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Platelet aggregation was studied in 14 diabetic children with no signs of angiopathy and in 14 healthy matched control children. The magnitude of the platelet shape change after ADP stimulation was decreased in diabetic patients while the maximal aggregation after ADP and low dose collagen was significantly higher than in healthy control children. In 28 diabetic children the platelet shape change after ADP stimulation was positively correlated with the serum concentration of apolipoprotein A-I and negatively correlated with serum triglyceride concentration. The ratio between the fatty acids 20:3/20:4 in cholesterol esters was strongly correlated with the relative incidence of irreversible aggregation (p less than 0.001) and with the magnitude of the maximal aggregation (p less than 0.01) after ADP stimulation (3.3 mumol/l). The ratio between the polyunsaturated and saturated fatty acids in the triglyceride fraction was negatively correlated to the maximal aggregation after collagen stimulation (10 mg/l). This study shows tha platelet aggregation is increased early in the course of diabetes in childhood. It suggests that the abnormalities in platelet aggregation pattern in diabetic patients are related to several of the lipid factors associated with an increased risk of atherosclerosis.

Increased platelet aggregability in diabetic children: Relation to serum lipid and fatty acid composition