Nomura Shosaku, Shouzu Akira, Omoto Seitarou, Nishikawa Mitsushige, Iwasaka Toshiji
First Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka, Japan.
Blood Coagul Fibrinolysis. 2005 Sep;16(6):423-8. doi: 10.1097/01.mbc.0000176197.48134.08.
We compared the levels of plasma adiponectin, platelet activation markers (P-selectin, CD63, PAC-1, annexin V, and platelet-derived microparticles), and endothelial injury markers (soluble E-selectin and soluble vascular cell adhesion molecule-1) in 53 patients with type 2 diabetes mellitus to investigate potential contributions to diabetic vascular complications. In addition, we administered serotonin antagonist (sarpogrelate hydrochloride) to type 2 diabetes patients who had increased soluble E-selectin levels. The concentrations of platelet activation markers and endothelial injury markers in diabetic patients were significantly higher than those in normal subjects. However, levels of adiponectin were lower in type 2 diabetes patients than in control subjects. A total of 32 patients had high-soluble E-selectin levels (soluble E-selectin >or= 62 ng/ml); a subset of patients that also had significant elevation of platelet activation and endothelial injury markers compared with patients without high soluble E-selectin. In addition, both platelet-P-selectin and platelet-derived microparticle levels negatively correlated with the adiponectin level. Patients with high soluble E-selectin exhibited significant improvement of all markers after sarpogrelate hydrochloride treatment. These findings suggest that there is a link between vascular change in type 2 diabetes and activated platelets, endothelial dysfunction, and an adiponectin abnormality.
我们比较了53例2型糖尿病患者的血浆脂联素水平、血小板活化标志物（P-选择素、CD63、PAC-1、膜联蛋白V和血小板衍生微粒）以及内皮损伤标志物（可溶性E-选择素和可溶性血管细胞黏附分子-1），以研究它们对糖尿病血管并发症的潜在影响。此外，我们对可溶性E-选择素水平升高的2型糖尿病患者给予了5-羟色胺拮抗剂（盐酸沙格雷酯）。糖尿病患者的血小板活化标志物和内皮损伤标志物浓度显著高于正常受试者。然而，2型糖尿病患者的脂联素水平低于对照组。共有32例患者可溶性E-选择素水平较高（可溶性E-选择素≥62 ng/ml）；与可溶性E-选择素水平不高的患者相比，这部分患者的血小板活化和内皮损伤标志物也显著升高。此外，血小板P-选择素和血小板衍生微粒水平均与脂联素水平呈负相关。盐酸沙格雷酯治疗后，可溶性E-选择素水平较高的患者所有标志物均有显著改善。这些发现表明，2型糖尿病的血管变化与活化血小板、内皮功能障碍和脂联素异常之间存在联系。
