Elalamy I, Chakroun T, Gerotziafas G T, Petropoulou A, Robert F, Karroum A, Elgrably F, Samama M-M, Hatmi M
Service d'Hématologie Biologique, Hôtel-Dieu, 1 Parvis Notre Dame 75181, Paris Cedex 04, Université Pierre et Marie Curie (Paris VI), France.
Thromb Res. 2008;121(6):843-8. doi: 10.1016/j.thromres.2007.07.016. Epub 2007 Sep 10.
Diabetes is associated with multiple disorders including metabolic, cellular and blood disturbances leading to vascular complications. Increased circulating levels of platelet-leukocyte aggregates (PLA) have been described in several thrombotic diseases. In this study, we have evaluated circulating PLA in diabetic patients and we have investigated whether they may be a marker of vascular complications. Using flow cytometry assay, we have quantified PLA percentages in 65 diabetics including 20 patients with type I and 45 with type II diabetes, and 25 healthy subjects. Specific labelling identified platelet-polymorphonuclear aggregates (PPA) and platelet-monocyte aggregates (PMA). We have observed a significant increase of PPA and PMA levels in diabetics (22+/-12% and 45+/-18%, respectively) compared to controls (7+/-4% and 19+/-10%, respectively) (p<0.01). However, both PPA and PMA values were similar in the two diabetes types. Circulating PPA and PMA were significantly enhanced in diabetics with vascular lesions (PPA: 24+/-13%; PMA: 50+/-18%) than in diabetics without vascular lesions (PPA: 18+/-8%; PMA: 38+/-15%) (p<0.05 and p<0.01). Patients with PPA>18% and/or PMA>38% showed a more important vascular injury (OR: 6; 95% CI: 1.6-23). Increased PMA circulating rate is particularly correlated to retinopathic injury (OR: 19; 95% CI: 2.3-154). Our findings established a relationship between increased circulating PLA levels, particularly PMA, and the incidence of microvascular complications in diabetes. They reinforce the concept of pro-inflammatory cells involvement in diabetic retinopathy pathogenesis and their link with thrombotic process.
糖尿病与多种病症相关，包括代谢、细胞及血液紊乱，进而导致血管并发症。在多种血栓性疾病中，血小板 - 白细胞聚集体（PLA）的循环水平均有所升高。在本研究中，我们评估了糖尿病患者的循环PLA，并研究了其是否可能作为血管并发症的标志物。通过流式细胞术检测，我们对65名糖尿病患者（包括20名I型糖尿病患者和45名II型糖尿病患者）以及25名健康受试者的PLA百分比进行了量化。特异性标记可识别血小板 - 多形核白细胞聚集体（PPA）和血小板 - 单核细胞聚集体（PMA）。我们观察到，与对照组（分别为7±4%和19±10%）相比，糖尿病患者的PPA和PMA水平显著升高（分别为22±12%和45±18%）（p<0.01）。然而，两种糖尿病类型的PPA和PMA值相似。与无血管病变的糖尿病患者（PPA：18±8%；PMA：38±15%）相比，有血管病变的糖尿病患者的循环PPA和PMA显著升高（PPA：24±13%；PMA：50±18%）（p<0.05和p<0.01）。PPA>18%和/或PMA>38%的患者显示出更严重的血管损伤（比值比：6；95%置信区间：1.6 - 23）。PMA循环率升高尤其与视网膜病变损伤相关（比值比：19；95%置信区间：2.3 - 154）。我们的研究结果确立了循环PLA水平升高，尤其是PMA，与糖尿病微血管并发症发生率之间的关系。它们强化了促炎细胞参与糖尿病视网膜病变发病机制及其与血栓形成过程联系的概念。
