Platelet sodium-proton exchanger and phospholipid-dependent procoagulant activity in patients with type 2 diabetes

Abstract Platelet Na + /H + exchanger (NHE) activity, phospholipid-dependent thrombin generation, and platelet factor 3 (PF3) availability were measured in 83 type 2 diabetics and in 40 age- and sex-matched healthy subjects. Na + /H + exchanger activity was significantly increased in diabetic patients in comparison to the controls (κ = 4.29 ± 0.71 × 10 −3 × s −1 v 3.21 ± 0.64 × 10 −3 × s −1 , P −3 × s −1 ) and without (κ = 4.26 ± 0.32 ×10 −3 × s −1 ) arterial hypertension, as well as between patients with normo- and microalbuminuria or overt proteinuria (κ = 4.26 ± 0.58 × 10 −3 × s −1 , κ = 4.47 ± 0.93 × 10 −3 × s −1 and κ = 4.07 ± 0.38 ×10 −3 × s −1 , respectively). Comparatively high NHE activity was observed in the group of patients with hemoglobin A 1c (HbA 1c ) less than 7.5%. Multiple regression analysis revealed that the factors independently related to platelet Na + /H + exchanger activity were: total PF3 activity (β = 0.77, P =.011) and triglyceride (TG) concentration (β = 0.44, P =.039). Phospholipid-dependent thrombin generation and PF3 availability were also enhanced in all plasma fractions of diabetic patients, especially in platelet-poor plasma (PPP) and platelet-free plasma (PFP) ( P P + /H + exchanger activity associated with raised phospholipid-dependent procoagulant activity may increase the risk of vascular damage in type 2 diabetic patients. Copyright 2003, Elsevier Science (USA). All rights reserved.