Gestational diabetes mellitus is associated with in vivo platelet activation and platelet hyperreactivity

Copyright © 2024. Published by Elsevier Inc..

OBJECTIVE: Gestational diabetes mellitus (GDM) is associated with obstetrical and long-term cardiovascular complications. While platelet hyperresponsiveness in type-2 diabetes mellitus has been well-characterized and shown to play a crucial role in cardiovascular complications, this aspect has been little studied in GDM. We aimed to evaluate platelet reactivity, in vivo platelet activation, and endothelial function in GDM compared with normal pregnancy.

RESEARCH DESIGN AND METHODS: Prospective case-control study including 23 GDM and 23 healthy pregnant (HP) women studied at 26-28, 34-36 weeks of gestation and 8 weeks post-partum. Platelet reactivity and in vivo platelet activation, including light transmission aggregometry, PFA-100®, platelet activation antigen expression, platelet adhesion under flow, platelet Nitric Oxide (NO) and reactive oxygen species production, as well as endothelial dysfunction markers, were assessed.

RESULTS: The study of platelet function showed a condition of platelet hyperreactivity in GDM compared with HP women at enrollment, further enhanced at the end of pregnancy, which tended to decrease 2 months after delivery but remained still higher in GDM. In vivo platelet activation was also evident in GDM, especially at the end of pregnancy, in part persisting upto 8 weeks after delivery. Finally, GDM women showed defective platelet NO production and endothelial dysfunction compared with HP.

CONCLUSIONS: Our data show that GDM generates a condition of platelet hyperreactivity that in part persists upto two months after delivery. Impaired platelet sensitivity to NO and reduced platelet and endothelial NO production may contribute to the platelet hyperreactivity condition. Platelet hyperreactivity may play a role in the long-term cardiovascular complications of GDM women.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

American journal of obstetrics and gynecology - (2024) vom: 04. Apr.

Sprache:

Englisch

Beteiligte Personen:

Guglielmini, Giuseppe [VerfasserIn]
Falcinelli, Emanuela [VerfasserIn]
Piselli, Elisa [VerfasserIn]
Mezzasoma, Anna Maria [VerfasserIn]
Tondi, Francesca [VerfasserIn]
Alfonsi, Luisa [VerfasserIn]
De Luca, Caterina [VerfasserIn]
Fino, Valeria [VerfasserIn]
Favilli, Alessandro [VerfasserIn]
Parrettini, Sara [VerfasserIn]
Minuz, Pietro [VerfasserIn]
Torlone, Elisabetta [VerfasserIn]
Gresele, Paolo [VerfasserIn]
Gerli, Sandro [VerfasserIn]

Links:

Volltext

Themen:

Endothelial dysfunction
GDM pregnancy
Gestational diabetes mellitus
In vitro platelet reactivity
In vivo platelet activation
Journal Article
Nitric oxide
Platelet hyperreactivity
Platelets
Reactive oxygen species

Anmerkungen:

Date Revised 06.04.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1016/j.ajog.2024.04.003

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM37071699X