Yamamoto Kiyoaki, Ito Takashi, Nagasato Tomoka, Shinnakasu Atsushi, Kurano Mihoko, Arimura Aiko, Arimura Hiroshi, Hashiguchi Hiroshi, Deguchi Takahisa, Maruyama Ikuro, Nishio Yoshihiko
1Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1, Sakuragaoka, Kagoshima, 890-8544 Japan.
2Department of Systems Biology in Thromboregulation, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1, Sakuragaoka, Kagoshima, 890-8544 Japan.
Thromb J. 2019 Sep 2;17:17. doi: 10.1186/s12959-019-0206-8. eCollection 2019.
Thrombus formation is an important factor affecting cardiovascular events and venous thromboembolism in type 2 diabetes. However, it is unclear whether glycemic control reduces thrombogenicity. We investigated the effect of short-term glycemic control (STUDY 1) and hypoglycemia (STUDY 2) on thrombus formation using an automated microchip flow chamber system.
For STUDY 1, we recruited 10 patients with type 2 diabetes. Before and after 2 weeks of treatment, blood glucose was analyzed with a continuous glucose monitoring system, and thrombogenicity was analyzed with an automated microchip flow chamber system. For STUDY 2, we recruited 10 subjects without diabetes who underwent an insulin tolerance test. We evaluated the change in thrombogenic potential with hypoglycemia.
STUDY1: The mean blood glucose level reduced from 10.1 ± 2.6 to 6.9 ± 0.97 mM ( < 0.01). T10, an indicator of thrombogenicity, significantly attenuated after glycemic control (338 ± 65 vs. 425 ± 117 s, < 0.05). The attenuation in T10 was significantly correlated with changes in mean blood glucose level after treatment ( = - 0.718, < 0.05). STUDY 2: Platelet function was enhanced with decreasing blood glucose; increased platelet function was strongly correlated with an increase in epinephrine.
We demonstrated attenuation in thrombogenicity with short-term comprehensive diabetes care and enhancement in thrombogenicity with hypoglycemia, using a new flow chamber system.
UMIN-CTR UMIN 000019899, registered 26-Jan-2015 (STUDY 2).
血栓形成是影响2型糖尿病患者心血管事件和静脉血栓栓塞的重要因素。然而，血糖控制是否能降低血栓形成倾向尚不清楚。我们使用自动微流控芯片系统研究了短期血糖控制（研究1）和低血糖（研究2）对血栓形成的影响。
在研究1中，我们招募了10例2型糖尿病患者。在治疗2周前后，使用连续血糖监测系统分析血糖，并使用自动微流控芯片系统分析血栓形成倾向。在研究2中,我们招募了10名未患糖尿病的受试者，他们接受了胰岛素耐量试验。我们评估了低血糖时血栓形成潜力的变化。
研究1：平均血糖水平从10.1±2.6降至6.9±0.97 mM（P<0.01）。血栓形成倾向指标T10在血糖控制后显著降低（338±65秒对425±117秒，P<0.05）。T10的降低与治疗后平均血糖水平的变化显著相关（r=-0.718，P<0.05）。研究2：血小板功能随着血糖降低而增强；血小板功能的增加与肾上腺素的增加密切相关。
我们使用新的微流控芯片系统证明，短期综合糖尿病护理可降低血栓形成倾向，而低血糖则会增强血栓形成倾向。
UMIN-CTR UMIN 000019899，于2015年1月26日注册（研究2）。
