INFLU ENCE OF DI ET THERAPY ON PLATELET AGGREGATION, VON WILL EBRAND FACTOR AND SOLU BLE FIBRIN IN PATIENTS WITH CARBOHYD RATE METABOLI SM DI SORDERS
DOI:
https://doi.org/10.32689/2663-0672-2025-4-8Keywords:
dietary carbohydrate restriction, basal insulin, vascular-platelet hemostasis, coagulation, thrombogenesisAbstract
Background. Diet therapy is a powerful means of correcting the human’s metabolism. However, the effect of dietary nutrition on hemostasis is not sufficiently elucidated. Objective. To study the effect of a dietary carbohydrate restriction up to 250 g per day on the vascular-platelet and coagulation links of hemostasis in patients with carbohydrate metabolism disorders and to evaluate its effect on carbohydrate metabolism. Materials and methods. 76 patients aged 27 to 64 years with hyperinsulinemia and an increased body mass index (BMI) were examined. Patients were divided into group I (26 patients who were prescribed standard drug therapy) and group II (50 patients who were prescribed basic drug therapy and a low-carbohydrate diet (up to 250 g of carbohydrates per day)). Before and after 12 weeks of the study, the following parameters were measured: BMI according to the standard formula, fasting blood glucose by the glucose oxidase-peroxidase method, basal insulin by the radioimmunoassay method, platelet aggregation (PA) by the spectrophotometric method with the aggregation inducer ristocetin, concentrations of von Willebrand factor (VWF) and soluble fibrin (SF) by the ELISA method. Statistical analysis was performed using the SPSS 22.0 program. Results. In group II after 12 weeks a decrease in basal insulin (p=0.02), but not BMI (p=0.16) and fasting glucose (p=o.09), improvement in ristocetin-induced PA (p=0.01), decrease in VWF (p=0.003) and SF (p=0.02) concentrations were registered unlike in group I. Conclusions. A dietary carbohydrate restriction up to 250 g per day is recommended to patients with carbohydrate metabolism disorders.
References
Alsharidah A. S. Diabetes mellitus and diabetic nephropathy: a review of the literature on hemostatic changes in coagulation and thrombosis. Blood Research. 2022. Vol. 57, № 2. P. 101–105. DOI: 10.5045/br.2022.2021204.
Barale C., Russo I. Influence of cardiometabolic risk factors on platelet function. International Journal of Molecular Sciences. 2020. Vol. 21, № 2. P. 623. DOI: 10.3390/ijms21020623.
Celada P., Olmedilla-Alonso B., Delgado-Pando G. et al. Coagulation, thrombogenesis, and insulin resistance markers in increased-cardiovascular-risk subjects consuming improved-fat meat products. Journal of the American College of Nutrition. 2019. Vol. 38, № 4. P. 334–341. DOI: 10.1080/07315724.2018.1513345.
Cosemans J. M., Iserbyt B. F., Deckmyn H. et al. Multiple ways to switch platelet integrins on and off. Journal of Thrombosis and Haemostasis. 2008. Vol. 6, № 8. P. 1253–1261. DOI: 10.1111/j.1538-7836.2008.03041.x.
de Vries J. J., Hoppenbrouwers T., Martinez-Torres C. et al. Effects of diabetes mellitus on fibrin clot structure and mechanics in a model of acute neutrophil extracellular traps (NETs) formation. International Journal of Molecular Sciences. 2020. Vol. 21, № 19. P. 7107. DOI: 10.3390/ijms21197107.
Iba T., Wada H., Levy J. H. Platelet activation and thrombosis in COVID-19. Seminars in Thrombosis and Hemostasis. 2023. Vol. 49, № 1. P. 55–61. DOI: 10.1055/s-0042-1749441.
Juhász A. E., Stubnya M. P., Teutsch B. et al. Ranking the dietary interventions by their effectiveness in the management of polycystic ovary syndrome: a systematic review and network meta-analysis. Reproductive Health. 2024. Vol. 21, № 1. Art. 28. DOI: 10.1186/s12978-024-01758-5.
Kramarova V., Tyravska Yu. Korektsiia trombotsytarnoi lanky hemostazu v patsiientiv z metabolichnym syndromom shliakhom diietychnoho kharchuvannia. Ukraina. Zdorovia natsii. 2025. № 1. P. 77–80. DOI: 10.32782/2077-6594/2025.1/15.
Lichota A., Szewczyk E. M., Gwozdzinski K. Factors affecting the formation and treatment of thrombosis by natural and synthetic compounds. International Journal of Molecular Sciences. 2020. Vol. 21, № 21. P. 7975. DOI: 10.3390/ijms21217975
Ludwig D. S., Apovian C. M., Aronne L. J. et al. Competing paradigms of obesity pathogenesis: energy balance versus
carbohydrate–insulin models. European Journal of Clinical Nutrition. 2022. Vol. 76, № 9. P. 1209–1221. DOI: 10.1038/s41430-022-01179-2.
Mashayekhi M., Beckman J. A., Nian H. et al. Comparative effects of weight loss and incretin-based therapies on vascular endothelial function, fibrinolysis and inflammation in individuals with obesity and prediabetes. Diabetes, Obesity and Metabolism. 2023. Vol. 25, № 2. P. 570–580. DOI: 10.1111/dom.14903.
Mensah E. O., Danyo E. K., Asase R. V. Exploring the effect of different diet types on ageing and age-related diseases. Nutrition. 2025. Vol. 129, № 1. Art. 112596. DOI: 10.1016/j.nut.2024.112596.
O’Hara A., Pozin J., Darki A. et al. Glycemic control and plasma levels of pro-inflammatory and pro-thrombotic biomarkers in diabetic patients presenting with acute pulmonary embolism. Clinical and Applied Thrombosis/Hemostasis. 2023. Vol. 29. Art. 10760296231165058. DOI: 10.1177/10760296231165058.
Oishi K., Uchida D., Ohkura N. et al. Ketogenic diet disrupts the circadian clock and increases hypofibrinolytic risk by inducing expression of plasminogen activator inhibitor-1. Arteriosclerosis, Thrombosis, and Vascular Biology. 2009. Vol. 29, № 10. P. 1571–1577. DOI: 10.1161/ATVBAHA.109.190140.
Raj P. N., Gopinath M., Hafeez M., An R. To study the platelet indices as a predictor of microvascular complications in type 2 diabetes mellitus. Journal of the Association of Physicians of India. 2022. Vol. 70, № 4. P. 11–12.
Russo M. P., Grande-Ratti M. F., Burgos M. A. Prevalence of diabetes, epidemiological characteristics and vascular complications. Archivos de Cardiología de México. 2023. Vol. 93, № 1. P. 30–36. DOI: 10.24875/ACM.21000410.
Verma S. K., Kalra S. The diabetic platelets. Journal of the Pakistan Medical Association. 2023. Vol. 73, № 5. P. 1130–1133. DOI: 10.47391/JPMA.23-34.
Yannakoulia M., Scarmeas N. Diets. New England Journal of Medicine. 2024. Vol. 390, № 22. P. 2098–2106. DOI: 10.1056/NEJMra2211889.
Yuan S., Bruzelius M., Damrauer S. M. et al. Anti-inflammatory diet and venous thromboembolism: two prospective cohort studies. Nutrition, Metabolism and Cardiovascular Diseases. 2021. Vol. 31, № 10. P. 2831–2838. DOI: 10.1016/j.numecd.2021.06.021.
