Reevaluation of circulating prostacyclin and thromboxane in diabetes.

Although several investigators have attempted to measure the plasma levels of prostacyclin (PGI2) and thromboxane A2 (TXA2) in diabetes and normal subjects, their results have been controversial. In this study, we measured plasma PGI2 and TXA2 levels in diabetic patients and normal subjects. The plasma PGI2 and TXA2 were determined by RIA as 6-keto-PGF1 alpha and TXB2, respectively. The plasma levels of 6-keto-PGF1 alpha were significantly reduced in diabetics with microangiopathy (52.5 +/- 18.9 pg/ml, mean +/- SE, p less than 0.05) compared with those of normal subjects. Diabetics as a whole also showed lower levels of 6-keto-PGF1 alpha than normal subjects (57.8 +/- 26.1 vs. 70.2 +/- 20.7 pg/ml), though this was not significant statistically. The plasma 6-keto-PGF1 alpha levels did not significantly correlate with either age of the patients or duration of diabetes in diabetics. Interestingly, however, hemoglobin A1c significantly correlated inversely with 6-keto-PGF1 alpha levels in diabetics without microangiopathy (r = -0.60, p less than 0.05). The plasma levels of TXB2 in diabetics were significantly higher than those of normal subjects (155.2 +/- 69.5 vs. 108.0 +/- 30.0 pg/ml, p less than 0.05). These data suggest that an imbalance of circulating PGI2 and TXA2 may contribute to the development of diabetic microangiopathy.