Increased platelet function during frailty

Abstract

Frailty is highly associated with cardiovascular diseases (CVD) and diabetes mellitus (DM). Aging, CVD, and DM are all associated with an increase in platelet function. Therefore, the aim of this study was to evaluate platelet function during frailty. We selected a total of 37 older adults who were divided into two groups, frail (n = 16) and robust (n = 21), with a mean age of 72.4 ± 4.4 years (range: 65-84 years) in robust adults and 72.6 ± 6.6 years (range: 65-88 years) in frail adults; 20 young healthy volunteers, with a mean age of 22.9 ± 2.7 years (range: 20-30 years), were included as a control platelet function was determined using the lumi-aggregometer (aggregation) and flow cytometry (platelet activation). We also performed Western blot to evaluate the intraplatelet activation pathways involved in activation. Platelet count decreased and mean platelet volume, aggregation, and P-selectin expression increased during aging compared with young adults was found. We observed an increase in P-selectin expression in frail adults compared with robust adults. We also evaluated the characteristics of the study population to explain this difference and found a higher prevalence of DM and a tendency toward hyperglycemia in frail adults compared with robust adults. In agreement with this, high doses of glucose were able to increase platelet aggregation and P-selectin expression through thrombin receptors and p38 phosphorylation.