Meal intake increases circulating procoagulant microparticles in patients with type 1 and type 2 diabetes mellitus. (3rd April 2019)

• Record Type: Journal Article
• Authors: Spectre, Galia; Mobarrez, Fariborz; Stålesen, Ragnhild; Östenson, Claes-Göran; Varon, David; Wallen, Håkan; Hjemdahl, Paul
• Is Part Of: Platelets. Volume 30:Number 3(2019)
• Page Start: 348
• Page End: 355
• Publication Date: 2019-04-03
• Subjects: Diabetes mellitus -- microparticles -- postprandial -- thrombin generation; Blood platelets -- Periodicals; Blood Platelets -- Periodicals; 615.39
• DOI: 10.1080/09537104.2018.1445837
• Languages: English
• ISSNs: 0953-7104

Abstract

Abstract: Diabetes mellitus (DM) is associated with prothrombotic alterations, and postprandial hyperglycemia is an independent risk factor for cardiovascular complications. We therefore investigated whether a standardized mixed meal alters circulating microparticles (MPs) and their procoagulant activity in DM patients. Patients with DM type 1 (T1DM, n = 11) and type 2 (T2DM; n = 9) were studied before and 90 min after a standardized meal (without premeal insulin). MPs in plasma derived from platelets (PMPs), endothelial cells (EMPs), or monocytes (MMPs) were measured by flow cytometry. MP-induced thrombin generation in plasma was assessed by a calibrated automated thrombogram. In the fasting state, MPs did not differ significantly between T1DM and T2DM. Meal intake increased the following microparticles: PMPs expressing phosphatidylserine (by 55%, on average), P-selectin (by 86%), and tissue factor (TF; by 112%); EMPs expressing E-selectin (by 96%) and MMPs expressing TF (by 164%), with no significant group differences between T1DM and T2DM. There were no increments in EMPs expressing phosphatidylserine or TF. Meal intake increased MP-induced thrombin generation similarly in T1DM and T2DM with increased endogenous thrombin potential ( p = 0.02) and peak thrombin ( p = 0.03) and shortened time to peak ( p = 0.02). Phosphatidylserine inhibition by lactadherin completely abolished MP-induced thrombin generation, while an anti-TF antibody had no effect. In conclusion, meal intake increased several types of circulating MPs in patients with diabetes mellitus. These MPs have a procoagulant potential, which is related to phosphatidylserine expression and negatively charged MP surfaces rather than to TF.