Correlation between platelet–monocyte aggregates and prevalence of vascular complications in type II diabetes

Background: Platelet–monocyte aggregates (PMA) play an important role in the development of microvascular disease and atheromatous lesions. Increased numbers of circulating proinflammatory monocytes, activated platelets, and/or leukocyte–platelet aggregates have been observed in patients with chronic inflammatory conditions such as diabetes mellitus (DM). Objective: The aim of the study was to investigate whether the circulating PMA levels were increased in patients with DM, whether they may be correlated to the vascular damage presently observed in DM, and whether PMA can be used as a simple marker for the early prediction of diabetic microvascular complications. Patients and methods: We examined PMA in 15 apparently healthy normal individuals who were included as the control group A, in 19 patients with DM without microvascular injuries who constituted control group B, and in 59 patients with DM with microvascular injuries who constituted group C, admitted to Benha University hospitals. All groups were subjected to a full medical history taking, thorough clinical examination and laboratory investigations (complete blood counts and measurement of the levels of cholesterol, triglycerides, serum creatinine, HbA1c), and detection of CD14 (monocyte marker) and CD41 (platelet marker) using flow cytometry.Results: There was a significant increase in the PMA% in patients with DM compared with the control group A, and it was increased in patients of group C compared with group B. Moreover, the study revealed that there was a significant positive correlation between the PMA% and glycemic state in patients with DM, represented by the HbA1c levels and a significant positive correlation between the PMA% and lipid state of patients (cholesterol and triglycerides).Conclusion: Determination of levels of circulating PMA using flow cytometry can be used as a simple marker of microvascular injury in patients with DM.