Davis T M, Bown E G, Turner R C
Diabetes Research Laboratories, Radcliffe Infirmary, Oxford, England.
Diabetes Res. 1990 Nov;15(3):103-7.
In vitro platelet aggregation in response to a wide range of final adenosine-5'-diphosphate (ADP) concentrations was assessed in 11 young, diabetic males without detectable vascular complications and in 11 closely-matched controls. First phase aggregation was assessed using a particle collision theory model and the "sigmoid Emax" dose-response equation. Platelets from the diabetics required a significantly lower ADP concentration to attain a sticking probability of 0.2 (EC20; median [95% confidence limits]; 0.38 mumol/l ADP [0.25-0.52]) than those from the controls (0.55 mumol/l [0.28-0.67]; p = 0.016). At higher concentrations (EC50, EC80), there were no significant differences between the two groups (p greater than 0.05). Second phase aggregation, assessed from threshold for initiation of the release reaction, occurred at lower ADP concentrations in the diabetic group (2.0 mumol/l [1.2-4.4] vs 3.2 mumol/l [1.6-7.0]; p = 0.009). Consistent with the multistep nature of ADP-induced aggregation, these results indicate dose-dependent platelet function abnormalities in diabetics without vasculopathy. Enhanced reversible microaggregate formation (associated with platelet shape change) at low ADP concentrations may precede other first phase changes in early diabetes and would explain apparent inconsistencies in the results of previous studies involving similar subject groups.
在11名无明显血管并发症的年轻男性糖尿病患者和11名年龄、性别相匹配的对照者中，评估了血小板对一系列终浓度腺苷-5'-二磷酸（ADP）的体外聚集反应。使用粒子碰撞理论模型和“sigmoid Emax”剂量反应方程评估第一阶段聚集。糖尿病患者的血小板达到0.2黏附概率（EC20；中位数[95%置信区间]；0.38 μmol/L ADP[0.25 - 0.52]）所需的ADP浓度显著低于对照组（0.55 μmol/L[0.28 - 0.67]；p = 0.016）。在较高浓度（EC50、EC80）时，两组之间无显著差异（p＞0.05）。从释放反应起始阈值评估的第二阶段聚集，在糖尿病组中发生的ADP浓度较低（2.0 μmol/L[1.2 - 4.4]对3.2 μmol/L[1.6 - 7.0]；p = 0.009）。与ADP诱导聚集的多步骤性质一致，这些结果表明无血管病变的糖尿病患者存在剂量依赖性血小板功能异常。在低ADP浓度下增强的可逆性微聚集体形成（与血小板形状改变相关）可能在早期糖尿病的其他第一阶段变化之前出现，这可以解释以往涉及类似受试者组的研究结果中明显的不一致性。
