Younger age, higher body mass index and lower adiponectin concentration predict higher serum thromboxane B2 level in aspirin-treated patients with type 2 diabetes: An observational study

被引:13
作者
Kaplon-Cieslicka A. [1 ]
Postula M. [2 ,3 ]
Rosiak M. [2 ]
Peller M. [1 ]
Kondracka A. [4 ]
Serafin A. [1 ]
Trzepla E. [5 ]
Opolski G. [1 ]
Filipiak K.J. [1 ]
机构
[1] 1st Chair and Department of Cardiology, Medical University of Warsaw, Public Central Teaching Hospital in Warsaw, 1a Banacha St., Warsaw
[2] Department of Noninvasive Cardiology and Hypertension, Central Clinical Hospital, Ministry of the Interior, Warsaw
[3] Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw
[4] Department of Internal Diseases and Endocrinology, Medical University of Warsaw, Warsaw
[5] Medical Centre, Medical University of Warsaw, Warsaw
关键词
Adipokines; Aspirin; Diabetes mellitus; Insulin resistance; Platelet aggregation;
D O I
10.1186/s12933-014-0112-0
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学科分类号
摘要
Background: Evidence from the literature suggests diminished acetylsalicylic acid (ASA) treatment efficacy in type 2 diabetes (DM2). High on-aspirin platelet reactivity (HAPR) in DM2 has been linked to poor glycemic and lipid control. However, there are no consistent data on the association between HAPR and insulin resistance or adipose tissue metabolic activity. The aim of this study was to assess the relationship between laboratory response to ASA and metabolic control, insulin resistance and adipokines in DM2.Methods: A total of 186 DM2 patients treated with oral antidiabetic drugs and receiving 75 mg ASA daily were included in the analysis. Response to ASA was assessed by measuring serum thromboxane B2 (TXB2) concentration and expressed as quartiles of TXB2 level. The achievement of treatment targets in terms of glycemic and lipid control, insulin resistance parameters (including Homeostatic Model Assessment-Insulin Resistance, HOMA-IR, index), and serum concentrations of high-molecular weight (HMW) adiponectin, leptin and resistin, were evaluated in all patients. Univariate and multivariate logistic regression analyses were performed to determine the predictive factors of serum TXB2 concentration above the upper quartile and above the median.Results: Significant trends in age, body mass index (BMI), HOMA-IR, HMW adiponectin concentration, C-reactive protein concentration and the frequency of achieving target triglyceride levels were observed across increasing quartiles of TXB2. In a multivariate analysis, only younger age and higher BMI were independent predictors of TXB2 concentration above the upper quartile, while younger age and lower HMW adiponectin concentration were predictors of TXB2 concentration above the median.Conclusions: These results suggest that in DM2, the most important predictor of HAPR is younger age. Younger DM2 patients may therefore require total daily ASA doses higher than 75 mg, preferably as a twice-daily regimen, to achieve full therapeutic effect. Higher BMI and lower HMW adiponectin concentration were also associated with less potent ASA effect. This is the first study to demonstrate an association of lower adiponectin concentration with higher serum TXB2 level in patients treated with ASA. © 2014 Kaplon-Cieslicka et al.; licensee BioMed Central Ltd.
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[1]  
Ryden L., Grant P.J., Anker S.D., Berne C., Cosentino F., Danchin N., Deaton C., Escaned J., Hammes H.P., Huikuri H., Marre M., Marx N., Mellbin L., Ostergren J., Patrono C., Seferovic P., Uva M.S., Taskinen M.R., Tendera M., Tuomilehto J., Valensi P., Zamorano J.L., ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: the Task Force on diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and de
[2]  
Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients, BMJ, 324, pp. 71-86, (2002)
[3]  
Crescente M., Di Castelnuovo A., Iacoviello L., Vermylen J., Cerletti C., de Gaetano G., Response variability to aspirin as assessed by the platelet function analyzer (PFA)-100. A systematic review, Thromb Haemost, 99, pp. 14-26, (2008)
[4]  
Simpson S.H., Abdelmoneim A.S., Omran D., Featherstone T.R., Prevalence of high on-treatment platelet reactivity in diabetic patients treated with aspirin, Am J Med, 127, (2014)
[5]  
Takahashi S., Ushida M., Komine R., Shimizu A., Uchida T., Ishihara H., Shibano T., Watanabe G., Ikeda Y., Murata M., Increased basal platelet activity, plasma adiponectin levels, and diabetes mellitus are associated with poor platelet responsiveness to in vitro effect of aspirin, Thromb Res, 119, pp. 517-524, (2007)
[6]  
Ertugrul D.T., Tutal E., Yildiz M., Akin O., Yalcin A.A., Ure O.S., Yilmaz H., Yavuz B., Deveci O.S., Ata N., Kucukazman M., Aspirin resistance is associated with glycemic control, the dose of aspirin, and obesity in type 2 diabetes mellitus, J Clin Endocrinol Metab, 95, pp. 2897-2901, (2010)
[7]  
Mylotte D., Kavanagh G.F., Peace A.J., Tedesco A.F., Carmody D., O'Reilly M., Foley D.P., Thompson C.J., Agha A., Smith D., Kenny D., Platelet reactivity in type 2 diabetes mellitus: a comparative analysis with survivors of myocardial infarction and the role of glycaemic control, Platelets, 23, pp. 439-446, (2012)
[8]  
DiChiara J., Bliden K.P., Tantry U.S., Hamed M.S., Antonino M.J., Suarez T.A., Bailon O., Singla A., Gurbel P.A., The effect of aspirin dosing on platelet function in diabetic and nondiabetic patients: an analysis from the aspirin-induced platelet effect (ASPECT) study, Diabetes, 56, pp. 3014-3019, (2007)
[9]  
Mortensen S.B., Larsen S.B., Grove E.L., Kristensen S.D., Hvas A.M., Reduced platelet response to aspirin in patients with coronary artery disease and type 2 diabetes mellitus, Thromb Res, 126, pp. e318-e322, (2010)
[10]  
Kuliczkowski W., Witkowski A., Polonski L., Watala C., Filipiak K., Budaj A., Golanski J., Sitkiewicz D., Pregowski J., Gorski J., Zembala M., Opolski G., Huber K., Arnesen H., Kristensen S.D., De Caterina R., Interindividual variability in the response to oral antiplatelet drugs: a position paper of the Working Group on antiplatelet drugs resistance appointed by the Section of Cardiovascular Interventions of the Polish Cardiac Society, endorsed by the Working Group on Thrombosis of the Europea