Increased levels of platelet activation markers are positively associated with carotid wall thickness and other atherosclerotic risk factors in obese patients

Éva Csongrádi; Bela Nagy Jr; Tibor Fulop; Zsuzsa Varga; Zsolt Karányi; Mária T. Magyar; László Oláh; Mária Papp; Andrea Facskó; János Kappelmayer; György Paragh; Miklós Káplar

doi:10.1160/TH11-01-0030

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2011; 106(04): 683-692
DOI: 10.1160/TH11-01-0030

Platelets and Blood Cells

Schattauer GmbH

Increased levels of platelet activation markers are positively associated with carotid wall thickness and other atherosclerotic risk factors in obese patients

Authors

Éva Csongrádi

¹1^st Department of Medicine, Medical and Health Science Center, University of Debrecen, Hungary

²Department of Physiology & Biophysics, Center for Excellence in Cardiovascular-Renal Research, University of Mississippi Medical Center, Jackson, Mississippi, USA
Bela Nagy Jr

³Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Center, University of Debrecen, Hungary
Tibor Fulop

⁴Department of Medicine, Division of Nephrology, University of Mississippi Medical Center, Jackson, Mississippi, USA
Zsuzsa Varga

¹1^st Department of Medicine, Medical and Health Science Center, University of Debrecen, Hungary
Zsolt Karányi

¹1^st Department of Medicine, Medical and Health Science Center, University of Debrecen, Hungary
Mária T. Magyar

⁵Department of Neurology, Medical and Health Science Center, University of Debrecen, Hungary
László Oláh

⁵Department of Neurology, Medical and Health Science Center, University of Debrecen, Hungary
Mária Papp

⁶2^nd Department of Medicine, Medical and Health Science Center, University of Debrecen, Hungary
Andrea Facskó

⁷Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Hungary
János Kappelmayer

³Department of Clinical Biochemistry and Molecular Pathology, Medical and Health Science Center, University of Debrecen, Hungary
György Paragh

¹1^st Department of Medicine, Medical and Health Science Center, University of Debrecen, Hungary
Miklós Káplar

¹1^st Department of Medicine, Medical and Health Science Center, University of Debrecen, Hungary

Abstract

Summary

The role of platelets in the development of atherosclerosis and obesity-related prothrombotic state is still under investigation. In this cross-sectional cohort study, we measured the levels of different platelet activation markers and evaluated their relationship with carotid intima-media thickness (IMT) along with other atherosclerotic risk factors in obese patients with or without atherosclerotic co-morbidities. We enrolled 154 obese patients, including 98 with either hypertension, type 2 diabetes mellitus or dyslipidaemia, 56 without these co-morbidities and 62 age- and sex-matched healthy controls. Platelet P-selectin expression and the number of platelet-derived microparticles (PMPs) were measured by flow cytometry; soluble P-selectin levels were analysed by ELISA and Thr715Pro P-selectin polymorphism was determined by PCR-RFLP. Carotid IMT was examined by ultrasonography. The levels of platelet activation parameters were significantly elevated in all obese subjects with increased carotid IMT compared to healthy controls. There was no effect of Thr715Pro genotype on soluble P-selectin levels in obese individuals contrary to normal subjects. Significant and positive association was revealed between carotid IMT and platelet P-selectin (p<0.0001), soluble P-selectin (p=0.039) and PMP (p=0.0001) levels. After adjusting for multiple variables, independent association was found between soluble P-selectin and fibrinogen (p=0.007), PMP levels and body mass index (p<0.0001) as well as platelet P-selectin and carotid IMT (p=0.012) plus plasminogen activator inhibitor-1 (p=0.009). In conclusion, P-selectin and PMP levels showed positive associations with abnormal carotid IMT and other risk factors in obesity suggesting a critical role of enhanced platelet reactivity in atherosclerotic wall alteration.

Keywords

Atherosclerosis - platelets - carotid intima-media thickness - P-selectin - microparticles - obesity - Thr715Pro polymorphism

Full Text

References

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