Published online Apr 15, 2015. doi: 10.4239/wjd.v6.i3.423
Peer-review started: September 1, 2014
First decision: November 27, 2014
Revised: January 12, 2015
Accepted: January 30, 2015
Article in press: February 2, 2015
Published online: April 15, 2015
Processing time: 231 Days and 1.3 Hours
Diabetes mellitus (DM) is an extremely common disorder which carries a risk of vascular impairment. DM type 2 (DM2) can be characterized by the dysfunction of haemostasis manifesting by stimulated coagulation process, disorder of platelet function and decreased fibrinolytic activity. These all are the reasons why DM2 is the most common acquired thrombophilia. Endothelial dysfunction along with platelet hyperactivity are unquestionably involved in the hyperactivation of platelets and clotting factors in DM. As a natural consequence of continuous investigation, many markers of endothelial dysfunction and diabetic thrombocytopathy have been identified and considered for implementation in clinical practice. Endothelial function can be assessed by the evaluation of endothelial markers, circulating molecules synthesised in various amounts by the endothelium. These markers precede the signs of evident microangiopathy. Platelets have an ethiopathogenic relation to the microangiopathy in DM. Their increased activity was confirmed in both types of DM. Predictors of endothelial and platelet disorder could improve the screening of individuals at increased risk, thus leading to the early diagnosis, appropriate treatment, as well as to the effective prevention of the complications of DM2. In the article we deal with the mechanisms involved in the pathogenesis of endothelial and platelet functional abnormalities, endothelial and platelet markers of DM2 considered for implementation in clinical practice and possibilities of their detection.
Core tip: Number of diabetics increases, what leads to worldwide increasing diabetes-associated vascular events. Moreover, diabetes mellitus type 2 is the most common acquired thrombophilia. Therefore, to prevent life-threatening vascular complications in subjects with diabetes, mechanisms and markers of endothelial and platelet dysfunction have been investigated. In order to contribute to better management of discussed patients and to increase knowledge about their origin, in this article we tried to summarize the pathogenesis of endothelial and platelet dysfunction and to characterize possible predictors of abnormalities of endothelium and platelets, as well as methods of their detection.