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无血管并发症的糖尿病患者表现出基础血小板活化增强和抗氧化状态降低。

Diabetic patients without vascular complications display enhanced basal platelet activation and decreased antioxidant status.

作者信息

Véricel Evelyne, Januel Caroline, Carreras Martine, Moulin Philippe, Lagarde Michel

机构信息

Unité mixte de Recherche 585 Institut National de la Santé et de la Recherche Médicale/Institut National des Sciences Appliquées de Lyon, Institute for Multidisciplinary Biochemistry of Lipids, Villeurbanne, France.

出版信息

Diabetes. 2004 Apr;53(4):1046-51. doi: 10.2337/diabetes.53.4.1046.

Abstract

Vascular complications are the leading causes of morbidity and mortality in diabetic patients. The contribution of platelets to thromboembolic complications is well documented, but their involvement in the initiation of the atherosclerotic process is of rising interest. Thus, the aim of the present study was to evaluate basal arachidonic acid metabolism in relation to the redox status of platelets in both type 1 and type 2 diabetic patients, in the absence of vascular complications, as compared with respective control subjects. For the first time, we show that basal thromboxane B(2), the stable catabolite of thromboxane A(2), significantly increased in resting platelets from both type 1 and type 2 diabetic patients (58 and 88%, respectively), whereas platelet malondialdehyde level was only higher in platelets from type 2 diabetic subjects (67%). On the other hand, both vitamin E levels and cytosolic glutathione peroxidase activities were significantly lower in platelets from diabetic patients as compared with respective control subjects. We conclude that platelet hyperactivation was detectable in well-controlled diabetic patients without complications. This abnormality was associated with increased oxidative stress and impaired antioxidant defense in particular in type 2 diabetic patients. These alterations contribute to the increased risk for occurrence of vascular diseases in such patients.

摘要

血管并发症是糖尿病患者发病和死亡的主要原因。血小板对血栓栓塞并发症的作用已有充分记录,但其在动脉粥样硬化进程起始中的作用越来越受到关注。因此,本研究的目的是评估1型和2型糖尿病患者在无血管并发症情况下,基础花生四烯酸代谢与血小板氧化还原状态的关系,并与相应的对照受试者进行比较。我们首次发现,血栓素A2的稳定分解产物基础血栓素B2在1型和2型糖尿病患者的静息血小板中显著增加(分别为58%和88%),而血小板丙二醛水平仅在2型糖尿病受试者的血小板中较高(67%)。另一方面,与相应的对照受试者相比,糖尿病患者血小板中的维生素E水平和胞质谷胱甘肽过氧化物酶活性均显著降低。我们得出结论,在病情得到良好控制且无并发症的糖尿病患者中可检测到血小板过度活化。这种异常与氧化应激增加和抗氧化防御受损有关,尤其是在2型糖尿病患者中。这些改变导致此类患者发生血管疾病的风险增加。

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