Endothelial dysfunction and vascular-platelet hemostasis in patients with type 2 diabetes mellitus and hypertension with poor glycemic compensation.

Authors

  • N. O. Pertseva State institution “Dnipropetrovsk medical academy of the Ministry of Health of Ukraine”, Ukraine

DOI:

https://doi.org/10.26641/1997-9665.2017.1.51-57

Keywords:

diabetes mellitus type 2, arterial hypertension, endothelial dysfunction, platelet hemostasis, relationship

Abstract

Background. Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance. Objective. The aim of this study is to determine the relationships between endothelial dysfunction, the degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis in patients with poor compensation of type 2 diabetes mellitus and arterial hypertension. Methods. In 78 patients with poor glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. Results. In patients with poor glycemic control content of unactivated platelets had high power feedback with all three studied markers of endothelial dysfunction ranging from r=-0,74 to r=-0,84 (p<0,05), and set the reliable correlation with the majority of clinical and laboratory parameters except diastolic blood pressure levels, hemoglobin and high density lipoprotein cholesterol. Initially, the study determined a significant increase in direct interdependence between the degree of platelet aggregation and levels of glycated hemoglobin (r=+0,86), endothelin-1 (r=+0,95), von Willebrand factor (r=+0,91) and thrombomodulin (r=+0,88). Also share aggregated platelets greatly strengthened correlation with the majority of renal function parameters (strongest of them – with microalbuminuria (r=+0,81)) and established significant direct correlation with parameters of atherogenic dyslipidemia triad. Similar in direction and structure of the correlation matrix revealed when calculating the correlation coefficient of linear relative degranulated and activated platelets forms. In patients with poor compensation of hyperglycemia the density of packing of the alpha- and delta-granules of platelets were in secure communication with reversible levels of HbA1c, systolic blood pressure, endothelin-1, triglycerides. Patients had inverse correlation of alpha-granules and delta-granules with von Willebrand factor concentrations (r=-0,66 and r=-0,53 respectively; p<0,05) and thrombomodulin (r=-0,70 and r=-0,78 respectively; p<0,05), and amplified power relations with low density lipoprotein cholesterol. Packing density of mitochondria, despite the significantly reduced levels compared with controls, not establish significant correlations with most of the clinical and laboratory parameters. Only the level of endothelin-1 were found inverse correlation (r=-0,62). Conclusion. It has been established that in the poor glycemic control by a significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis formed extremely dense correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes.

References

  1. Shilov AM. Gipertenziya i reologiya krovi [Hypertension and blood rheology]. Moscow: BARS; 2005. 328 p. Russian.
  2. Torimoto K, Okada Y, Mori H, Tanaka Y. Relationship between fluctuations in glucose levels measured by continuous glucose monitoring and vascular endothelial dysfunction in type 2 diabetes mellitus. Cardiovasc Diabetol. 2013;13:18-24.
  3. Blair P. Platelet α-granules: Basic biology and clinical correlates. Blood Rev. 2009;23(4):177-89.
  4. Demirtunc R, Duman D, Basar M. The rela-tionship between glycemic control and platelet activity in type 2 diabetes mellitus. J Diabetes Complications. 2009;23(2):89-94.
  5. Barkis GL. Pathogenesis of hypertension in diabetes. Diabetes Rev. 1995;3:460-76.
  6. Vaskina EA, Tsirendorzhiev DD, Demina LM. Rol neytrofilov i prooksidantnogo potentsiala krovi v razvitii endotelialnoy disfunktsii pri arterialnoy gipertenzii [Role of neutrophils and pro-oxidant capacity of the blood in the development of endothelial dysfunction in hypertension]. Bulletin SO RAMN. 2003;2:107-12. Russian.
  7. Mathewkutty S, McGuire DK. Platelet per-turbations in diabetes: implications for cardiovascu-lar disease risk and treatment. Expert Rev Cardiovasc Ther. 2009;7(5):541-9.
  8. Martin-Gallan P, Carrascosa A, Gussinye M, Dominguez C. Biomarkers of diabetes-associated oxidative stress and antioxidant status in young diabetic patients with or without subclinical complications. Free Rad Biol Med. 2003;34(12):1563-74.
  9. Heude B. Cognitive decline and fatty acid composition of erythrocyte membranes. Amer J Clin Nutrition. 2003;77(4):803-8.
  10. Vitkovskiy YuA, Kuznik BI, Solpov AV. [Pathogenetic significance of lymphocyte-platelet adhesion]. Medical immunology. 2006;5:745-52. Russian.
  11. Alekseev VV, Karpishchenko AI. [Medical laboratory technology. Manual of Clinical Laboratory Diagnostics]. Moscow: GEOTAR-Media; 2006. 386 p. Russian.
  12. Sawatzke CL, Solomons CC. Fixation and embedding of small volumes of platelets for trans-mission electron microscopy. J Clin Pathol. 1980;33(6):600-2.
  13. Mironov AA, Komissarchik YuYa, Mironov VA. Metodyi elektronnoy mikroskopii v biologii i meditsine: Metodicheskoe rukovodstvo. [Electron microscopy methods in biology and medicine : Methodological Guide]. St. Petersburg: Science; 1994. 400 p. Russian.
  14. Medvedev IV, Kumova TA. Oslablenie agregatsionnoy sposobnosti trombotsitov u bolnyih arterialnoy gipertoniey pri metabolicheskom sindrome na fone lozartana. [Weakening aggregability platelets in hypertensive patients with metabolic syndrome on a background of losartan]. Russ J Cardiol. 2008;5:53-5. Russian.
  15. Lakin GF. Biometriya [Biometrics: 4th ed.]. Moscow: Vysshaya shkola; 1990. 352 p. Russian.

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How to Cite

Pertseva, N. O. (2017). Endothelial dysfunction and vascular-platelet hemostasis in patients with type 2 diabetes mellitus and hypertension with poor glycemic compensation. Морфологія / Morphologia / Morfologìâ, 11(1), 51–57. https://doi.org/10.26641/1997-9665.2017.1.51-57

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Vol. 11 No. 1 (2017)

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