Aspirin Resistance Is Associated with Glycemic Control, the Dose of Aspirin, and Obesity in Type 2 Diabetes Mellitus

Objective: Aspirin resistance (AR) is increased in diabetic patients. It is not known whether glycemic control has effect on AR. Design: To test the hypothesis that glycemic control might have influence on aspirin resistance, we measured aspirin resistance and glycated hemoglobin (HbA1c) in diabetic patients. We also measured aspirin resistance in nondiabetic subjects and compared the results with the diabetic group. Methods: We examined AR in 108 diabetic patients and 67 nondiabetic subjects with impedance platelet aggregometry. Glycemic control was evaluated according to both fasting blood glucose (FBG) and HbA1c levels. Results: According to the analyses, diabetic patients had significantly higher AR (P < 0.01), alanine aminotransferase (P < 0.005), and body mass index (P < 0.05) and significantly lower high-density lipoprotein cholesterol (P < 0.005) levels compared with nondiabetic controls. A correlation analysis revealed that AR was positively correlated with body mass index (r = 0.190, P < 0.01), fasting blood glucose (r = 0.224, P < 0.001), and HbA1c levels (r = 0.297, P < .0001). Using low-dose aspirin (100 mg/d) was a risk factor for aspirin-resistant status in both diabetic patients (odds ratio 1.26, 95% confidence interval 1.01-1.58, P < 0.05) and overall study group (odds ratio 1.3, 95% confidence interval 1.08-1.56, P < 0.01). Conclusions: These data suggest that glycemic control, obesity, and the dose of aspirin have influence on AR in diabetic subjects. Further studies with larger groups are needed to clarify the role of glycemic control on AR. (J Clin Endocrinol Metab 95: 2897-2901, 2010)