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Plasma Cofactors of Platelet Function: Correlation with Diabetic Retinopathy and Hemoglobins Ala-c: Studies in Diabetic Patients and Normal Persons

BARRY S. COLLER, M.D.; ROBERT N. FRANK, M.D.; ROY C. MILTON, Ph.D.; and HARVEY R. GRALNICK, M.D., F.A.C.P.
[+] Article and Author Information

▸Requests for reprints should be addressed to Barry S. Coller, M.D.; Division of Hematology, State University of New York at Stony Brook, Health Sciences Center; Stony Brook, NY 11794.


Bethesda, Maryland


Ann Intern Med. 1978;88(3):311-316. doi:10.7326/0003-4819-88-3-311
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We studied 29 diabetic patients (eight without and 21 with retinopathy) and 29 matched control subjects for hemoglobins Ala-c and plasma levels of fibrinogen, von Willebrand factor, and factor VIII/von Willebrand factor antigen. Hemoglobins Ala-c were elevated in all diabetic patients, regardless of retinopathy (P < 0.001); fibrinogen was elevated only in those with retinopathy (P < 0.001); and plasma von Willebrand factor was clearly elevated in those with proliferative retinopathy and minimally, if at all, elevated in those with background or no retinopathy. Plasma from five diabetic patients with proliferative retinopathy and five control subjects was tested for its ability to enhance the ADP-induced platelet aggregation of normal or von Willebrand platelet-rich plasma; no differences were found. We conclude that elevated levels of fibrinogen and von Willebrand factor, both recognized plasma cofactors of platelet function, are associated with proliferative diabetic retinopathy. A plasma factor that enhances ADP-induced platelet aggregation could not be found in diabetic plasma, and we doubt that increased von Willebrand factor is responsible for its finding by others.

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