Toshinaga Yonemoto

State-of-the-Art Review : Effect of Sarpogrelate Hydrochloride on Platelet-Derived Microparticles and Various Soluble Adhesion Molecules in Diabetes Mellitus

We measured platelet-derived microparticles, ac tivated platelets, and various adhesion molecules in 48 patients with diabetes mellitus. We also performed a comparative study of these parameters before and after administration of sarpo grelate hydrochloride. The numbers of platelet-derived micro particles and activated platelets were increased significantly in diabetic patients, and CD63-positive platelets were increased in patients with diabetic complications and poorly controlled blood glucose. Soluble adhesion molecules and thrombomodu lin were also increased significantly. After administration of sarpogrelate hydrochloride, not only CD62p- and CD63- positive platelets, but also platelet-derived microparticles were decreased significantly. Soluble adhesion molecules and throm bomodulin were also significantly decreased after the treat ment. These data suggest that (a) in patients with diabetes, antiplatelet therapy with sarpogrelate hydrochloride is a useful antithrombin therapy because it suppresses the production of intrinsic coagulants by activated platelets; and (b) sarpogrelate hydrochloride decreases endothelial cell damage via adhesion molecules.

Serum concentration and renal handling of 1,5-anhydro-D-glucitol in patients with chronic renal failure

We measured serum and urinary 1,5-anhydro-D-glucitol (1,5-AG) during a glucose tolerance test (GTT) in patients with chronic renal failure (CRF) and compared the fractional excretion of 1,5-AG (FEAG) with that of diabetes mellitus (DM) patients and healthy controls. The mean serum 1,5-AG in CRF patients [60 ± 23(SE) μmol/L] was significantly lower than in controls (155 ± 7 μmol/L) in spite of a normal glycaemia. The levels in the CRF group were similar to those in the DM group. During GTT, the blood glucose profile in the CRF group was not significantly different from that of the control group, and urinary glucose excretion was negligible. However, FEAG was significantly higher in CRF patients than in controls. These data suggest that serum 1,5-AG in patients with CRF decreases due to a decrease in 1,5-AG reabsorption, independently of glucose excretion, and that serum and/or urinary 1,5-AG can be a useful marker for renal tubular dysfunction because the 1,5-AG reabsorption system is more vulnerable than the glucose reabsorption system.