Younger age, higher body mass index and lower adiponectin concentration predict higher serum thromboxane B2 level in aspirin-treated patients with type 2 diabetes: an observational studyReport as inadecuate




Younger age, higher body mass index and lower adiponectin concentration predict higher serum thromboxane B2 level in aspirin-treated patients with type 2 diabetes: an observational study - Download this document for free, or read online. Document in PDF available to download.

Cardiovascular Diabetology

, 13:112

First Online: 15 August 2014Received: 23 April 2014Accepted: 08 July 2014

Abstract

BackgroundEvidence from the literature suggests diminished acetylsalicylic acid ASA treatment efficacy in type 2 diabetes DM2. High on-aspirin platelet reactivity HAPR in DM2 has been linked to poor glycemic and lipid control. However, there are no consistent data on the association between HAPR and insulin resistance or adipose tissue metabolic activity. The aim of this study was to assess the relationship between laboratory response to ASA and metabolic control, insulin resistance and adipokines in DM2.

MethodsA total of 186 DM2 patients treated with oral antidiabetic drugs and receiving 75 mg ASA daily were included in the analysis. Response to ASA was assessed by measuring serum thromboxane B2 TXB2 concentration and expressed as quartiles of TXB2 level. The achievement of treatment targets in terms of glycemic and lipid control, insulin resistance parameters including Homeostatic Model Assessment-Insulin Resistance, HOMA-IR, index, and serum concentrations of high-molecular weight HMW adiponectin, leptin and resistin, were evaluated in all patients. Univariate and multivariate logistic regression analyses were performed to determine the predictive factors of serum TXB2 concentration above the upper quartile and above the median.

ResultsSignificant trends in age, body mass index BMI, HOMA-IR, HMW adiponectin concentration, C-reactive protein concentration and the frequency of achieving target triglyceride levels were observed across increasing quartiles of TXB2. In a multivariate analysis, only younger age and higher BMI were independent predictors of TXB2 concentration above the upper quartile, while younger age and lower HMW adiponectin concentration were predictors of TXB2 concentration above the median.

ConclusionsThese results suggest that in DM2, the most important predictor of HAPR is younger age. Younger DM2 patients may therefore require total daily ASA doses higher than 75 mg, preferably as a twice-daily regimen, to achieve full therapeutic effect. Higher BMI and lower HMW adiponectin concentration were also associated with less potent ASA effect. This is the first study to demonstrate an association of lower adiponectin concentration with higher serum TXB2 level in patients treated with ASA.

KeywordsAspirin Platelet aggregation Diabetes mellitus Insulin resistance Adipokines AbbreviationsASAAcetylsalicylic acid

BMIBody mass index

CIConfidence interval

COXCyclooxygenase

DM2Type 2 diabetes mellitus

HAPRHigh on-aspirin platelet reactivity

HMWHigh-molecular weight

HOMA-IRHomeostatic Model Assessment-Insulin Resistance

OROdds ratio

TXB2Thromboxane B2

Electronic supplementary materialThe online version of this article doi:10.1186-s12933-014-0112-0 contains supplementary material, which is available to authorized users.

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Author: Agnieszka Kaplon-Cieslicka - Marek Postula - Marek Rosiak - Michal Peller - Agnieszka Kondracka - Agnieszka Serafin - Ewa T

Source: https://link.springer.com/article/10.1186/s12933-014-0112-0







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