Naslov
Učinak intenzivirane terapije inzulinom na aktivnost trombocita u šećernoj bolesti
(Effect of intensified insulin therapy on platelet activities in diabetes)

Autori
Turk, Zdenka ; Flego, Iris ; Turk, Nikša ; Metelko, Željko

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Liječnički vjesnik, 119 (suppl 1) / Čikeš, Nada - Zagreb, 1997, 57-57

Skup
Prvi hrvatski dijabetološki kongres

Mjesto i datum
Dubrovnik, Hrvatska, 04.06.1997. - 07.06.1997

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Šećerna bolest; Trombociti; Intenzivirana terapija inzulinom
(Diabetes mellitus; Platelets; Intensified insulin treatment)

Sažetak
The effect of metabolic control on platelet activities was studied in 11 IDDM patients during 6 months of continuous subcutaneous insulin infusion (CSII) treatment in comparison to 3 months of conventional therapy. Patients chosen for the study were free of microvascular disease. The effectiveness of intensive therapy in lowering blood glucose was reflected in a significant HbA1c reduction (8.26&#61617; 1.78 vs 6.16&#61617; 0.46% , p<0.001). The accompanying improvement in ex vivo aggregation of platelets in response to two doses of agonists was only observed with the achievement of glycemia control (ADP: 20.84&#61617; 4.61 vs 14.84&#61617; 3.03%, p<0.001 ; arachidonic acid: 22.04&#61617; 4.26 vs 16.0&#61617; 3.15%, p<0.01). The synthesis of thromboxane-B2, as a response to arachidonate, was lower during the CSII period (TxB2:415&#61617; 51 vs 382&#61617; 46 &#61549; g/lx106 plts), but with no statistical significance. Inspite of the fact that in all patients, lipoproteins were of normal values both before and after intensified therapy (HDL-c: 1.48&#61617; 0.5 vs 1.52&#61617; 0.4 mmol/l, NS ; LDL-c:3.2&#61617; 1.3 vs 2.78&#61617; 1.0 mmol/l, NS), a significant correlation was observed between the atherogenic lipoproteins and proaggregatory thromboxane B2. Thus, in all patients, LDL-cholesterol before and during CSII showed a significant correlation with TXB2 generation (r=0.75, p<0.001), whereas at the same time its correlation with the corresponding values of HDL-cholesterol (r=-0.77, p<0.001) was negative. Along with normal fibrinogen level pre- and post-CSII (346ą79 vs 307ą56 g/l) we found a significant association between fibrinogen and ADP-induced aggregation in pretreatment period (r=0.63, p&#61500; 0.03), but during CSII treatment this association was not observed. In the present study plasma fibrinogen significantly correlated with the level of glycemia (r=0.61, p&#61500; 0.002).Results suggested that intensive insulin treatment reduced platelet aggregation in patients without microvascular disease when strict glycemia control was maintained and indicated that changes in platelet aggregation could directly result from changes in plasma glucose concentrations.

Izvorni jezik
Hrvatski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA