Effects of low-dose aspirin and fish oil on platelet function and NF-kappaB in adults with diabetes mellitus

Abstract

Introduction: Many diabetics are insensitive to aspirin's platelet anti-aggregation effects. The possible modulating effects of co-administration of aspirin and fish oil in subjects with diabetes are poorly characterized.

Participants and methods: Thirty adults with type 2 diabetes mellitus were treated with aspirin 81 mg/d for 7 days, then with fish oil 4 g/day for 28 days, then the combination of fish oil and aspirin for another 7 days.

Results: Aspirin alone and in combination with fish oil reduced platelet aggregation in most participants. Five of 7 participants classified as aspirin insensitive 1 week after daily aspirin ingestion were sensitive after the combination. Although some platelet aggregation measures correlated positively after aspirin and fish oil ingestion alone and (in combination) in all individuals, correlation was only observed in those who were aspirin insensitive after ingestion of the combination.

Conclusions: Co-administration of aspirin and fish oil may reduce platelet aggregation more than aspirin alone in adults with diabetes mellitus.

Trial registration: ClinicalTrials.gov NCT01181882.

Copyright © 2013 Elsevier Ltd. All rights reserved.

Figures

Figure 1. Effects of aspirin with and without fish oil on agonist-induced platelet aggregation

The effects of aspirin alone (BD1-3) or aspirin + fish oil (BD4-6) on platelet aggregation induced by (A) arachidonic acid, (B) ADP, and (C) collagen. Data are expressed as means and confidence intervals after log transformation (see Methods). Asterisks (*) represent a significant difference from baseline blood draw (p

Figure 2. Effects of aspirin with and without fish oil on plasma thromboxane B2

Plasma TXB2 was suppressed immediately after aspirin ingestion (BD2 and BD5) and fell progressively during both treatment arms. Data and asterisks are as in Figure 1.

Figure 3. Effects of aspirin with and without fish oil on plasma leptin levels

Plasma leptin levels were suppressed immediately after acute aspirin ingestion only (BD2 and BD5). * indicated p

Figure 4. Effects of aspirin with and without fish oil on NF-kappaB DNA binding activity in peripheral blood mononuclear cells

Peripheral blood mononuclear cells were isolated from a subset of subjects and nuclear extracts analyzed for NF-kB DNA binding activity (see Methods). Log transformed data and asterisks are expressed as in Figure 1.

Figure 5. Combination therapy appears to decrease the numbers of subjects who are aspirin resistant

Frequency distribution of subjects defined as aspirin sensitive or resistant (see text) expressed as percent change from aspirin resistant with aspirin alone to aspirin sensitive with aspirin + fish oil, and vice versa, both 4 hours and 1 week after ingestion. Bars represent percent change and 95% CI.

Figure 6. Effects of aspirin with and without fish oil on the subset of aspirin resistant subjects

Data are arachidonic acid-induced platelet aggregation (A) and plasma thromboxane B2 levels (B) in the 7 aspirin resistant subjects, expressed as after log transformation. * indicates p