Elevated levels of remnant lipoproteins are associated with plasma platelet microparticles in patients with type-2 diabetes mellitus without obstructive coronary artery disease
Elevated levels of remnant lipoproteins are associated with plasma platelet microparticles in patients with type-2 diabetes mellitus without obstructive coronary artery disease
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DOI：
10.1093/eurheartj/ehi746
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发表时间：
2006-04-01
影响因子：
39.3
通讯作者：
Ogawa, H
中科院分区：
文献类型：
--
作者：
Koga, H;Sugiyama, S;Ogawa, H
血小板活化参与了动脉血栓形成的发病过程，糖尿病患者血小板活化增强。血脂异常是糖尿病的常见特征。我们研究了2型糖尿病患者某些脂质组分与血浆血小板衍生微粒（PMP）水平之间的关系。方法和结果（RLP-胆固醇），并通过定量血浆中PMP的数量来评估体内血小板活化，PMP的数量通过流式细胞术在日本型-2无阻塞性冠状动脉疾病的糖尿病患者与西方糖尿病患者相比更苗条。2型糖尿病患者（n=105）的总胆固醇、甘油三酯、RLP-胆固醇和血糖水平显著高于非糖尿病患者（n=92）。2型糖尿病患者血浆PMP水平显著高于非糖尿病对照组[7.41（5.39-10.50）x10（6）vs.3.44（2.43-4.41）x10（6），P < 0.001]。在多元线性回归分析中，我们发现RLP-胆固醇水平是PMP的最佳预测因子（β =0.375，P < 0.001）。结论2型糖尿病患者的RLP-胆固醇和血小板微粒均较正常对照组升高（P < 0.05）。在多变量分析中，RLP-胆固醇是血小板微粒的主要和唯一预测因子，其中包括几个标准的动脉粥样硬化危险因素。这表明，降低高RLP-胆固醇与降脂治疗可能是一种有效的策略，以防止血栓形成血管并发症的2型糖尿病。
Aims Platelets participate in the pathogenesis of arterial thrombosis and it has been demonstrated that enhanced platelet activation occurs in patients with diabetes mellitus (DM). Dyslipidaemia is a common feature of diabetes. We investigated the association between certain lipid fractions and plasma platelet-derived microparticle (PMP) levels in patients with type-2 DM.Methods and results We measured fasting serum levels of remnant-like lipoprotein particles-cholesterol (RLP-cholesterol) and assessed in vivo platelet activation by quantifying the number of PMP in the plasma detected as CD42b-positive microparticles by flow cytometry in Japanese type-2 DM patients without obstructive coronary artery disease who were more slender when compared with Western diabetic patients. The levels of total cholesterol, triglycerides, RLP-cholesterol, and plasma glucose were significantly higher in patients with type-2 DM (n=105) than in non-diabetic patients (n=92). The plasma levels of PMP were elevated significantly in type-2 DM patients when compared with non-diabetic control subjects [7.41(5.39-10.50)x10(6) vs. 3.44(2.43-4.41)x10(6), P < 0.001]. We found that RLP-cholesterol levels were the best predictor of PMP in multivariable linear regression analyses (beta=0.375, P < 0.001). Lipid-lowering medication with bezafibrate successfully reduced levels of both RLP-cholesterol and PMP in patients with type-2 DM (P < 0.05).Conclusions RLP-cholesterol and platelet microparticles are both elevated in type-2 DM patients when compared with controls. RLP-cholesterol is the primary and only predictor of platelet microparticles in the multivariable analysis, which include several standard atherosclerosis risk factors. This suggested that reducing elevated RLP-cholesterol with lipid-lowering therapy may be an effective strategy to prevent thrombogenic vascular complications in type-2 DM.