Guerrasio
- Department of Clinical and Biological Sciences of Turin University, 10043 Orbassano, Turin, Italy; (C.B.); (A.M.); (A.G.)
| | - Isabella Russo
- Department of Clinical and Biological Sciences of Turin University, 10043 Orbassano, Turin, Italy; (C.B.); (A.M.); (A.G.)
- Correspondence: ; Tel.: +39-011-9026622; Fax: +39-011-9038639
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Modulation of Blood Coagulation and Hematological Parameters by Crassocephalum crepidioides Leaf Methanol Extract and Fractions in STZ-Induced Diabetes in the Rat. ScientificWorldJournal 2020; 2020:1036364. [PMID: 32508536 PMCID: PMC7245657 DOI: 10.1155/2020/1036364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 03/17/2020] [Accepted: 04/17/2020] [Indexed: 12/04/2022] Open
Abstract
Diabetes affects the homeostasis of the circulatory system. Crassocephalum crepidioides Benth S. Moore (Asteraceae) is an edible plant locally used in the treatment of wounds, stomach ulcer, and skin-related conditions in Africa and some other parts of the world. This study investigated the effects of C. crepidioides leaf methanol extract and fractions on blood coagulation profile of diabetic Wistar rats. The effect of 100 mg/kg body weight of the methanol extract and partitioned fractions of C. crepidioides on blood coagulation profile of STZ-induced diabetic rats were initially evaluated, while graded concentrations (50–200 mg/kg body weight) of the aqueous and hexane fractions were further tested in diabetic rats against standard drugs aspirin (anticoagulant) and metformin (antidiabetic). Rats were allocated into groups (n = 6) and administration was done orally, once daily for 2 weeks. The methanol extract and fractions of C. crepidioides at concentrations of 50, 100, and 200 mg/kg significantly prolonged the bleeding (58–200%), clotting (65–133%), prothrombin (176–441%), and activated partial thromboplastin (209–518%) times in diabetic rats compared to the control rats (LD50 ≥ 5000 mg/kg). Highest prolongation effects were recorded in the diabetic group treated with 100 mg/kg body weight of the hexane fraction. Plasma calcium concentration and platelet counts of C. crepidioides treated diabetic rats were significantly (P < 0.05) reduced compared to diabetic control rats, while the red blood cells (RBC), hemoglobin concentration, and packed cell volume (PCV) were significantly increased. This study showed that C. crepidioides possess anticoagulant and antianemic activities. The leaves can thus be a potential source of novel anticoagulant and nutraceutical for management of the thrombotic disorder in diabetes and other diseased states.
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Rosado JA, Diez-Bello R, Salido GM, Jardin I. Fine-tuning of microRNAs in Type 2 Diabetes Mellitus. Curr Med Chem 2019; 26:4102-4118. [PMID: 29210640 DOI: 10.2174/0929867325666171205163944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 11/23/2017] [Accepted: 11/23/2017] [Indexed: 12/13/2022]
Abstract
Type 2 diabetes mellitus is a metabolic disease widely spread across industrialized countries. Sedentary lifestyle and unhealthy alimentary habits lead to obesity, boosting both glucose and fatty acid in the bloodstream and eventually, insulin resistance, pancreas inflammation and faulty insulin production or secretion, all of them very well-defined hallmarks of type 2 diabetes mellitus. miRNAs are small sequences of non-coding RNA that may regulate several processes within the cells, fine-tuning protein expression, with an unexpected and subtle precision and in time-frames ranging from minutes to days. Since the discovery of miRNA and their possible implication in pathologies, several groups aimed to find a relationship between type 2 diabetes mellitus and miRNAs. Here we discuss the pattern of expression of different miRNAs in cultured cells, animal models and diabetic patients. We summarize the role of the most important miRNAs involved in pancreas growth and development, insulin secretion and liver, skeletal muscle or adipocyte insulin resistance in the context of type 2 diabetes mellitus.
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Affiliation(s)
- Juan A Rosado
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
| | - Raquel Diez-Bello
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
| | - Ginés M Salido
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
| | - Isaac Jardin
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
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Nerve conduction velocity is negatively associated with intima-media thickness and brachial-ankle pulse wave velocity in men with type 2 diabetes mellitus. PLoS One 2018; 13:e0209503. [PMID: 30571795 PMCID: PMC6301707 DOI: 10.1371/journal.pone.0209503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022] Open
Abstract
Objective Previous studies suggest that the presence of diabetic peripheral polyneuropathy (DPN) is associated with atherosclerotic diseases; however, little is known about the relationship between diabetic nerve conduction velocity (NCV) versus arterial stiffness and atherosclerosis parameters. Methods The subjects in this study were 292 men with type 2 diabetes mellitus (T2DM). All subjects underwent NCV examination at median and tibial nerves as motor nerve (MCV) as well as median and sural nerves as sensory nerve (SCV). Brachial-ankle pulse wave velocity (baPWV) and carotid intima-media thickness (IMT) were evaluated as arterial stiffness and atherosclerosis parameters. Results Pearson’s correlation coefficient showed that NCV at all sites negatively correlated with baPWV, maximal and mean IMT (IMT-Max and IMT-Mean), and plaque score (all p values p<0.01 at least). Multiple regression analyses adjusted for confounding factors such as age, duration of diabetes, body mass index, HbA1c, fasting C-peptide, systolic blood pressure, HDL-cholesterol, LDL-cholesterol and albuminuria showed that the association of NCV with IMT-Max, ITM-Mean, and plaque score remained significant (all p values p<0.05 at least) except that between SCV at median and IMT-Max. Moreover, SCV at median (forearm) and sural were significantly associated with baPWV (p = 0.023 and p = 0.027, respectively). Conclusion The present study showed that DPN estimated by quantitative NCV is linearly associated with the deterioration of arterial stiffness and atherosclerosis parameters in T2DM independently of various diabetic and atherosclerotic factors.
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Konieczyńska M, Bryk AH, Malinowski KP, Draga K, Undas A. Interplay between elevated cellular fibronectin and plasma fibrin clot properties in type 2 diabetes. Thromb Haemost 2017; 117:1671-1678. [PMID: 28569923 DOI: 10.1160/th17-04-0259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 05/09/2017] [Indexed: 12/22/2022]
Abstract
Type 2 diabetes is associated with faster formation of poorly lysable, denser fibrin clots and elevated cellular fibronectin (cFn), a marker of vascular injury. We investigated whether cFn affects clot properties in type 2 diabetes. In 200 consecutive patients with type 2 diabetes and 100 control subjects matched for age and sex, we determined plasma cFn along with clot formation and degradation using turbidimetric and permeability assays. Diabetic patients had elevated cFn (median, 3.99 [interquartile range, 2.87-4.81] µg/ml]), increased clot density (MaxAbsC) and prolonged lysis time (LysT) compared with those without type 2 diabetes (all p<0.01). Diabetic patients with documented cardiovascular disease (CVD, n=127, 63.5 %) had increased cFn (4.53 [3.68-4.95] µg/ml), decreased clot permeability (Ks) and increased MaxAbsC compared with those without CVD (all p<0.001). Diabetic patients with cFn in the top quartile (>4.81 µg/ml) were two times more likely to have CVD compared with those in the lowest quartile (odds ratio 1.80, 95 % confidence interval 1.41-2.46, p<0.001). No differences in cFn were observed in relation to microvascular complications. After adjustment for potential confounders, cFn accounted for 10.2 % of variance in Ks, 18.2 % of variance in clot density and 10.2 % of variance in AUC in diabetic patients. This study shows that elevated cFn is associated with unfavourably modified clot properties in type 2 diabetes, especially with concomitant CVD, which indicates novel links between vascular injury and prothrombotic alterations in diabetes. Coagulation, cellular fibronectin, type 2 diabetes, cardiovascular disease.
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Affiliation(s)
| | | | | | | | - Anetta Undas
- Anetta Undas, MD, PhD, Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka St., 31-202 Krakow, Poland, Tel.: +48 12 6143004, Fax: +48 12 6142120, E-mail:
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Yang SL, Zhu LY, Han R, Sun LL, Li JX, Dou JT. Pathophysiology of peripheral arterial disease in diabetes mellitus. J Diabetes 2017; 9:133-140. [PMID: 27556728 DOI: 10.1111/1753-0407.12474] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 07/07/2016] [Accepted: 08/16/2016] [Indexed: 12/12/2022] Open
Abstract
Peripheral arterial disease (PAD) increases the risk of lower extremity amputation. It is also an independent predictor of cardiovascular and cerebrovascular ischemic events, affecting both the quality and expectancy of life. Many studies have demonstrated that the prevalence of PAD in patients with diabetes mellitus (DM) is higher than in non-diabetic patients. In diabetic patients, PAD occurs early with rapid progression, and is frequently asymptomatic. Multiple metabolic aberrations in DM, such as advanced glycation end-products, low-density lipoprotein cholesterol, and abnormal oxidative stress, have been shown to worsen PAD. However, the role of DM in PAD is not completely understood. The purpose of the present article is to review and discuss the pathophysiology of PAD in DM.
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Affiliation(s)
- Shao-Ling Yang
- Department of Endocrinology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Lv-Yun Zhu
- Department of Endocrinology, Bethune International Peace Hospital of PLA, Shijiazhuang, China
| | - Rui Han
- Department of Neurology, The First Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lei-Lei Sun
- Graduate School of Logistics University of People's Armed Police Force, Tianjin, China
| | - Jun-Xia Li
- Department of Cardiology, PLA General Hospital, Beijing, China
| | - Jing-Tao Dou
- Department of Endocrinology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
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Di Rosa M, Malaguarnera L. Chitinase 3 Like-1: An Emerging Molecule Involved in Diabetes and Diabetic Complications. Pathobiology 2016; 83:228-42. [DOI: 10.1159/000444855] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 02/18/2016] [Indexed: 11/19/2022] Open
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Karahaliloğlu Z, Demirbilek M, Ulusoy İ, Gümüşkaya B, Denkbaş EB. Active nano/microbilayer hemostatic agents for diabetic rat bleeding model. J Biomed Mater Res B Appl Biomater 2016; 105:1573-1585. [DOI: 10.1002/jbm.b.33696] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/20/2016] [Accepted: 04/06/2016] [Indexed: 01/10/2023]
Affiliation(s)
- Zeynep Karahaliloğlu
- Department of Biology; Faculty of Science and Arts, Aksaray University; Aksaray Turkey
| | - Murat Demirbilek
- Advanced Technologies Research and Application Center, Hacettepe University, Beytepe; Ankara Turkey
| | - İbrahim Ulusoy
- Adacell, Yıldırım Beyazıt Training and Research Hospital, Dışkapı; Ankara Turkey
| | - Berrak Gümüşkaya
- Department of Pathology; Faculty of Medicine, Yıldırım Beyazıt University, Bilkent; Ankara Turkey
- Department of Pathology; Atatürk Training and Research Hospital, Bilkent; Ankara Turkey
| | - Emir Baki Denkbaş
- Department of Chemistry; Faculty of Science, Hacettepe University, Beytepe; Ankara Turkey
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Stauffer F, Viswanathan B, Jean M, Kinabo P, Bovet P. Comparison between capillary glucose measured with a Contour glucometer and plasma glucose in a population survey. ACTA ACUST UNITED AC 2016. [DOI: 10.1515/labmed-2015-0089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractCapillary glucose (CG) measured with point-of-care glucometers can provide useful approximation of plasma glucose (PG) in selected circumstances but the validity of measurements has been adequately assessed only for a few glucometers.We assessed the difference between CG measured with a glucometer (Contour Ascensia, Bayer) and PG measured with a standard laboratory method in participants to a population-based cardiovascular survey in the Seychelles (sample size 1227).CG correlated well with PG (r=0.94; p<0.001). The overall difference between PG and CG was –0.55 mmol/L for PG <4.0 mmol/L (n=19; 95% CI –0.92; –0.18); 0.14 mmol/L for PG 4.0–4.9 (n=344; 95% CI 0.08–0.20) and increased according to PG up to 1.64 mmol/L for PG >9.0 mmol/L (n=68; 95% CI 1.36; 1.91). The prevalence of diabetes in the study sample was 29% lower with CG than with PG (8.6% vs. 12.1%) but this bias could be corrected by analytical re-calibration.CG underestimated PG, although the bias was small among persons with low glycemia. This systematic difference may bear little significance when the purpose is to simply monitor blood glucose but has large impact on prevalence estimates at the population level if CG values are not adequately calibrated.
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Papazafiropoulou A, Papanas N, Pappas S, Maltezos E, Mikhailidis DP. Effects of oral hypoglycemic agents on platelet function. J Diabetes Complications 2015; 29:846-51. [PMID: 26026848 DOI: 10.1016/j.jdiacomp.2015.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 04/09/2015] [Accepted: 04/10/2015] [Indexed: 12/15/2022]
Abstract
Platelet dysfunction plays a role in diabetic macrovascular complications. Several studies have assessed the effect of oral hypoglycemic agents (OHAs) on platelet function. Data from both in vivo and in vitro studies show a favorable effect for most of the traditional glucose-lowering therapies, while evidence is limited for the newer ones. Metformin, sulfonylureas, glitazones and acarbose exert a favorable effect on platelet function. Among incretin therapies, only sitagliptin has so far been demonstrated to have a beneficial effect on platelet aggregation. More in vivo and in vitro evidence is required to increase our knowledge on any potential beneficial effects of OHAs on platelet function. Any such effect may have implications for the reduction of cardiovascular risk in type 2 diabetes mellitus.
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Affiliation(s)
- Athanasia Papazafiropoulou
- Diabetes Centre, Third Department of Internal Medicine, General Hospital of Nikaia, Piraeus, Greece; Diabetes Centre, First Department of Internal Medicine, Tzaneio General Hospital of Piraeus, Piraeus, Greece.
| | - Nikolaos Papanas
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stavros Pappas
- Diabetes Centre, Third Department of Internal Medicine, General Hospital of Nikaia, Piraeus, Greece
| | - Efstratios Maltezos
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, London, UK
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Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Cañizo-Gómez FJD. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes 2014; 5:444-470. [PMID: 25126392 PMCID: PMC4127581 DOI: 10.4239/wjd.v5.i4.444] [Citation(s) in RCA: 485] [Impact Index Per Article: 48.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 03/11/2014] [Accepted: 06/20/2014] [Indexed: 02/05/2023] Open
Abstract
Diabetes mellitus is a chronic condition that occurs when the body cannot produce enough or effectively use of insulin. Compared with individuals without diabetes, patients with type 2 diabetes mellitus have a considerably higher risk of cardiovascular morbidity and mortality, and are disproportionately affected by cardiovascular disease. Most of this excess risk is it associated with an augmented prevalence of well-known risk factors such as hypertension, dyslipidaemia and obesity in these patients. However the improved cardiovascular disease in type 2 diabetes mellitus patients can not be attributed solely to the higher prevalence of traditional risk factors. Therefore other non-traditional risk factors may be important in people with type 2 diabetes mellitus. Cardiovascular disease is increased in type 2 diabetes mellitus subjects due to a complex combination of various traditional and non-traditional risk factors that have an important role to play in the beginning and the evolution of atherosclerosis over its long natural history from endothelial function to clinical events. Many of these risk factors could be common history for both diabetes mellitus and cardiovascular disease, reinforcing the postulate that both disorders come independently from “common soil”. The objective of this review is to highlight the weight of traditional and non-traditional risk factors for cardiovascular disease in the setting of type 2 diabetes mellitus and discuss their position in the pathogenesis of the excess cardiovascular disease mortality and morbidity in these patients.
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Stratmann B, Xu T, Meisinger C, Menart B, Roden M, Herder C, Grallert H, Peters A, Koenig W, Illig T, Wichmann HE, Wang-Sattler R, Rathmann W, Tschoepe D. PLA1A2 platelet polymorphism predicts mortality in prediabetic subjects of the population based KORA S4-Cohort. Cardiovasc Diabetol 2014; 13:90. [PMID: 24886443 PMCID: PMC4022397 DOI: 10.1186/1475-2840-13-90] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 04/28/2014] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The genetic polymorphism concerning the ß3-subunit of platelet integrin receptor glycoprotein IIIa is held responsible for enhanced binding of adhesive proteins resulting in increased thrombogenic potential. Whether it is associated with mortality, HbA1c or platelet volume is tested prospectively in an epidemiological cohort. RESEARCH DESIGN AND METHODS Population-based Cooperative Health Research in the Region of Augsburg (KORA) S4-Survey (N = 4,028) was investigated for prognostic value of PLA1A2-polymorphism regarding all-cause mortality, correlation with HbA1c, and mean platelet volume. Multivariate analysis was performed to investigate association between genotype and key variables. RESULTS Prevalence of thrombogenic allele variant PLA2 was 15.0%. Multivariate analysis revealed no association between PLA1A2 polymorphism and mortality in the KORA-cohort. HbA1c was a prognostic marker of mortality in non-diabetic persons resulting in J-shaped risk curve with dip at HbA1c = 5.5% (37 mmol/mol), confirming previous findings regarding aged KORA-S4 participants (55-75 years). PLA1A2 was significantly associated with elevated HbA1c levels in diabetic patients (N = 209) and reduced mean platelet volume in general population. In non-diabetic participants (N = 3,819), carriers of PLA2 allele variant presenting with HbA1c > 5.5% (37 mmol/mol) showed higher relative risk of mortality with increasing HbA1c. CONCLUSION PLA1A2 polymorphism is associated with mortality in participants with HbA1c ranging from 5.5% (37 mmol/mol) to 6.5% (48 mmol/mol). Maintenance of euglycemic control and antiplatelet therapy are therefore regarded as effective primary prevention in this group.
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Affiliation(s)
- Bernd Stratmann
- Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstr. 11, D-32545 Bad Oeynhausen, Germany
| | - Tao Xu
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Barbara Menart
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Harald Grallert
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Wolfgang Koenig
- Department Internal Medicine II, University Clinic Ulm, Ulm, Germany
| | - Thomas Illig
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
- Hannover Unified Biobank, Hannover Medical School, Hannover, Germany
| | - Heinz-Erich Wichmann
- Institute of Epidemiology I, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Rui Wang-Sattler
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum Muenchen, German Research Center of Environmental Health, Neuherberg, Germany
| | - Wolfgang Rathmann
- Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Duesseldorf, Germany
| | - Diethelm Tschoepe
- Heart and Diabetes Center NRW, Ruhr University Bochum, Georgstr. 11, D-32545 Bad Oeynhausen, Germany
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19
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Konieczynska M, Fil K, Bazanek M, Undas A. Prolonged duration of type 2 diabetes is associated with increased thrombin generation, prothrombotic fibrin clot phenotype and impaired fibrinolysis. Thromb Haemost 2013; 111:685-93. [PMID: 24306139 DOI: 10.1160/th13-07-0566] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 11/03/2013] [Indexed: 11/05/2022]
Abstract
It has been shown that type 2 diabetes (DM) is associated with enhanced thrombin generation and formation of denser fibrin clots of reduced lysability. We sought to investigate the impact of diabetes duration versus glycaemia control on fibrin clot phenotype and its determinants in type 2 diabetic patients. In 156 consecutive Caucasian patients with type 2 diabetes we investigated ex vivo thrombin generation, fibrinolytic proteins, along with plasma fibrin clot permeation (Ks), compaction, turbidity, and efficiency of tissue plasminogen activator (t-PA)-mediated fibrinolysis. Patients with longer diabetes duration (>5 years, median; n=68) had higher peak thrombin generation (+16.3%, p<0.001), plasminogen activator inhibitor-1 (PAI-1) antigen (+14.8%, p=0.001), t-PA antigen (+13.9%, p=0.002) compared with those with duration ≤5 years (n=88). No such differences were observed between patients with inadequate glycaemic control, defined as glycated haemoglobin (HbA1C) >6.5% (48 mmol/mol) (n=77), versus those with HbA1C≤6.5% (n=79). Fibrinogen, thrombin-activatable fibrinolysis inhibitor antigen, plasminogen and soluble thrombomodulin were unaffected by disease duration or glycaemia control. Lower clot permeability, longer clot lysis, and higher maximum D-dimer levels released from clots (all p<0.05 after adjustment for fibrinogen, age, body mass index, insulin, acetylsalicylic acid treatment, and HbA1c or diabetes duration) were also observed in patients with diabetes duration >5 years and those with HbA1C>6.5%. We conclude that prolonged duration of type 2 diabetes is associated with increased thrombin formation, hypofibrinolysis, and prothrombotic fibrin clot phenotype. The impact of disease duration on coagulation is different and stronger than that observed during inadequate glycaemia control.
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Affiliation(s)
| | | | | | - Anetta Undas
- Anetta Undas, MD, PhD, Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka St., 31-202 Krakow, Poland, Tel.: +48 126143004, Fax: +48 124233900, E-mail:
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20
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Diabetes Mellitus. Platelets 2013. [DOI: 10.1016/b978-0-12-387837-3.00035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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21
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Babu PVA, Si H, Fu Z, Zhen W, Liu D. Genistein prevents hyperglycemia-induced monocyte adhesion to human aortic endothelial cells through preservation of the cAMP signaling pathway and ameliorates vascular inflammation in obese diabetic mice. J Nutr 2012; 142:724-30. [PMID: 22399524 PMCID: PMC3301991 DOI: 10.3945/jn.111.152322] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Hyperglycemia-induced vascular inflammation resulting in the enhanced monocyte-endothelial cell (EC) interaction is the key event in the pathogenesis of atherosclerosis in diabetes. Here, we investigated the effect of isoflavone genistein on hyperglycemia-stimulated vascular inflammation. Human aortic EC (HAEC) were pretreated with genistein before the addition of high glucose (HG; 25 mmol/L) for 48 h. Genistein at a physiological concentration (0.1 μmol/L) significantly inhibited HG-induced adhesion of monocytes to HAEC and suppressed endothelial production of monocyte chemotactic protein-1 (MCP-1) and IL-8. Inhibition of adenylate cyclase or protein kinase A (PKA) significantly attenuated the antiadhesion effect of genistein. Consistently, genistein improved HG-impaired intracellular cAMP production and PKA activity in HAEC. Six-week-old diabetic db/db mice were untreated (db/db) or treated with a diet containing 1 g genistein/kg diet (db/db+G) for 8 wk. Their nondiabetic db/+ mice were used as normal controls. Circulating concentrations of MCP-1/JE and KC were significantly greater, whereas IL-10 concentrations were lower in db/db mice than those in normal mice. Dietary supplementation of genistein did not normalize but significantly suppressed the elevated serum concentrations of MCP-1/JE from 286 ± 30 ng/L to 181 ± 35 ng/L and KC from 321 ± 21 ng/L to 232 ± 20 ng/L while increasing that of IL-10 from 35 ± 4 ng/L to 346 ± 35 ng/L in db/db+G mice. Further, genistein treatment suppressed diabetes-induced adhesion of monocytes to EC by 87% and endothelial secretion of adhesion molecules. We conclude that genistein improves diabetes-caused vascular inflammation, which may be mediated through promoting the cAMP/PKA pathway.
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Affiliation(s)
| | | | | | | | - Dongmin Liu
- To whom correspondence should be addressed. E-mail:
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22
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Davì G, Vazzana N, Sestili S. Variability in the response to antiplatelet treatment in diabetes mellitus. Prostaglandins Other Lipid Mediat 2012; 98:48-55. [PMID: 22330860 DOI: 10.1016/j.prostaglandins.2012.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2011] [Revised: 12/22/2011] [Accepted: 01/27/2012] [Indexed: 10/14/2022]
Abstract
Atherothrombosis is a leading cause of death in patients with diabetes mellitus. Among factors contributing to the diabetic prothrombotic state, platelet activation plays a pivotal role. Numerous studies have investigated the benefits of antiplatelet therapy for primary and secondary cardiovascular prevention in diabetic patients. However, there are limited evidences that low-dose aspirin may be effective in this clinical setting. Several disease-specific factors have been identified as potential determinants of aspirin treatment failure. In this review, the main determinants of interindividual variability in response to antiplatelet agents are discussed, with particular emphasis on the pharmacokinetic and pharmacodynamic mechanisms of clinical efficacy and safety of antiplatelet drugs in patients with diabetes mellitus.
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Affiliation(s)
- Giovanni Davì
- Internal Medicine and Center of Excellence on Aging, "G. D'Annunzio" University of Chieti, Italy.
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23
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Qualitative scanning electron microscopy analysis of fibrin networks and platelet abnormalities in diabetes. Blood Coagul Fibrinolysis 2011; 22:463-7. [PMID: 21467917 DOI: 10.1097/mbc.0b013e3283468a0d] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Diabetes is a condition defined by hyperglycaemia and these patients have a high risk of thrombosis. Previous research showed that ultrastructural changes in clot formation occur in patients in whom there are changes in the coagulation system due to, for example, an inflammatory condition. In the current study, the ultrastructures of platelets and fibrin networks were investigated in 25 diabetic patients. Plasma smears, with and without the addition of thrombin, were prepared. Results indicated that the fibrin network in all diabetic patients had thickened masses of thin, minor fibres over the major fibres, a profile typical of an inflammatory condition. A changed platelet membrane ultrastructure could also be observed in the diabetic patients that revealed typical apoptotic morphology, in whom membrane blebbing could be seen. It can, therefore, be concluded that in diabetic patients, the ultrastructure of fibrin networks show a typical systemic inflammatory profile, although platelets seem to be apoptotic.
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24
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Hess K, Grant PJ. Inflammation and thrombosis in diabetes. Thromb Haemost 2011; 105 Suppl 1:S43-54. [PMID: 21479339 DOI: 10.1160/ths10-11-0739] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Accepted: 02/14/2011] [Indexed: 02/06/2023]
Abstract
Patients with diabetes mellitus are at increased risk of cardiovascular morbidity and mortality. Atherothrombosis, defined as atherosclerotic lesion disruption with superimposed thrombus formation, is the most common cause of death among these patients. Following plaque rupture, adherence of platelets is followed by local activation of coagulation, the formation of a cross-linked fibrin clot and the development of an occlusive platelet rich fibrin mesh. Patients with diabetes exhibit a thrombotic risk clustering which is composed of hyper-reactive platelets, up regulation of pro-thrombotic markers and suppression of fibrinolysis. These changes are mainly mediated by the presence of insulin resistance and dysglycaemia and an increased inflammatory state which directly affects platelet function, coagulation factors and clot structure. This prothrombotic state is related to increased cardiovascular risk and may account for the reduced response to antithrombotic therapeutic approaches, underpinning the need for adequate antithrombotic therapy in patients with diabetes to reduce their cardiovascular mortality.
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Affiliation(s)
- Katharina Hess
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics, Health and Therapeutics, LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds, UK
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25
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Kanazawa I, Yano S, Notsu Y, Yamaguchi T, Nabika T, Sugimoto T. Asymmetric dimethylarginine as a risk factor for cardiovascular disease in Japanese patients with type 2 diabetes mellitus. Clin Endocrinol (Oxf) 2011; 74:467-72. [PMID: 21128993 DOI: 10.1111/j.1365-2265.2010.03946.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIMS Although asymmetric dimethylarginine (ADMA) is known to be involved in the developing process of cardiovascular diseases (CVD), little is known about the effects of ADMA on atherosclerosis in Asian patients with diabetes, who have the racial feature of lower body mass index (BMI) and decreased capacity of insulin secretion and sensitivity. METHODS We employed 55 Japanese patients with type 2 diabetes mellitus (mean age, 64·2 years; 56% men) in a 6-month-longitudinal study and 450 patients (mean age, 62·7 years; 56% men) in a cross-sectional study and examined the association of serum ADMA with atherosclerosis parameters [intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV)] as well as with the presence of CVD. RESULTS In the longitudinal study, multiple regression analysis showed that basal serum ADMA level had a significantly positive association with changes in IMT (β=0·35, P=0·03) independently of age, duration of diabetes, BMI, blood pressure, low-density lipoprotein and high-density lipoprotein (LDL and HDL) cholesterol, HbA(1c) , and renal function. In the cross-sectional study, the serum ADMA level was significantly and positively associated with the presence of CVD (odds ratio=7·22, 95% confidence interval 1·29-40·40, P=0·02, by logistic analysis) and with baPWV (β=0·14, P <0·01, by multiple regression analysis). In contrast, serum symmetric dimethylarginine level, a structural isomer of ADMA, was associated neither with parameters for atherosclerosis nor with the presence of CVD in both studies. CONCLUSIONS Serum ADMA is a predictor of atherosclerosis and associated with the presence of CVD in Japanese patients with type 2 diabetes mellitus.
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Affiliation(s)
- Ippei Kanazawa
- Department of Internal Medicine 1, The Center for Community-based Health Research and Education (COHRE), Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Japan.
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26
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Honma A, Koyama T, Yazawa K. Anti-hyperglycemic effects of sugar maple Acer saccharum and its constituent acertannin. Food Chem 2010. [DOI: 10.1016/j.foodchem.2010.04.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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27
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Abstract
Atherothrombotic complications are the main cause of mortality in subjects with diabetes. Premature atherosclerosis, increased platelet reactivity and activation of coagulation factors with associated hypofibrinolysis all contribute to increased cardiovascular risk in this population. Blood clot formation represents the last step in the atherothrombotic process, and the structure of the fibrin network has a role in determining predisposition to cardiovascular disease. In this review, we discuss alterations in coagulation factor plasma levels and/or activity in diabetes and clarify their role in predisposition to cardiovascular events. The effect of diabetes on fibrin network structure/fibrinolysis is reviewed and potential mechanisms that modify clot properties are discussed. Finally, modulation of clotting potential by the various therapeutic agents used in diabetes is examined. Understanding the mechanisms by which diabetes influences the coagulation pathway will help to develop more effective treatment strategies to reduce thrombotic events in subjects with this condition.
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Affiliation(s)
- S H Alzahrani
- Division of Cardiovascular and Diabetes Research, Leeds Institute of Genetics Health and Therapeutics, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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28
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Honma A, Koyama T, Yazawa K. Anti-hyperglycaemic effects of the Japanese red maple Acer pycnanthum and its constituents the ginnalins B and C. J Enzyme Inhib Med Chem 2010; 26:176-80. [DOI: 10.3109/14756366.2010.486795] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Atsushi Honma
- Laboratory of Nutraceuticals and Functional Foods Science, Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7 Konan, Minato-ku, Tokyo 108-8477, Japan
| | - Tomoyuki Koyama
- Laboratory of Nutraceuticals and Functional Foods Science, Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7 Konan, Minato-ku, Tokyo 108-8477, Japan
| | - Kazunaga Yazawa
- Laboratory of Nutraceuticals and Functional Foods Science, Graduate School of Marine Science and Technology, Tokyo University of Marine Science and Technology, 4-5-7 Konan, Minato-ku, Tokyo 108-8477, Japan
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