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Postprandial hyperglycemia is a determinant of platelet activation in early type 2 diabetes mellitus.
J Thromb Haemost. 2010 Apr; 8(4):828-37.JT

Abstract

BACKGROUND

Chronic hyperglycemia is a major contributor to in vivo platelet activation in diabetes mellitus.

OBJECTIVES

To evaluate the effects of acarbose, an alpha-glucosidase inhibitor, on platelet activation and its determinants in newly diagnosed type 2 diabetic patients.

METHODS

Forty-eight subjects (26 males, aged 61 +/- 8 years) with early type 2 diabetes (baseline hemoglobin A(1c) < or = 7% and no previous hypoglycemic treatment) were randomly assigned to acarbose up to 100 mg three times a day or placebo, and evaluated every 4 weeks for 20 weeks. The main outcome measures were urinary 11-dehydro-thromboxane (TX)B(2) (marker of in vivo platelet activation) and 8-iso-prostaglandin (PG)F(2alpha) (marker of in vivo lipid peroxidation) excretion rate, 2-h postprandial plasma glucose (PPG) after a test meal, and assessment of glucose fluctuations by mean amplitude of glycemic excursions (MAGE).

RESULTS

Baseline measurements revealed biochemical evidence of enhanced lipid peroxidation and platelet activation. As compared with the placebo group, patients treated with acarbose had statistically significant reductions in urinary 11-dehydro-TXB(2) and 8-iso-PGF(2alpha) excretion rate as early as after 8 weeks and at each subsequent time point (between-group P < 0.0001 at 12, 16 and 20 weeks), following earlier decreases in PPG and MAGE. Multiple regression analyses in the acarbose group revealed that PPG was the only significant predictor of 11-dehydro-TXB(2) urinary excretion rate (beta = 0.39, P = 0.002) and MAGE the only predictor of 8-iso-PGF(2alpha) urinary excretion rate (beta = 0.42, P = 0.001).

CONCLUSIONS

Postprandial hyperglycemia is associated with enhanced lipid peroxidation and platelet activation in early type 2 diabetes. A moderate decrease in PPG achieved with acarbose causes time-dependent downregulation of these phenomena, suggesting a causal link between early metabolic abnormalities and platelet activation in this setting.

Authors+Show Affiliations

Centre of Excellence on Aging, G. d'Annunzio University Foundation, Chieti, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20088941

Citation

Santilli, F, et al. "Postprandial Hyperglycemia Is a Determinant of Platelet Activation in Early Type 2 Diabetes Mellitus." Journal of Thrombosis and Haemostasis : JTH, vol. 8, no. 4, 2010, pp. 828-37.
Santilli F, Formoso G, Sbraccia P, et al. Postprandial hyperglycemia is a determinant of platelet activation in early type 2 diabetes mellitus. J Thromb Haemost. 2010;8(4):828-37.
Santilli, F., Formoso, G., Sbraccia, P., Averna, M., Miccoli, R., Di Fulvio, P., Ganci, A., Pulizzi, N., Lattanzio, S., Ciabattoni, G., Consoli, A., Lauro, R., Patrono, C., & Davì, G. (2010). Postprandial hyperglycemia is a determinant of platelet activation in early type 2 diabetes mellitus. Journal of Thrombosis and Haemostasis : JTH, 8(4), 828-37. https://doi.org/10.1111/j.1538-7836.2010.03742.x
Santilli F, et al. Postprandial Hyperglycemia Is a Determinant of Platelet Activation in Early Type 2 Diabetes Mellitus. J Thromb Haemost. 2010;8(4):828-37. PubMed PMID: 20088941.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postprandial hyperglycemia is a determinant of platelet activation in early type 2 diabetes mellitus. AU - Santilli,F, AU - Formoso,G, AU - Sbraccia,P, AU - Averna,M, AU - Miccoli,R, AU - Di Fulvio,P, AU - Ganci,A, AU - Pulizzi,N, AU - Lattanzio,S, AU - Ciabattoni,G, AU - Consoli,A, AU - Lauro,R, AU - Patrono,C, AU - Davì,G, Y1 - 2010/01/17/ PY - 2010/1/22/entrez PY - 2010/1/22/pubmed PY - 2010/7/9/medline SP - 828 EP - 37 JF - Journal of thrombosis and haemostasis : JTH JO - J Thromb Haemost VL - 8 IS - 4 N2 - BACKGROUND: Chronic hyperglycemia is a major contributor to in vivo platelet activation in diabetes mellitus. OBJECTIVES: To evaluate the effects of acarbose, an alpha-glucosidase inhibitor, on platelet activation and its determinants in newly diagnosed type 2 diabetic patients. METHODS: Forty-eight subjects (26 males, aged 61 +/- 8 years) with early type 2 diabetes (baseline hemoglobin A(1c) < or = 7% and no previous hypoglycemic treatment) were randomly assigned to acarbose up to 100 mg three times a day or placebo, and evaluated every 4 weeks for 20 weeks. The main outcome measures were urinary 11-dehydro-thromboxane (TX)B(2) (marker of in vivo platelet activation) and 8-iso-prostaglandin (PG)F(2alpha) (marker of in vivo lipid peroxidation) excretion rate, 2-h postprandial plasma glucose (PPG) after a test meal, and assessment of glucose fluctuations by mean amplitude of glycemic excursions (MAGE). RESULTS: Baseline measurements revealed biochemical evidence of enhanced lipid peroxidation and platelet activation. As compared with the placebo group, patients treated with acarbose had statistically significant reductions in urinary 11-dehydro-TXB(2) and 8-iso-PGF(2alpha) excretion rate as early as after 8 weeks and at each subsequent time point (between-group P < 0.0001 at 12, 16 and 20 weeks), following earlier decreases in PPG and MAGE. Multiple regression analyses in the acarbose group revealed that PPG was the only significant predictor of 11-dehydro-TXB(2) urinary excretion rate (beta = 0.39, P = 0.002) and MAGE the only predictor of 8-iso-PGF(2alpha) urinary excretion rate (beta = 0.42, P = 0.001). CONCLUSIONS: Postprandial hyperglycemia is associated with enhanced lipid peroxidation and platelet activation in early type 2 diabetes. A moderate decrease in PPG achieved with acarbose causes time-dependent downregulation of these phenomena, suggesting a causal link between early metabolic abnormalities and platelet activation in this setting. SN - 1538-7836 UR - https://www.unboundmedicine.com/medline/citation/20088941/Postprandial_hyperglycemia_is_a_determinant_of_platelet_activation_in_early_type_2_diabetes_mellitus_ L2 - https://doi.org/10.1111/j.1538-7836.2010.03742.x DB - PRIME DP - Unbound Medicine ER -