ISSN:
1432-5233
Keywords:
Key words Type 2 diabetes mellitus
;
Prothrombin fragment 1+2
;
D-dimer
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract To evaluate whether or not activated coagulation is present in the preclinical phases of type 2 diabetes mellitus, we studied 46 non-diabetic first-degree relatives of type 2 diabetic patients and 21 matched controls with no family history of diabetes. We determined the plasma levels of prothrombin fragment 1+2, D-dimer, fibrinogen, plasminogen activator inhibitor type 1, tissue plasminogen activator, von Willebrand factor and coagulation factors VII and VIII. Glucose tolerance, beta-cell function and insulin sensitivity were assessed in all subjects by a continuous glucose infusion of 5 mg ⋅ kg ideal body weight–1 ⋅ min–1 for 60 min with model assessment of glucose, insulin and C-peptide values. Plasma levels of prothrombin fragment 1+2 (median 1.24 vs 0.68 nmol ⋅ l–1; P=0.0001) and D-dimer (331 vs 254 µg ⋅ l–1 UEF; P=0.018) were higher in relatives, without significant differences in the other haemostatic variables. Relatives showed higher fasting (5.5 vs 4.9 mmol ⋅ l–1, P=0.004) and post-infusion (9.3 vs 8.3 mmol ⋅ l–1, P=0.02) serum glucose, no differences in insulin or C-peptide levels, lower beta-cell function (122% vs 147%; P=0.02) and no significant differences in insulin sensitivity. Fifteen relatives were glucose-intolerant and had lower beta-cell function and insulin sensitivity than glucose-tolerant relatives. Both subsets of relatives exhibited higher levels of prothrombin fragment 1+2 and D-dimer than control subjects. Thus, first-degree relatives of type 2 diabetic patients present an activated coagulation, even in the absence of minor degrees of glucose intolerance. These abnormalities can play a role in the pathogenesis of cardiovascular diseases frequently seen at diagnosis of type 2 diabetes.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00569421
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