Sabatier Florence, Darmon Patrice, Hugel Benedicte, Combes Valery, Sanmarco Marielle, Velut Jean-Gabriel, Arnoux Dominique, Charpiot Phillipe, Freyssinet Jean-Marie, Oliver Charles, Sampol Jose, Dignat-George Francoise
INSERM EMI 0019, Laboratory of Immunology and Hematology, UFR de Pharmacie, Université de la Méditerranée, Marseille, France.
Diabetes. 2002 Sep;51(9):2840-5. doi: 10.2337/diabetes.51.9.2840.
The development of vasculopathies in diabetes involves multifactorial processes including pathological activation of vascular cells. Release of microparticles by activated cells has been reported in diseases associated with thrombotic risk, but few data are available in diabetes. The aim of the present work was to explore the number and the procoagulant activity of cell-derived microparticles in type 1 and 2 diabetic patients. Compared with age-matched control subjects, type 1 diabetic patients presented significantly higher numbers of platelet and endothelial microparticles (PMP and EMP), total annexin V-positive blood cell microparticles (TMP), and increased levels of TMP-associated procoagulant activity. In type 2 diabetic patients, only TMP levels were significantly higher without concomitant increase of their procoagulant activity. Interestingly, in type 1 diabetic patients, TMP procoagulant activity was correlated with HbA(1c), suggesting that procoagulant activity is associated with glucose imbalance. These results showed that a wide vesiculation process, resulting from activation or apoptosis of several cell types, occurs in diabetes. However, diabetic patients differ by the procoagulant activity and the cellular origin of microparticles. In type 1 diabetic patients, TMP-procoagulant activity could be involved in vascular complications. Moreover, its correlation with HbA(1c) reinforces the importance of an optimal glycemic control in type 1 diabetes.
糖尿病血管病变的发展涉及多因素过程，包括血管细胞的病理激活。在与血栓形成风险相关的疾病中，已报道活化细胞会释放微粒，但关于糖尿病的此类数据较少。本研究的目的是探究1型和2型糖尿病患者细胞来源微粒的数量及促凝活性。与年龄匹配的对照受试者相比，1型糖尿病患者的血小板微粒和内皮微粒（PMP和EMP）、膜联蛋白V阳性血细胞微粒总数（TMP）显著增多，且TMP相关促凝活性水平升高。在2型糖尿病患者中，仅TMP水平显著升高，但其促凝活性并未随之增加。有趣的是，在1型糖尿病患者中，TMP促凝活性与糖化血红蛋白（HbA1c）相关，提示促凝活性与葡萄糖失衡有关。这些结果表明，糖尿病中存在由多种细胞类型激活或凋亡导致的广泛囊泡形成过程。然而，糖尿病患者在微粒的促凝活性和细胞来源方面存在差异。在1型糖尿病患者中，TMP促凝活性可能与血管并发症有关。此外，其与HbA1c的相关性强化了1型糖尿病患者最佳血糖控制的重要性。
