In vivo thromboxane-dependent platelet activation is persistently enhanced in subjects with impaired glucose tolerance

糖耐量受损患者体内血栓素依赖性血小板活化持续增强

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作者:Francesca Santilli, Francesco Zaccardi, Rossella Liani, Giovanna Petrucci, Paola Simeone, Dario Pitocco, Romina Tripaldi, Alessandro Rizzi, Gloria Formoso, Alfredo Pontecorvi, Ermanno Angelucci, Francesca Pagliaccia, Maria Golato, Francesca De Leva, Ester Vitacolonna, Bianca Rocca, Agostino Consoli,

Background

Impaired glucose tolerance (IGT) is associated with increased cardiovascular morbidity and mortality. Enhanced thromboxane (TX)-dependent platelet activation plays a pivotal role in atherothrombosis and characterizes type 2 diabetes mellitus (DM). Whether this also pertains to IGT is currently unknown. We investigated whether TXA2 -dependent platelet activation, as reflected by 11-dehydro-TXB2 (TXM) urinary excretion, is comparably abnormal in IGT as in DM, is persistent over long-term follow-up, changes as a function of metabolic disease progression, and is influenced by food intake.

Conclusions

We conclude that TXA2 -dependent platelet activation was at least as high in IGT as in patients with DM and further increased over time, especially in those who progressed to overt diabetes.

Methods

We prospectively investigated subjects with IGT (n = 48) and two control groups with DM diagnosed either less than 12 months (n = 60) or 12 months or more (n = 58).

Results

Baseline TXM excretion was comparable between subjects with IGT and DM, with no evidence of a circadian variation. During a 36-month follow-up, urinary TXM excretion was stable over time in the DM groups, while tended to increase in subjects with IGT. Increasing urinary TXM excretion over time was observed in the subjects who progressed to diabetes vs nonprogressors. Conclusions: We conclude that TXA2 -dependent platelet activation was at least as high in IGT as in patients with DM and further increased over time, especially in those who progressed to overt diabetes.

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