We investigated markers of platelet reactivity and low-grade inflammation, and their association with early markers of vascular disease in subjects with prediabetes and new onset type 2 diabetes (NODM).

Methods: 121 subjects without history of diabetes were stratified into 3 groups according to glycemic status: controls (n=41), prediabetes (n=42) and NODM (n=39). Platelet reactivity was evaluated as 11-dehydro thromboxane B2 urinary levels (TXB2), mean platelet volume (MPV) and platelet/lymphocytes ratio (PLR); cardiovascular risk was evaluated with arterial stiffness [pulse wave velocity (PWV), Augmentation pressure (AP), Subendocardial viability ratio (SEVR)] and intima media thickness (IMT).

Results: Subjects with prediabetes exhibited: higher TXB2 urinary levels (10.7 ± 4.8 vs. 6.4 ± 1.8 pg/mg creatinine, p<0.05), PLR (143.7 ± 43 vs. 106.1 ± 26.7, p<0.05) and lower MPV (8.7 ± 0.7 vs. 9.5 ± 1.1 fl, p<0.05). Prediabetes showed higher fibrinogen and C creative protein (CRP) serum levels (333.2 ± 63 vs. 310.6 ± 58 mg/dL, p<0.05; 0.34 (0.11-0.47) vs. 0.14 (0.08-0.27) mg/dL, p<0.05, respectively). Subjects with prediabetes exhibited increased PWV, AP and IMT (8.1 ± 0.9 cm/sec vs. 7.5 ± 1.5, p<0.05; 13.2 ± 9.5 mmHg vs. 11.2 ± 4.6, p<0.05 and 710.2 ± 93.4 vs. 659 ± 93.1 μm, p<0.05, respectively) and decreased SEVR (159.4 ± 11 vs. 171.8 ± 32.3, p<0.05) compared with controls. No differences were found between prediabetes and NODM subjects regarding platelet reactivity and cardiovascular risk markers.TXB2 urinary levels were independently associated with hs-CRP, fibrinogen and HbA1c in multiple regression analysis. In simple regression analysis AP, PWV and SEVR showed a significant association with TXB2 urinary levels (r=0.32, p<0.05, r=0.16, p<0.05 and r=0.26 p<0.05 respectively).

Conclusions: Subjects with prediabetes showed increased platelet reactivity and inflammation markers. These alterations were associated with early markers of cardiovascular disease.

Disclosure

A. Di Pino: None. F. Urbano: None. R. Scicali: None. S. Piro: None. A. Rabuazzo: None. F. Purrello: None.

Funding

University of Catania

© 2019 by the American Diabetes Association.
2019
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