Aspirin resistance associated with HbA1c and obesity in diabetic patients

Hillel W. Cohen, Jill P. Crandall, Susan M. Hailpern, Henny H. Billett

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Introduction: Diabetes is known to be a prothrombotic state. Since serotonin uptake plays a role in both platelet activation and depression, we undertook to examine a hypothesis that aspirin resistance (AR) may be associated with both HbA1c and depressive symptoms and to assess other potential determinants of AR in diabetic patients. Methods: A whole-blood desktop platelet function analyzer (PFA-100) with an epinephrine agonist was used to assess AR among patients with type 2 diabetes. AR was defined as PFA closure times <192 s. Depression symptoms were assessed with the Physicians Health Questionnaire. Patients being treated for type 2 diabetes (N=48) who took aspirin within the past 24 h constituted the study sample. Associations with AR were assessed with the use of the Mann-Whitney test and Fisher's Exact Test as well as with logistic regression models. Results: AR was observed in 11 patients (23%) and was not significantly associated with age, sex, or race. AR was significantly associated with HbA1c≥8% (P=.002) and obesity (BMI≥30 kg/m2; P=.01) and borderline associated with having ≥1 depressive symptom (P=.07). Results were similar after multivariable adjustment in logistic regression models. No statistically significant associations of AR with age, sex, race, plasma glucose, blood pressure, cholesterol, or smoking were observed. Conclusion: These data suggest that AR may be of special concern for diabetic patients with poor glucose control and obesity. Whether the PFA-100 or any other practical measure of AR can be used in clinical practice to identify added cardiovascular disease risk and to inform platelet inhibition therapy needs further study.

Original languageEnglish (US)
Pages (from-to)224-228
Number of pages5
JournalJournal of Diabetes and its Complications
Volume22
Issue number3
DOIs
StatePublished - May 2008

Fingerprint

Aspirin
Obesity
Logistic Models
Depression
Type 2 Diabetes Mellitus
Blood Platelets
Social Adjustment
Glucose
Platelet Activation
Epinephrine
Serotonin
Cardiovascular Diseases
Smoking
Cholesterol
Blood Pressure
Physicians
Health

Keywords

  • Aspirin
  • Diabetes
  • Drug resistance
  • HbA1c
  • Obesity

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Aspirin resistance associated with HbA1c and obesity in diabetic patients. / Cohen, Hillel W.; Crandall, Jill P.; Hailpern, Susan M.; Billett, Henny H.

In: Journal of Diabetes and its Complications, Vol. 22, No. 3, 05.2008, p. 224-228.

Research output: Contribution to journalArticle

@article{d83622896f4c476cb9a49f7069a04e61,
title = "Aspirin resistance associated with HbA1c and obesity in diabetic patients",
abstract = "Introduction: Diabetes is known to be a prothrombotic state. Since serotonin uptake plays a role in both platelet activation and depression, we undertook to examine a hypothesis that aspirin resistance (AR) may be associated with both HbA1c and depressive symptoms and to assess other potential determinants of AR in diabetic patients. Methods: A whole-blood desktop platelet function analyzer (PFA-100) with an epinephrine agonist was used to assess AR among patients with type 2 diabetes. AR was defined as PFA closure times <192 s. Depression symptoms were assessed with the Physicians Health Questionnaire. Patients being treated for type 2 diabetes (N=48) who took aspirin within the past 24 h constituted the study sample. Associations with AR were assessed with the use of the Mann-Whitney test and Fisher's Exact Test as well as with logistic regression models. Results: AR was observed in 11 patients (23{\%}) and was not significantly associated with age, sex, or race. AR was significantly associated with HbA1c≥8{\%} (P=.002) and obesity (BMI≥30 kg/m2; P=.01) and borderline associated with having ≥1 depressive symptom (P=.07). Results were similar after multivariable adjustment in logistic regression models. No statistically significant associations of AR with age, sex, race, plasma glucose, blood pressure, cholesterol, or smoking were observed. Conclusion: These data suggest that AR may be of special concern for diabetic patients with poor glucose control and obesity. Whether the PFA-100 or any other practical measure of AR can be used in clinical practice to identify added cardiovascular disease risk and to inform platelet inhibition therapy needs further study.",
keywords = "Aspirin, Diabetes, Drug resistance, HbA1c, Obesity",
author = "Cohen, {Hillel W.} and Crandall, {Jill P.} and Hailpern, {Susan M.} and Billett, {Henny H.}",
year = "2008",
month = "5",
doi = "10.1016/j.jdiacomp.2007.05.002",
language = "English (US)",
volume = "22",
pages = "224--228",
journal = "Journal of Diabetes and its Complications",
issn = "1056-8727",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Aspirin resistance associated with HbA1c and obesity in diabetic patients

AU - Cohen, Hillel W.

AU - Crandall, Jill P.

AU - Hailpern, Susan M.

AU - Billett, Henny H.

PY - 2008/5

Y1 - 2008/5

N2 - Introduction: Diabetes is known to be a prothrombotic state. Since serotonin uptake plays a role in both platelet activation and depression, we undertook to examine a hypothesis that aspirin resistance (AR) may be associated with both HbA1c and depressive symptoms and to assess other potential determinants of AR in diabetic patients. Methods: A whole-blood desktop platelet function analyzer (PFA-100) with an epinephrine agonist was used to assess AR among patients with type 2 diabetes. AR was defined as PFA closure times <192 s. Depression symptoms were assessed with the Physicians Health Questionnaire. Patients being treated for type 2 diabetes (N=48) who took aspirin within the past 24 h constituted the study sample. Associations with AR were assessed with the use of the Mann-Whitney test and Fisher's Exact Test as well as with logistic regression models. Results: AR was observed in 11 patients (23%) and was not significantly associated with age, sex, or race. AR was significantly associated with HbA1c≥8% (P=.002) and obesity (BMI≥30 kg/m2; P=.01) and borderline associated with having ≥1 depressive symptom (P=.07). Results were similar after multivariable adjustment in logistic regression models. No statistically significant associations of AR with age, sex, race, plasma glucose, blood pressure, cholesterol, or smoking were observed. Conclusion: These data suggest that AR may be of special concern for diabetic patients with poor glucose control and obesity. Whether the PFA-100 or any other practical measure of AR can be used in clinical practice to identify added cardiovascular disease risk and to inform platelet inhibition therapy needs further study.

AB - Introduction: Diabetes is known to be a prothrombotic state. Since serotonin uptake plays a role in both platelet activation and depression, we undertook to examine a hypothesis that aspirin resistance (AR) may be associated with both HbA1c and depressive symptoms and to assess other potential determinants of AR in diabetic patients. Methods: A whole-blood desktop platelet function analyzer (PFA-100) with an epinephrine agonist was used to assess AR among patients with type 2 diabetes. AR was defined as PFA closure times <192 s. Depression symptoms were assessed with the Physicians Health Questionnaire. Patients being treated for type 2 diabetes (N=48) who took aspirin within the past 24 h constituted the study sample. Associations with AR were assessed with the use of the Mann-Whitney test and Fisher's Exact Test as well as with logistic regression models. Results: AR was observed in 11 patients (23%) and was not significantly associated with age, sex, or race. AR was significantly associated with HbA1c≥8% (P=.002) and obesity (BMI≥30 kg/m2; P=.01) and borderline associated with having ≥1 depressive symptom (P=.07). Results were similar after multivariable adjustment in logistic regression models. No statistically significant associations of AR with age, sex, race, plasma glucose, blood pressure, cholesterol, or smoking were observed. Conclusion: These data suggest that AR may be of special concern for diabetic patients with poor glucose control and obesity. Whether the PFA-100 or any other practical measure of AR can be used in clinical practice to identify added cardiovascular disease risk and to inform platelet inhibition therapy needs further study.

KW - Aspirin

KW - Diabetes

KW - Drug resistance

KW - HbA1c

KW - Obesity

UR - http://www.scopus.com/inward/record.url?scp=42149163034&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42149163034&partnerID=8YFLogxK

U2 - 10.1016/j.jdiacomp.2007.05.002

DO - 10.1016/j.jdiacomp.2007.05.002

M3 - Article

VL - 22

SP - 224

EP - 228

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

SN - 1056-8727

IS - 3

ER -