Coated-platelet levels in patients with Type 1 and with Type 2 diabetes mellitus

doi:10.1016/j.diabres.2008.04.004

Diabetes Research and Clinical Practice

Volume 81, Issue 2, August 2008, Pages e8-e10

https://doi.org/10.1016/j.diabres.2008.04.004 Get rights and content

Abstract

Coated-platelet levels were quantified in 58 people with Type 1 diabetes, 90 with Type 2 diabetes, and 54 non-diabetic controls. In diabetes high coated-platelet levels were related to smoking and glucose control drugs, but not to glycaemia or other drugs. Prospective studies should evaluate coated-platelets and complications and drug effects.

Section snippets

Methods

The study, which meets Declaration of Helsinki principles, was approved by local Ethics Committees, and each participant gave written informed consent. Microvascular complications were laser-treated retinopathy or increased albuminuria. Macrovascular disease was defined as clinically evident cardiovascular, cerebrovascular, or peripheral vascular disease. Venous blood was collected from 58 Type 1 and 90 Type 2 diabetic and 54 non-diabetic subjects. HbA1c, lipids, and renal function tests were

Clinical characteristics and coated-platelet levels

Age, diabetes duration and HbA1c of diabetic subjects were 52(12) years (mean (S.D.)), 14(12) years, and 8.2(1.8)%, respectively. Eighty percent of the Type 2 group were on oral agents, and 48% were on insulin. Of the diabetes group, 33% had microvascular complications and 45% had macrovascular disease. Twenty-five percent of the diabetic subjects and 9.3% of the controls were smokers. The control group was younger, 39(10) years, with lower HbA1c; 5.1 (0.4)%. Forty-five percent of diabetic and

Discussion

As coated-platelets may be pro-thrombotic and related to inflammation, we hypothesized that levels would be increased in diabetes or its complications and relate to vascular risk factors. In this, we believe the first study in diabetes, we demonstrated lack of significant difference in coated-platelet levels in Type 1 or Type 2 diabetic patients (not on dialysis) and healthy controls, nor were there differences in coated-platelets by age, gender, BMI, lipids, CRP, diabetes duration or

Conflict of interest statement

The authors declare that they have no conflict of interest.

Acknowledgements

Authors acknowledge study participants and the OU General Clinical Research Center staff. American Heart Association Grant-in-Aid (GLD).

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Cited by (15)

Acute hemorrhagic complications are associated with lower coated-platelet levels in non-lacunar brain infarction
2015, Journal of Thrombosis and Haemostasis
Coated platelets are procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin. Coated‐platelet levels are elevated in patients with non‐lacunar ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage as compared with controls.
To investigate whether acute hemorrhagic complications occurring during the initial hospital admission for non‐lacunar ischemic stroke are associated with lower coated‐platelet levels.
Coated‐platelet levels were determined in 385 consecutive patients with non‐lacunar stroke. Hemorrhagic complications were defined as either intracranial hemorrhage or significant extracranial bleeding (drop in hemoglobin of ≥ 2 g dL⁻¹). The rate of acute hemorrhagic complication was compared among subjects categorized into tertiles of coated‐platelet levels using an exact Cochrane‐Armitage trend test. Logistic regression was used to estimate the adjusted odds of hemorrhagic complication associated with coated‐platelet levels.
Hemorrhagic complications were present in 15 (3.9%) cases. Of these, four had intracranial hemorrhage and 11 had extracranial hemorrhage. The occurrence of hemorrhagic complications differed among the coated‐platelet tertiles: 10.2% for the first tertile (coated‐platelet levels < 35.5%), 1.5% for the second tertile and 0% for the third tertile (coated‐platelet levels ≥ 47.5%, trend test). Logistic regression showed that the odds of hemorrhagic complication in those with levels < 35.5% were 14.59 times the odds for patients with levels ≥ 35.5% (95% CI: 3.24–65.7).
Lower levels of procoagulant platelets are associated with acute hemorrhagic complications following non‐lacunar ischemic stroke. These results suggest a role for coated‐platelets in risk/benefit assessment in the early stages of stroke.
Cerebral microbleeds in nonlacunar brain infarction are associated with lower coated-platelet levels
2014, Journal of Stroke and Cerebrovascular Diseases
Citation Excerpt :
However, none of these differences were statistically significant (Table 1). To investigate the potential modifying and confounding effects of the recorded subject characteristics and clinical measures, differences in coated-platelet levels between subjects with and without CMBs were calculated after stratifying by smoking status, gender, race/ethnicity, age, use of medications that may influence coated-platelet levels (selective serotonin reuptake inhibitors, statins, or antiplatelets),19 history of diabetes,21 end-stage renal disease,22 or hypertension.23 With the exception of patients that reported taking statins, subjects with CMBs tended to have lower coated–platelet levels compared with those without CMBs regardless of the subgroup under consideration.
Coated-platelets are a subset of platelets with high procoagulant potential observed on dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with nonlacunar ischemic stroke compared with controls, although the presence of early hemorrhagic transformation is associated with lower coated–platelet levels. In contrast to infarction, patients with spontaneous intracerebral hemorrhage have lower coated–platelet levels, and these levels inversely correlate with bleed size. Cerebral microbleeds (CMBs) represent previous small hemorrhagic occurrences. We undertook a pilot study to investigate coated-platelet production and the presence of CMBs in patients with nonlacunar ischemic stroke.
Coated-platelet levels were determined in 110 consecutive patients with a diagnosis of nonlacunar stroke. Microbleeds were identified using the published criteria by an experienced stroke neurologist. Coated-platelet levels were compared statistically between patients with and without CMBs using the nonparametric Wilcoxon rank sum test.
Coated-platelet levels (median [interquartile range]) for all patients were 44.1% [34%-51.2%]. CMBs were detected in 22 patients (20%); these patients had significantly lower coated–platelet levels compared with those without CMBs (35.6% [22.6%-47.2%] versus 45.1% [36.1%-51.5%]; P = .025), whereas other demographic and clinical factors did not differ significantly.
The presence of CMBs in patients with nonlacunar ischemic stroke is associated with lower levels of coated-platelets. Larger prospective studies are needed to better establish the potential connection between altered coated–platelet synthesis, microbleeds, cerebral infarction, and possible hemorrhage-prone vascular changes.
Higher levels of coated-platelets are observed in patients with subarachnoid hemorrhage but lower levels are associated with increased mortality at 30 days
2013, Journal of the Neurological Sciences
Citation Excerpt :
All data analyses for this paper were generated using SAS software, Version 9.2 of the SAS System for Windows (SAS Institute Inc., Cary, NC, USA). Table 1 lists demographics, current smoking, co-morbidities pertinent to coated-platelet levels (hypertension and diabetes) [17,18], use of medications that may alter coated-platelet levels, such as selective serotonin reuptake inhibitors (SSRIs), HMG-CoA reductase inhibitors (statins) or antiplatelet agents [1,26,27], and coated-platelet levels for patients and controls. Of note, although we planned to include patients with ≤ 96 h between the onset of the symptoms and enrollment, all blood samples were actually obtained within 48 h of onset.
Coated-platelets are procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in non-lacunar ischemic stroke compared to either lacunar stroke or controls. In contrast, coated-platelet levels are decreased in spontaneous intracerebral hemorrhage (ICH) and inversely correlated with bleed size. We now report the first investigation of coated-platelets in patients with subarachnoid hemorrhage (SAH).
Coated-platelet levels were determined in 40 consecutive patients with spontaneous SAH and in 40 controls. Results are reported as percent of cells converted to coated-platelets. Mortality at one month was recorded for all patients.
Coated-platelet levels (mean ± SD) were significantly higher in SAH patients compared to controls (41.8 ± 11.4% vs. 30.7 ± 12.2%, p < 0.0001). Among all patients, mortality at 1 month was 20% (8 deaths). Patients were analyzed according to tertiles of coated-platelet levels (split at < 36.7%, 36.7–46.2%, > 46.2%). The 1-month mortality differed significantly between the coated-platelet tertiles (p = 0.01) with 46% mortality (6/13) among patients in the lowest tertile (lowest levels) compared to 14.3% (2/14) among those in the middle tertile and 0% in the highest tertile.
Coated-platelet levels are higher in SAH patients compared to controls. However, lower coated-platelet levels are associated with increased 1-month mortality in SAH patients, a finding compatible with prior observations of an inverse relationship between coated-platelet levels and bleed volume in ICH. The current data support the role played by these prothrombotic platelets in thrombosis or hemorrhage and suggest a potential place for coated-platelet levels in predicting prognosis after SAH.
Lower coated-platelet levels are associated with early hemorrhagic transformation in patients with non-lacunar brain infarction
2010, Journal of Thrombosis and Haemostasis
Background: Coated‐platelets, representing a subset of platelets with procoagulant potential, are elevated in patients with non‐lacunar ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage. However, within the non‐lacunar patient population there are individuals with lower levels of coated‐platelets, which raises the possibility that these individuals would be susceptible to early hemorrhagic transformation (HT) of ischemic stroke. Objective: Because extremes in coated‐platelet potential may be associated with either thrombotic or hemorrhagic events, we undertook a pilot study to investigate whether there is an association between coated‐platelet production and the presence of early HT in patients with non‐lacunar ischemic stroke. Patients and methods: Coated‐platelet levels were determined in 115 consecutive eligible patients with a diagnosis of non‐lacunar ischemic stroke. Early HT was determined on CT scan examination and confirmed by MRI studies. The distribution of coated‐platelet levels was summarized using the median and interquartile range (25th–75th percentiles) and compared statistically between patients with and without early HT using the non‐parametric Wilcoxon rank sum test. Results: The median coated‐platelet level in all non‐lacunar stroke patients was 38.0% (interquartile range 30.5–48.3%). Early HT was detected in 11 patients (9.6%), and these patients had significantly lower coated‐platelet levels compared with those without early HT [median 25.1% (interquartile range 20.4–35.5%) vs. 39.2% (31.6–49.5%), P = 0.003]. Conclusions: Lower levels of coated‐platelets are associated with the presence of early HT in patients with non‐lacunar ischemic stroke.
In Vitro Exposure to Glucose Alters the Expression of Phosphorylated Proteins in Platelets
2023, Biomedicines
Levels of procoagulant microparticles expressing phosphatidylserine contribute to bleeding phenotype in patients with inherited thrombocytopenia
2021, Blood Coagulation and Fibrinolysis

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¹: These authors contributed equally.

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Brief reportCoated-platelet levels in patients with Type 1 and with Type 2 diabetes mellitus

Abstract

Section snippets

Methods

Clinical characteristics and coated-platelet levels

Discussion

Conflict of interest statement

Acknowledgements

J. Thromb. Haemost.

J. Thromb. Haemost.

J. Thromb. Haemost.

Pathobiology and cell interactions of platelets in diabetes

Diab. Vasc. Dis. Res.

COAT platelets

Curr. Opin. Hematol.

Brief report
Coated-platelet levels in patients with Type 1 and with Type 2 diabetes mellitus