Spontaneous Whole Blood Platelet Aggregation in Insulin-Dependent Diabetes Mellitus: An Evaluation in an Epidemiologic Study

Summary

Spontaneous whole blood platelet aggregation (SWBPA) was examined in a case-control study, comparing a consecutive series of IDDM subjects (n = 30) to age, and sex matched controls. Subjects were free of platelet altering medications. Platelet aggregation was measured by the percent fall in single platelet count after 15 minutes of both shaking (SK) and magnetic stirring (ST). IDDM subjects showed a significantly greater percent fall in SK (x = 12.1) and ST (x = 34.0) compared to controls (SK x = 8.4, p <0.01; ST x = 24.3, p <0.05). Long-term repeat testing on 15 subjects (diabetics and non-diabetics) up to 4 months apart showed a correlation of 0.7 for SK, p <0.01 but only 0.4 for ST. In a further series of IDDM subjects (n = 176) those with macrovascular disease (n = 27) showed significantly greater percent fall in SK (p<0.05), and ST (p<0.05).

We conclude that SWBPA is a simple useful epidemiological technique (shaking being more repeatable than stirring) which relates to both diabetes and macrovascular disease.

Key words

Platelet aggregation - Diabetes - Macrovascular disease

• References

• 1 Entmacher PS, Howard FR, Herbert HM. Longevity of diabetic patients in recent years. Diabetes 1964; 13 (04) 373-377
• 2 Garcia MJ, McNamara PM, Gordon T, Kannell WB. Morbidity and mortality in diabetics in the Framingham population sixteen-year follow-up study. Diabetes 194 23 (02) 105-111
• 3 Keen H, Rose G, Pyke DA, Boyns D. et al Blood-sugar and arterial disease. Lancet 1965; 2: 505-508
• 4 Bern MM. Platelet functions in diabetes mellitus. Diabetes 1978; 27 (03) 342-350
• 5 Wu KK, Hoak JC. A new method for the quantitative detection of platelet aggregation in patients with arterial insufficiency. Lancet 1974; 2: 924-926
• 6 Mustard JF, Packham MA. Factors influencing platelet function: adhesion, release and aggregation. Pharmacol Rev 1970; 22: 97-187
• 7 Harrison MJ G, Weisblatt E. A sex difference in the effect of Aspirin on “spontaneous” platelet aggregation in whole blood. Thromb Haemostas 1983; 50: 773-774
• 8 Mulley GP, Heptinstall S, Taylor PM, Mitchell JR A. ADP-induced platelet release reaction in acute stroke. Thromb Haemostas 1983; 50: 524-526
• 9 O’Malley BC, Timperley WR, Ward JD, Porter NR. et al Platelet abnormalities in diabetic peripheral neuropathy. Lancet 1975; 2: 1274-1276
• 10 Meade TW, Vickers MV, Thompson SG, Stirring Y. et al Epidemiological characteristics of platelet aggregability. Br Med J 1985; 290: 428-432
• 11 Born GV R. Quantitative investigations into the aggregation of blood platelets. J Physiol 1962; 162: 67-68
• 12 Born GV R. Aggregation of blood platelets by Adenosine diphosphate and its reversal. Nature 1962; 194: 927-929
• 13 Waldorf DS, Wilkens RF, Decker JL. Impaired delayed hypersensitivity in an aging population. J Am Med Assoc 1968; 203 (10) 111-114
• 14 Benvensite J, Cochrane CG, Henson PM. Leukocyte-dependent histamine release from rabbit platelets: the role of IgE, basophils and a platelet-activating factor. J Exp Med 1972; 136: 1356-1377
• 15 Heath H, Brigden WD, Canever JV, Pollock J. et al Platelet adhesiveness and aggregation in relation to diabetic retinopathy. Diabetology 1971; 7: 308-315
• 16 Gaarder A, Jonsen J, Laland S, Hellem AJ. et al Adenosine diphosphate in red cells as a factor in the adhesiveness of human blood platelets. Nature 1961; 192: 531-532
• 17 Fox SC, Burgess-Wilson M, Heptinstall S, Mitchell JR A. Platelet aggregation in whole blood determined using the Ultra-Flo 100 Platelet Counter. Thromb Haemostas 1982; 48 (03) 327-329
• 18 Breddin K, Grun H, Krzywanek HJ, Schremmer WP. On the measurement of spontaneous platelet aggregation. The platelet aggregation test III. Methods and first clinical results Thromb Haemostas 1976; 35: 669-691
• 19 Hamsten A, Iselius L, Faire V. et al Genetic and cultural inheritance of plasma fibrinogen concentration. Lancet 1987; 2: 988-990