Abstract 1317: Progression Of Carotid Intima-media Thickness Is Associated With Platelet-leucocyte Activation In Patients With Diabetes mellitus Type 2.
Background: Platelet activation is critically involved in the pathogenesis of atherosclerosis, however the impact of enhanced platelet-leucocyte activation on progression of atherosclerosis is poorly investigated so far.
Aim: The aim of the study was to evaluate the impact of platelet-leucocyte activation on the progression of carotid intima-media thickness (CIMT) in patients with diabetes mellitus type 2 (DM-2)
Methods: We measured consecutively in 172 asymptomatic DM-2 (age 63.7 ± 0.63years, 79 female, HbA1c 8.2 ± 0.1%, body mass index (bmi) 30.9 ± 0.4) CIMT bilaterally at a definite site at study entry and after one year by ultrasound. CIMT total was defined as the sum of CIMT left and CIMT right.The difference of DCIMT total (Total CIMT after one year - total CIMT at study entry) was calculated and DCIMTtotal > 0 indicated progression. Platelet activation (P-selectin, CD63) and platelet-leucocyte activation(L-selectin) was assessed by flow cytometric techniques.
Results: DM-2 patients (n=108) with progression of CIMT (DCIMT total (median,[ 25th-75th];0.25mm, [0.11–0.38]) demonstrated a significant enhanced expression of P-selectin, CD63, and decreased expression of L-selectin compared to DM-2 patients without progression. A multivariate logistic regression analysis including classical risk factors, duration of diabetes, HbA1c, bmi, age, P-selectin, CD63 and L-selectin revealed CD63 as an independent predictor for progression of CIMT during one year.
Conclusion: Progression of carotid artery disease is associated with systemic enhanced platelet and platelet-leucocyte activation. CD63 represents even an independent predictor for CIMT progression.