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Acute, short-term hyperglycemia enhances shear stress-induced platelet activation in patients with type II diabetes mellitus

Paolo Gresele, MD, PhD^*,*, Giuseppe Guglielmini, BSc^*, Massimiliano De Angelis, MD, Silvia Ciferri, BSc^*, Marco Ciofetta, MD, Emanuela Falcinelli, BSc^*, Carlo Lalli, MD, Giovanni Ciabattoni, MD, Giovanni Davì, MD and Geremia B. Bolli, MD

^* Division of Internal and Cardiovascular Medicine, Department of Internal Medicine, University of Perugia, Perugia, Italy
Division of Internal Medicine, Endocrinology and Metabolism, Department of Internal Medicine, University of Perugia, Perugia, Italy
Departments of Medicine and Aging, Drug Sciences, University of Chieti, Chieti, Italy

View larger version (42K): [in a new window]   Figure 1 Shear stress-induced platelet activation before and after the euglycemic and hyperglycemic clamps. (A) Filter closure time (s). (B) Platelets retained between 20 and 40 s (% of total). #p = 0.0012 vs. hyper-pre (i.e., before hyperglycemic clamp). p = 0.002 vs. hyper-pre. Eu = euglycemic clamp.

View larger version (27K): [in a new window]   Figure 2 Platelet activation in bleeding-time blood before and after the euglycemic and hyperglycemic clamps. (A) P-selectin expression on platelets. (B) Expression of LIMP on platelets. Open bars = euglycemic; striped bars = hyperglycemic. Data are reported as the percent increase in positive platelets between samples after versus before clamping. *p < 0.04, p < 0.02 vs. before clamping. **p < 0.004, #p < 0.03 vs. before clamping, ##p < 0.005 vs. before clamping.

View larger version (24K): [in a new window]   Figure 3 Correlations between different parameters. (A) Correlation between vWF:activity and vWF:Ag (r = 0.84, p 0.0001). (B) Correlation between vWF:activity and shear stress-induced platelet activation (filter closure time) (r = –0.32, p = 0.02). (C) Correlation between vWF:activity and P-selectin (P-Sel) expression on platelets in bleeding-time blood (AUC) (r = 0.36, p = 0.03). (D) Correlation between vWF:activity and LIMP expression on platelets in bleeding-time blood (AUC) (r = 0.34, p = 0.02). (E) Correlation between vWF:activity and urinary 11-dehydro-TxB2 excretion during clamping (r = 0.34, p = 0.03). (F) Correlation between urinary 11-dehydro-TxB2 excretion during clamping and P-selectin expression on platelets in bleeding-time blood (AUC) (r = 0.37, p = 0.02). Ct = creatinine.