Using flow-cytometry in measuring platelet activity in type 2 diabetes and predicting macrovascular complications

Platelets are hyperactive in patients with type2 diabetes (T2DM), they adhere to vascular endothelium and play a key role in macrovascular complications. Platelets activity can be measured by flow-cytometry (cluster of differentiation (CD) 41, CD 42, CD 62, CD 63), which allows detection of surface antigens in a sensitive and specific manner. This study aimed to describe platelets activity in T2DM in association with cardiovascular and cerebrovascular complications in relation to duration of diabetes (DM). This was a case-control study with 130 participants (65 diabetic cases and 65 normal controls). All cases were subjected to history and clinical examination, base-line laboratory investigations and surface expression of platelets receptors e.g. CD 41% and mean fluorescent intensity (MFI), CD 42% and MFI, CD 62% and MFI, CD 63% and MFI were determined by flow-cytometry. There was a statistically significant higher expression of CD 62%, CD 62 MFI, CD 63% and CD 63 MFI (p<0.001 for all) in diabetic cases compared to controls. There were significantly higher CD 62 %, CD 62 MFI, CD 63% and CD 63 MFI in cases with cardiovascular complications (p=0.001, p<0.001, p=0.05 and p=0.007, respectively) and in cases with cerebrovascular complications compared to cases without complications (p=0.05, p=0.008, p=0.035, p=0.017, respectively). A significant positive correlation was found between glycated hemoglobin, body mass index and CD 62 %, CD 62 MFI and CD 63%. Using the receiver operating characteristic curve showed that CD 62 %, CD 62 MFI, CD 63 % and CD 63 MFI have a diagnostic ability to early predict DM (area under the curve (AUC)=0.998) as well as cardiovascular (AUC=0.855) and cerebrovascular (AUC=0.765) complications. In conclusion CD 62%, CD 62 MFI, CD 63% and CD 63 MFI markers have a diagnostic ability for early prediction of cardiovascular and cerebrovascular complications among diabetic patients.