PaperFibrinogen binding and ADP-induced aggregation in platelets from diabetic subjects
Review articleOpen access

AbstractThe factors responsible for the platelet hyperaggregability often found in diabetics are obscure. Since fibrinogen is essential for ADP-induced aggregation and specific fibrinogen receptors exist on the platelet membrane, ADP-induced platelet aggregation and fibrinogen binding were measured in 16 diabetics (8 background and 7 proliferative retinopathy, 1 maculopathy) and 9 non-diabetic controls. The velocity of platelet aggregation induced by a range of concentrations of ADP was measured and the 1/Km (1/μM ADP) derived from a Lineweaver-Burk plot. 125I-fibrinogen binding was measured in washed platelets and expressed as per cent total radioactivity. Metabolic control of diabetes was assessed by HbA1. Mean per cent specific fibrinogen binding 15 min after the addition of ADP was significantly increased in the 8 diabetics with severe retinopathy compared to controls (5.08 ± 1.04 SEM vs 3.04 ± 0.53: p<0.05). Platelets from diabetics with and without severe retinopathy were significantly more sensitive to ADP-induced aggregation (mean 1/Km0.74±0.13 SEM vs 0.36 ±0.08; p<0.05) and a highly significant correlation with HbA1 was found (r + 0.79; p<0.001). There was no correlation between percentage bound fibrinogen and 1/Km. Thus the increased fibrinogen binding found in these diabetics appears to be associated with the presence of retinopathy, whereas the increased sensitivity of platelets to ADP may also be related to poor metabolic control.

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