Altered Platelets' Morphological Parameters in Kids With T1D
Altered Platelets' Morphological Parameters in Kids With T1D
Type 1 diabetes mellitus (T1DM) is the most common metabolic disease among children, adolescents and young adults and its incidence rate is still rapidly increasing. As the onset of the disease occurs in early life, the afflicted are at great risk of developing cardiovascular disease as a complication of diabetes. Those long-term complications are the leading cause of premature mortality in this group of patients. The majority of ischemic events - occur due to intravascular thrombosis. This is a state in which subtle equilibrium between pro- and antithrombotic mechanisms is disrupted and the balance is shifted to favour platelet aggregation and adhesion. The main abnormality observed in diabetic platelets is their hypersensitivity to agonists which leads to their hyperreactivity. It has been shown that platelets obtained from patients suffering from diabetes expressed augmented adhesiveness and aggregation both spontaneous and in response to stimulating agents. Currently available reports have shown unequivocally that increased platelet activity is associated with an elevated frequency of vascular complications in adult patients with type 2 diabetes (T2DM). Based on these observations large clinical trials were undertaken and resulted in the introduction of the antiplatelet drugs as a form of primary prevention in those patients.
Mean platelet volume (MPV) is considered as a marker of platelet function. This is based on the fact that the larger platelets are younger, contain more dense granules and thus produce more thromboxane A2.In vitro studies showed that increased MPV was associated with greater aggregation in response to ADP and collagen. Larger platelets are more sensitive to platelets' stimulants are thus are more rapidly recruited to thrombus formation. Taking into consideration aforementioned facts platelet size is thought to be indirect indicator of platelet activity and thus an important factor in micro- and macrovascular diabetes complications. Higher MPV was noted in people with both T1DM and T2DM and these alterations are connected with metabolic control. However the influence of metabolic control on platelet morphologic parameters, especially in patients with T1DM, is still unclear and several studies have yielded ambiguous data. Studies concerning the link between platelet morphology or function alteration and diabetes were most often conducted on adult populations with T2DM. Our study was aimed to compare morphological platelet parameters – as the indirect indicators of platelet activity - between children with T1DM and their healthy peers. Additionally, we wanted to correlated platelet morphology parameters with glycated haemoglobin level.
Background
Type 1 diabetes mellitus (T1DM) is the most common metabolic disease among children, adolescents and young adults and its incidence rate is still rapidly increasing. As the onset of the disease occurs in early life, the afflicted are at great risk of developing cardiovascular disease as a complication of diabetes. Those long-term complications are the leading cause of premature mortality in this group of patients. The majority of ischemic events - occur due to intravascular thrombosis. This is a state in which subtle equilibrium between pro- and antithrombotic mechanisms is disrupted and the balance is shifted to favour platelet aggregation and adhesion. The main abnormality observed in diabetic platelets is their hypersensitivity to agonists which leads to their hyperreactivity. It has been shown that platelets obtained from patients suffering from diabetes expressed augmented adhesiveness and aggregation both spontaneous and in response to stimulating agents. Currently available reports have shown unequivocally that increased platelet activity is associated with an elevated frequency of vascular complications in adult patients with type 2 diabetes (T2DM). Based on these observations large clinical trials were undertaken and resulted in the introduction of the antiplatelet drugs as a form of primary prevention in those patients.
Mean platelet volume (MPV) is considered as a marker of platelet function. This is based on the fact that the larger platelets are younger, contain more dense granules and thus produce more thromboxane A2.In vitro studies showed that increased MPV was associated with greater aggregation in response to ADP and collagen. Larger platelets are more sensitive to platelets' stimulants are thus are more rapidly recruited to thrombus formation. Taking into consideration aforementioned facts platelet size is thought to be indirect indicator of platelet activity and thus an important factor in micro- and macrovascular diabetes complications. Higher MPV was noted in people with both T1DM and T2DM and these alterations are connected with metabolic control. However the influence of metabolic control on platelet morphologic parameters, especially in patients with T1DM, is still unclear and several studies have yielded ambiguous data. Studies concerning the link between platelet morphology or function alteration and diabetes were most often conducted on adult populations with T2DM. Our study was aimed to compare morphological platelet parameters – as the indirect indicators of platelet activity - between children with T1DM and their healthy peers. Additionally, we wanted to correlated platelet morphology parameters with glycated haemoglobin level.