Quantitative morphological characteristics of platelet hemostasis in patients with type 1 and 2 diabetes mellitus depending on the glomerular filtration rate.

Authors

  • T. O. Pertseva SI «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», Dnipro, Ukraine https://orcid.org/0000-0002-5828-6270
  • I. V. Tverdokhlib SI «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», Dnipro, Ukraine https://orcid.org/0000-0002-8672-3773
  • D. I. Chub SI «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», Dnipro, Ukraine

DOI:

https://doi.org/10.26641/1997-9665.2018.4.64-72

Keywords:

type 1 and 2 diabetes mellitus, diabetic nephropathy, platelet hemostasis, platelet activation, platelet aggregates, ultrastructural changes

Abstract

Background. The use of only a complex of clinical and laboratory parameters characterizing the state of the kidneys and a lipid profile profile with anamnestic data to determine the initial manifestations of functional renal insufficiency is not sufficient. This necessitates the search for new, more informative markers for the risk of development and progression of diabetic nephropathy in type 1 diabetes mellitus patients, which may be endothelial dysfunction markers and morphological parameters of thrombocyte hemostasis. Objective. The purpose of the study is to analyze the quantitative parameters of platelet hemostasis in patients with diabetes mellitus type 1 and type 2, depending on the velocity of glomerular filtration rate. Methods. Transmission electron microscopy and phase contrast microscopy quantitatively assessed the state of platelet hemostasis in the blood of 66 patients with type 1 diabetes mellitus and 58 patients with type 2 diabetes mellitus, depending on the velocity of glomerular filtration rate. Results. Quantitative characterization of the morphological features of platelet hemostasis revealed early signs of damage to the platelet structure, which occur at normal levels of glomerular filtration rate in patients with diabetes mellitus type 1 and type 2. Increased degranulation of alpha-granules and the growth of circulating platelet aggregates in the setting of significant activation of thrombocytes in the hyaline type are the most sensitive signs of hemostasis disorder in patients without clinical signs of diabetic kidney disease. The degree of pathomorphological changes in platelet count in patients with type 2 diabetes mellitus is higher than that of type 1 diabetes mellitus. With the progression of diabetic nephropathy, there is a significant deepening of platelet hemostasis disorders with the involvement of ultrastructural lesions of erythrocytes and leukocytes, massive platelet degranulation, the formation of numerous complex platelets, consolidation of correlations between the greater part of morphological parameters characterizing the hemostatic profile in patients with diabetes mellitus 1 and 2 type. Conclusion. Morphological changes in platelet hemostasis in patients with diabetes mellitus occur to the clinical manifestations of diabetic kidney disease and clearly correlate with the profundity of diabetic nephropathy at the stages of its development.

References

  1. Leon BM, Maddox TM. Diabetes and cardiovascular disease: epidemiology, biological mechanisms, treatment recommendations and future research. World J Diabetes. 2015;6(13):1246–58. doi: 10.4239/wjd.v6.i13.1246.
  2. Donelly R, Emsly-Smith AM, Gardner ID, Morris AD. Vascular complications of diabetes. BMJ. 2000;3:1062-6.
  3. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney international. 2013;3:1–150.
  4. Pretorius E, Mbotwe S, Kell DB. Lipopolysaccharide-binding protein (LBP) reverses the amyloid state of fibrin seen in plasma of type 2 diabetics with cardiovascular co-morbidities. Sci Rep. 2017;7(1):9680. doi: 10.1038/s41598-017-09860-4.
  5. 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.
  6. Pertseva NO. [Ultrastructural features of platelets in the patients with diabetes mellitus type 2 in a decompensation with arterial hypertension under correction of arterial blood pressure with losartan]. Morphologia. 2012;6(2):43-9. Ukrainian.
  7. Dzyak GV, Pertseva NO. [Quantitative morphological characteristics of intravascular platelet activity in patients with diabetes mellitus type 2 with arterial hypertension under losartan treatment]. Morphologia. 2012;6(4):39-52. Ukrainian.
  8. Pertseva NO. [Dynamics of platelet ultrastructural changes under correction of arterial blood pressure with losartan in patients with diabetes mellitus in a subcompensation]. Morphologia. 2012;6(3):43-50. Ukrainian.
  9. Morel A, Rywaniak J, Bijak M, Miller E, Niwald M, Saluk H. Flow cytometric analysis reveals the high levels of platelet activation parameters in circulation of multiple sclerosis patients. J. Mol Cell Biochem. 2017;430(1-2):69-80.
  10. Tverdokhleb IV, Pertseva NO, Turliun TS. [Dynamics of morphological changes of platelet granules in patients with hypertension and high cardiovascular risk in applying losartan potassium]. Morphologia. 2014;8(2):61-6. Ukrainian.
  11. Pertseva NO, Tverdokhleb IV. Tsukrovyy diabet 2 typu: endotelialʹna funktsiya ta trombotsytarnyy hemostaz [Type 2 diabetes mellitus: endothelial function and platelet hemostasis]. Kyiv : Doktor-media grup; 2016. 420 p. Ukrainian.
  12. Soma P, Swanepoel AC, du Plooy JN, Mqoco T, Pretorius E. Flow cytometric analysis of platelets type 2 diabetes mellitus reveals angry platelets. Cardiovasc Diabetol. 2016;15(1):52. doi: 10.1186/s12933-016-0373-x.
  13. Soma P, Pretorius E. Interplay between ultrastructural findings and atherothrombotic complications in type 2 diabetes mellitus. Cardiovasc Diabetol. 2015;14:96. doi: 10.1186/s12933-015-0261-9.
  14. Pertseva NO, Chub DI. [Early diagnosis of progressing of diabetic nephropathy in patients with diabetes 1 type using clinical and laboratory indicators]. Urology. 2018;22(1):54-61. Ukrainian.
  15. Sawatzke CL, Solomons CC. Fixation and embedding of small volumes of platelets for transmission electron microscopy. J Clin Pathol. 1980;33(6):600-2.
  16. 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.
  17. Kuo J. Electron microscopy: methods and protocols. Totowa, New Jersey: Humana Press Inc. 2007. 608 p.
  18. Nikonenko A.G. Vvedeniye v kolichestvennuyu gistologiyu [Introduction to quantitative histology]. Kyiv : Knyga-plus; 2013. 256 p. Russian.
  19. Medvedev IV, Kumova TA. [Weakening aggregability platelets in hypertensive patients with metabolic syndrome on a background of losartan]. Russ J Cardiol. 2008;5:53-5. Russian.
  20. Lakin GF. Biometriya [Biometrics: 4th ed.]. Moskva : Vysshaya shkola; 1990. 352 p. Russian.

Downloads

How to Cite

Pertseva, T. O., Tverdokhlib, I. V., & Chub, D. I. (2018). Quantitative morphological characteristics of platelet hemostasis in patients with type 1 and 2 diabetes mellitus depending on the glomerular filtration rate. Морфологія / Morphologia / Morfologìâ, 12(4), 64–72. https://doi.org/10.26641/1997-9665.2018.4.64-72

Issue

Vol. 12 No. 4 (2018)

Section

Статті

License

Copyright (c) 2018 Pertseva T.O., Tverdokhlib I.V., Chub D.I., Morphologia

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 The authors reserve the right to authorship of their work and transfer to the Journal the right to the first publication of this work under the terms of a license Creative commons Attribution 4.0 International (CC BY 4.0), which allows other people to freely distribute the published work with a mandatory reference to the authors of the original work and the first publication of the work in this journal.
        By submitting a manuscript to the editorial office of the Journal ‘Morphologia’ authors agree to transfer the rights to protect and use the manuscript (all supplemental materials, particularly protected objects such as photos, drawings, diagrams, tables, etc.), including the reproduction in the press and distribution via the Internet; translation of the manuscript into any language; export and import of journal copies with the Authors’ article in order to make it available for public. Authors convey the rights mentioned above to the editorial office without any temporal or territorial limitation all over the world. 
        The Authors guarantee that they have the exclusive rights to use the material transferred to editorial office. Editors are not responsible to third parties for contraventions of warranty given by the Authors. The considered rights are transferred to the editorial office since the moment when the current issue is signed for publishing. Reproduction of materials published in the Journal by other individuals and legal entities is possible only with the consent of Editorial office, with the obligatory indication of the full bibliographic reference of the primary publication. The Authors reserve the right to use the published material, its fragments and parts for teaching materials, oral presentations, dissertation thesis prepararion with obligatory bibliographic citation of the original paper. Electron copy of the published article, downloaded from official journal web-site in .pdf format may be put by authors on the official web-site of their institutions, any other official resources with open access.