ISSN:
1432-0428
Keywords:
Keywords Protein C
;
protein S
;
diabetes mellitus
;
soluble thrombomodulin
;
microalbuminuria
;
activated protein C-protein C inhibitor complex
;
fibrin monomer
;
soluble E-selectin.
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary Enhanced activation of the clotting system has been recently implicated in the pathogenesis of vascular complications in patients with diabetes mellitus. Abnormalities of the anticoagulant system may constitute a potential trigger factor for the haemostatic activation observed in diabetic subjects. The current study aimed to evaluate anticoagulant activity in diabetic patients by assessing the plasma levels of activated protein C-protein C inhibitor complex; and by measuring the anticoagulant response to exogenous thrombomodulin. This study comprised 61 patients (34 men, 27 women) with non-insulin-dependent diabetes mellitus (NIDDM) of whom 22 showed microalbuminuria and 39 normoalbuminuria. Data obtained in 31 non-obese and non-diabetic subjects were available for comparison. The plasma levels of fibrinogen (p 〈 0.02), prothrombin fragment 1 + 2 (p 〈 0.05), fibrin monomer (p 〈 0.0001), protein C antigen (p 〈 0.005), total protein S antigen (p 〈 0.02), soluble thrombomodulin (p 〈 0.005) and soluble E-selectin (p 〈 0.005) were significantly higher in diabetic patients than in healthy subjects. The plasma level of activated protein C-protein C inhibitor complex (7.4 ± 3.8 vs 3.0 ± 0.4 pmol/l) was significantly higher (p 〈 0.0001) and the anticoagulant response to exogenous thrombomodulin (23.4 ± 2.6 vs 35.3 ± 3.0 ng/ml) was markedly lower (p = 0.005) in all diabetic patients than in healthy subjects. Cases with microalbuminuria presented low plasma levels of activated protein C-protein C inhibitor complex (5.5 ± 0.6 vs 8.6 ± 0.7 pmol/l, p 〈 0.05) and significantly decreased values of the anticoagulant response to exogenous thrombomodulin (16.5 ± 2.9 vs 23.4 ± 2.6 %, p = 0.03) as compared to those with normoalbuminuria. The present study suggests that the hyper-coagulable state in NIDDM is associated with an increased activation of protein C but with a poor plasma reactivity to the anticoagulant effect of thrombomodulin. [Diabetologia (1996) 39: 1455–1461]
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001250050598
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