Atherosclerosis is the leading cause of death in patients with
diabetes mellitus, increasing mortality in all forms of the disease. Classical risk factors, including
hyperlipidemia,
hypertension and
obesity, do not completely account for the increased incidence of
atherosclerosis in diabetes. Some platelet activation markers such as CD62P, CD63, PAC-1,
Annexin V and platelet-derived microparticles (
PDMP) are elevated in patients with diabetes, since diabetic platelets often have increased sensitivity to secondary aggregation in response to agonist. PDMPs are thought to play a role in clinical disease because they express
phospholipids that function as procoagulants. High shear stress can initiate both platelet aggregation and shedding of procoagulant-containing
PDMP, suggesting that
PDMP generation by high shear stress occurs in small diseased arteries and arterioles under various clinical conditions. Platelet activation markers were significantly higher in the hypertensive or hyperlipidemic patients than in the controls.
Selectins and
cell adhesion molecules were also higher in the hypertensive or hyperlipidemic patients, and they were significantly higher in these patients with diabetes. Activated microparticles and
PDMP may contribute to the development of
atherosclerosis in diabetes, and platelet activation markers seem to be useful for the assessment of vascular damage in these patients.