Dynamic Role of Microparticles in Type 2 Diabetes Mellitus

Shosaku      Nomura

Abstract

Type 2 diabetes mellitus increases the risk of cerebro/cardiovascular events, since this disease leads to the development of premature atherosclerosis and atherothrombosis associated with diabetes accelerates diabetic macroangiopathy. Microparticles (MPs) released from cells (MPs) may play a role in the normal hemostatic response to vascular injury and a role in clinical diseases because they express phospholipids, which function as procoagulants. MPs were first observed as released vesicles from platelets following adhesion to vessel walls. Currently, the number of clinical disorders associated with elevated MPs is increasing. A few studies on the potential role of platelet-derived MPs in diabetic complications can be reported. MPs are elevated in diabetic patients however studies have found differences in the MP profile in relation to disease type and the presence or absence of MPs. Levels of platelet-derived MPs and monocyte-derived MPs have been shown to correlate with diabetic complications or the extent of diabetic retinopathy, which is associated with microvascular damage. Elevated endothelial cell-derived MP levels are predictive for the presence of coronary artery lesions, and it is a more significant independent risk factor than length of diabetic disease, lipid levels or presence of hypertension. Interestingly, elevated endothelial cell-derived MP levels are predictive in identifying a subpopulation of diabetic patients without typical anginal symptoms who have angiographic evidence of coronary artery disease. We will present evidence for a dynamic role of MPs in type 2 diabetes.

Keywords: Microparticle, Procoagulant activity, Endothelial cell, Atherothrombosis, Type 2 diabetes