ORIGINAL ARTICLE

Plasma Levels of Soluble P-Selectin, Beta-Thromboglobulin and Platelet Indices in Patients With Prediabetes: Effects of Acute Hyperglycemic Stress
Prediyabetik Hastalarda Oral Glukoz Yüklemesinin Trombosit İndeks Değerleri ile Plazma P-Selektin ve Beta-Tromboglobülin Düzeyleri Üzerine Akut Etkisinin Araştırılması
Received Date : 13 Oct 2020
Accepted Date : 03 Mar 2021
Available Online : 23 Mar 2021
Doi: 10.25179/tjem.2020-79546 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:174-183
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Amaç: Çalışmamızın amacı, prediyabetik hastalarda plazma P-selektin ve betatromboglobülin düzeyleri ile trombosit indekslerinin ilişkisinin incelenmesi ve oral glukoz yüklemesi ile oluşturulan akut hiperglisemik stresin trombosit aktivasyon belirteçleri üzerine etkisinin araştırılmasıdır. Gereç ve Yöntemler: Amerikan Diyabet Derneği kriterlerine göre; oral glukoz tolerans testi sonuçları baz alınarak kontrol (n=31) ve prediyabet (n=103) grupları oluşturuldu. Oral glukoz yüklemesinden önce ve yüklemenin 2. saatinde alınan kan örneklerinde trombosit sayısı [platelet count (PLT)], ortalama trombosit hacmi [mean platelet volume (MPV)], trombosit dağılım genişliği ve plateletkrit [plateletcrit (PCT)] impedans yöntemi ile P-selektin ve beta-tromboglobülin düzeyleri “Enzyme Linked İmmunabsorbent Assay” yöntemi ile belirlendi. İstatistiksel anlamlılık p<0,05 olarak değerlendirildi. Bulgular: Trombosit sayısı ve indeksleri ile plazma, P-selektin bazal değerleri açısından kontrol ve prediyabet grupları arasında anlamlı farklılık saptanmadı. Bazal plazma beta-tromboglobülin düzeyleri prediyabet grubunda, kontrol grubuna göre anlamlı yüksek bulundu (p<0,001). Glukoz yüklemesi sonrasında PLT, PCT ve P-selektin değerleri kontrol (her biri için p<0,05) ve prediyabet (her biri için p<0,001) gruplarında bazal değerlere göre anlamlı olarak azaldı. PCT ve PLT’deki azalma oranı prediyabetik grupta (%3,88 ve %3,18) kontrol grubuna (%2,04 ve %1,44) göre daha belirgindi. Prediyabet grubunda kontrol grubundan farklı olarak MPV’de de anlamlı azalma gözlendi (p<0,05). Sonuç: Çalışmamızın sonuçları, prediyabetik dönemde trombosit büyüklüğü henüz etkilenmeden granül aktivasyonunun başladığını ve trombosit indekslerinin prediyabetik dönemde değişmediğini düşündürmektedir. Akut hiperglisemi ise hem sağlıklı hem prediyabetik kişilerde, trombosit morfolojisi ve fonksiyonlarını etkilemektedir; bu etkilenme prediyabetik bireylerde daha belirgin olmaktadır.
ÖZET
Objective: To examine the effects of acute hyperglycemic stress on platelet activation by analyzing the plasma levels of P-selectin, beta-thromboglobulin, and platelet indices in an oral glucose tolerance test (OGTT). Material and Methods: The OGTT results were used to form four study groups: a control group (n=31) and a prediabetic group (n=103) comprising three subgroups according to the American Diabetes Association criteria for diabetes. Platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) were determined using the impedance method, and P-selectin and beta-thromboglobulin (β-TG) levels were determined by enzyme-linked immunosorbent assay. P<0.05 was considered significant. Results: No significant difference was observed in the baseline values of PLT, platelet indices, or plasma P-selectin level between the control and prediabetic groups. The baseline plasma β-TG level was significantly higher in the prediabetic group than in the control group (p<0.001). PLT, PCT and P-selectin levels significantly reduced during OGTT in both control (p<0.05 for each) and prediabetic groups (p<0.001 for each). The reduction in PCT (3.88%) and PLT (3.18%) after glucose loading was greater in the prediabetic group than in the control group (2.04% and 1.44%, respectively). The MPV decreased in the prediabetic group (p<0.05), while no significant decrease was observed in the control group. Conclusion: The platelet indices do not change in the prediabetic stage and the initiation of granule activation is independent of platelet morphology. Acute hyperglycemia appears to affect platelet morphology and function in both healthy and prediabetic subjects, and can be marked in prediabetic individuals.
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