THROMBOSIS RESEARCH Printed in the United States
vol.
9,
pp.
467-471,
1976
Pergamon Press, Inc.
IN VIVO PLATELET FUNCTION IN DIABETES MELLITUS" Alan
I.
Fleischman, Marvin L. Bierenbaum, Arleane Stier, Sister Helen Somol and Portia B. Watson Division of Community Health Services, New Jersey State Department of Health, Montclair, N.J.+‘: and the Atherosclerosis Research Group, St. Vincent’s Hospital, Montclair, N.J.
(Received 26.4.1976; in revised form 10.9.1976. Accepted by Editor K.M. Brinkhous)
ABSTRACT In vivo platelet aggregation time is significantly shorter in diabetics compared to age and sex matched controls. A significantly greater number of the diabetic subjects failed to In a geriatric diabetic population, increasing disaggregate. absorbed dietary linoleate lengthened aggregation time so that the aggregation time was not significantly different from the Similarly, increased absorbed dietary control population. linoleate significantly improved platelet disaggregation in diabetic subjects. INTRODUCTION In view of the tendency toward vascular disease in diabetes mellitus, many workers have examined various aspects of platelet function in the diabetic. Sage1 et al. (1) reported that both latent and frank diabetics exhibited increased platelet aggregation in reponse to ADP, epinephrine and collagen. Similar results were reported by Kwaan et al. (2) and O’,Malley et al. (3). Kwaan (2) further suggested that increased platelet aggregation in the diabetics was a factor in diabetic retinopathy and nephropathy. This was corroborated by O’Malley et al. (3). In previous studies, platelet aggregation was examined --in vitro in the In this study, platelet function absence of other formed elements of the blood. in a flowing stream in the presence of all formed elements of the blood will In addition, the effect of diet on be, compared in diabetics and controls. platelet function in diabetics will be evaluated. METHODS The patient population for the comparison mean age 60.5_+3.2 years, 14 female diabetics, 4 This work was supported G+:The opinions expressed necessarily the official
study consisted of six male and and 6 male and 14 female controls
by a grant from the Charles Edison Fund. in this paper are those of the authors and are not position of the New Jersey State Department of Health
467
Vol.9,No.5
PLATEZETS IN DIABETES MELLITUS
468
All subjects had adult onset diabetes which was well mean age 58.7~3.7years. to moderately well controlled by diet, insulin or sulfonylureas. There was no clinical evidence of nephropathy or cardiovascular disease. Pl ate1 et function was examined by the filtration procedure of Hornstra et al. (4,5). Failure to disaggregate was defined as no reversal of the pressure differential in 600 seconds. The effect of diet on platelet aggregation in diabetics was studied on a second cohort, 18 female and 2 male subjects. All were residents of a geriatric center. The mean age of these subjects was 78.8k2.0years. In this study each patient acted as his own control. Subjects were placed on a diet low in linoleic acid for two weeks and platelet function studied. This was followed by a two-week period on a linoleic acid enriched diet after which platelet function was restudied. Serum cholesterol and triglycerides were run by previously described linoleate was calculated (6). Absorbed dietary autoanalyzer methodology from the results of the fatty acid analysis of the serum triglyceride fraction
(7,8) Statistical analysis of the comparisons between diabetics and controls was done by the student “t” test. In the diet study, statistical analysis was done by the paired student “t” tests (9). The significance of the changes for platelet disaggregation were evaluated by the chi square test. TABLE 1 COMPARISON OF PLATELET FUNCTION AND SERUM LIPIDS DIABETIC
AND CONTROL SUBJECTS
Diabetics Aggregation Time % Disaggregating Serum Chol ester01 Serum Triqlycerides 1. ::
(set)
(mg/dl
,
)
(mq/dl)
Mean ,+ standard error Statistical analysis Statisticial analysis
IN
217.a40.9 20 235.2215.2 233.7+29.3
of the mean employed student “t” employed chi square
Controls 322.1Gg.71 223.gf8.o 153.5i16.7
P 0.05; 0.01 0.025~
test test
RESULTS The mean aggregation time in the diabetic subjects was 104.9 seconds faster than the aggregation time in the matched controls, ~(0.05. Table 1. The platelets of sixteen diabetics failed to disaggregate in 600 seconds, while the platelets of only three of the controls failed, p
vol.
9,
pp.
467-471,
1976
Pergamon Press, Inc.
IN VIVO PLATELET FUNCTION IN DIABETES MELLITUS" Alan
I.
Fleischman, Marvin L. Bierenbaum, Arleane Stier, Sister Helen Somol and Portia B. Watson Division of Community Health Services, New Jersey State Department of Health, Montclair, N.J.+‘: and the Atherosclerosis Research Group, St. Vincent’s Hospital, Montclair, N.J.
(Received 26.4.1976; in revised form 10.9.1976. Accepted by Editor K.M. Brinkhous)
ABSTRACT In vivo platelet aggregation time is significantly shorter in diabetics compared to age and sex matched controls. A significantly greater number of the diabetic subjects failed to In a geriatric diabetic population, increasing disaggregate. absorbed dietary linoleate lengthened aggregation time so that the aggregation time was not significantly different from the Similarly, increased absorbed dietary control population. linoleate significantly improved platelet disaggregation in diabetic subjects. INTRODUCTION In view of the tendency toward vascular disease in diabetes mellitus, many workers have examined various aspects of platelet function in the diabetic. Sage1 et al. (1) reported that both latent and frank diabetics exhibited increased platelet aggregation in reponse to ADP, epinephrine and collagen. Similar results were reported by Kwaan et al. (2) and O’,Malley et al. (3). Kwaan (2) further suggested that increased platelet aggregation in the diabetics was a factor in diabetic retinopathy and nephropathy. This was corroborated by O’Malley et al. (3). In previous studies, platelet aggregation was examined --in vitro in the In this study, platelet function absence of other formed elements of the blood. in a flowing stream in the presence of all formed elements of the blood will In addition, the effect of diet on be, compared in diabetics and controls. platelet function in diabetics will be evaluated. METHODS The patient population for the comparison mean age 60.5_+3.2 years, 14 female diabetics, 4 This work was supported G+:The opinions expressed necessarily the official
study consisted of six male and and 6 male and 14 female controls
by a grant from the Charles Edison Fund. in this paper are those of the authors and are not position of the New Jersey State Department of Health
467
Vol.9,No.5
PLATEZETS IN DIABETES MELLITUS
468
All subjects had adult onset diabetes which was well mean age 58.7~3.7years. to moderately well controlled by diet, insulin or sulfonylureas. There was no clinical evidence of nephropathy or cardiovascular disease. Pl ate1 et function was examined by the filtration procedure of Hornstra et al. (4,5). Failure to disaggregate was defined as no reversal of the pressure differential in 600 seconds. The effect of diet on platelet aggregation in diabetics was studied on a second cohort, 18 female and 2 male subjects. All were residents of a geriatric center. The mean age of these subjects was 78.8k2.0years. In this study each patient acted as his own control. Subjects were placed on a diet low in linoleic acid for two weeks and platelet function studied. This was followed by a two-week period on a linoleic acid enriched diet after which platelet function was restudied. Serum cholesterol and triglycerides were run by previously described linoleate was calculated (6). Absorbed dietary autoanalyzer methodology from the results of the fatty acid analysis of the serum triglyceride fraction
(7,8) Statistical analysis of the comparisons between diabetics and controls was done by the student “t” test. In the diet study, statistical analysis was done by the paired student “t” tests (9). The significance of the changes for platelet disaggregation were evaluated by the chi square test. TABLE 1 COMPARISON OF PLATELET FUNCTION AND SERUM LIPIDS DIABETIC
AND CONTROL SUBJECTS
Diabetics Aggregation Time % Disaggregating Serum Chol ester01 Serum Triqlycerides 1. ::
(set)
(mg/dl
,
)
(mq/dl)
Mean ,+ standard error Statistical analysis Statisticial analysis
IN
217.a40.9 20 235.2215.2 233.7+29.3
of the mean employed student “t” employed chi square
Controls 322.1Gg.71 223.gf8.o 153.5i16.7
P 0.05; 0.01 0.025~
test test
RESULTS The mean aggregation time in the diabetic subjects was 104.9 seconds faster than the aggregation time in the matched controls, ~(0.05. Table 1. The platelets of sixteen diabetics failed to disaggregate in 600 seconds, while the platelets of only three of the controls failed, p
