急性早幼粒细胞白血病患者止血和凝血分子标志物的检测分析

目的:检测急性早幼粒细胞白血病(APL)患者止血和凝血分子标志物含量变化及其临床意义。方法:采用ELISA方法检测46例APL患者于化疗前和完全缓解后的血浆血小板α颗粒膜糖蛋白-140(GMP-140)、D-二聚体(D-D)、凝血酶-抗凝血酶复合物(TAT)、凝血酶原片段F1+2、纤溶酶-抗纤溶酶复合物(PAP)含量,并与38例正常人对照。结果:化疗前46例APL患者血浆TAT、D-D、F1+2、GMP-140、PAP含量明显高于正常对照组(P<0.05~0.01),完全缓解后GMP-140、TAT、D-D、F1+2、PAP水平恢复正常;未缓解和复发患者GMP-140、TAT、D-D、F1+2、PAP水平与初诊患者无明显差异(P>0.05)。结论:APL患者凝血系统激活、纤溶亢进,但随病情好转可逐渐改善。止血和凝血分子标志物检测有助于APL病情和疗效观察。     

2型糖尿病合并冠心病患者血栓分子标志物水平分析

目的:分析2型糖尿病(T2DM)合并冠心病(CHD)患者血栓分子标志物水平变化。方法:2018-01—2018-12本院收治的166例CHD患者,按照是否合并T2DM将其分为单纯CHD组(CHD组,n=101)和CHD合并T2DM组(CHD+T2DM组,n=65),另选同期体检健康者作为对照组(n=82)。采用化学发光免疫分析两步法检测各组受检者血浆血栓调节蛋白(TM)、凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α2抗纤溶酶复合物(PIC)和组织型纤溶酶原激活剂抑制剂复合物(tPAI-C)水平并比较组间差异。结果:各组TM、TAT、PIC和tPAI-C水平比较差异均有统计学意义,且均呈对照组CHD组CHD+T2DM组趋势,差异均有统计学意义(P0.05或P0.01,CHD组与CHD+T2DM组PIC水平除外)。结论:CHD和T2DM患者均存在凝血和纤溶系统异常,监测血浆TM、TAT、PIC和tPAI-C水平对评估患者出凝血状态有重要临床意义。     

凝血纤溶异常与早期糖尿病肾病的关系

目的:分析凝血纤溶异常在糖尿病肾病(DN)发生、发展中的作用,为早期诊断DN提供检测指标。方法:将90例2型糖尿病(DM)病人分为:无并发症组、正常白蛋白尿组(DMa组)、微量白蛋白尿组(DMb组)和临床蛋白尿组(DMc组)。测定其抗凝血酶-Ⅲ(AT-Ⅲ)、蛋白C(PC)、凝血酶-抗凝血酶复合物(TAT)、组织型纤溶酶原激活物(t-PA)、纤溶酶原激活抑制物(PAI)等指标水平。结果:①无并发症组PAI、TAT、PC水平升高,AT-Ⅲ、t-PA活性降低,并随UAE增加而加重。②TAT、AT-Ⅲ水平在DMa、DMb、DMc组与无并发症组间,呈显著性差异(P<0.01),且DMc组TAT水平依次高于DMb组、DMa组(P<0.01);AT-Ⅲ水平DMc组依次低于DMb组、DMa组(P<0.01)。③PC、TAT、PAI与DM病程呈正相关。结论:DN患者早期即存在凝血功能亢进、纤溶活性低下,并随DN的进展而逐渐加重。     

妊娠高血压综合征患者vWF、t-PA、PAI-1的检测分析

目的:探讨妊娠高血压综合征(妊高征)患者内皮细胞功能指标的变化及其临床意义。方法:应用ELISA法及发色底物法测定妊高征患者血浆血管性血友病因子(vWF)、织织型纤溶酶原激活物(t-PA)及纤溶酶原激活抑制物-1(PAI-1)活性。结果:妊高征患者vWF、t-PA、PAI-1较正常非孕组明显升高(P<0.05或P<0.01);妊高征各组患者vWF、PAI-1活性比正常晚孕组显著增高(P<0.05或P<0.01),且病情越重增高越明显;t-PA无明显改变。中、重度妊高征组血浆vWF与PAI-1水平呈直线正相关关系(r=0.723,P<0.05;r=0.765,P<0.05)。结论:妊高征患者内皮细胞功能异常,凝血及纤溶抑制功能亢进。测定血浆vWF和PAI-1水平,对于临床诊断妊高征有重要意义。     

妊娠糖尿病孕妇糖化血红蛋白与部分止凝血指标活性的相关性

目的探讨妊娠糖尿病（GDM）孕妇的部分凝血、纤溶指标活性的变化及其与糖化血红蛋白（GHbA1c）的相关性。方法对正常非孕妇女、正常妊娠妇女（各40例）和GDM孕妇（50例）的GHbA1c、血浆Ⅶc因子（FⅦc）、组织型纤溶酶原激活物（t-PA）及其抑制物（PAI-1）、蛋白C活性依赖凝固时间（PCAT）及抗凝血酶-Ⅲ（AT-Ⅲ）等指标进行检测,并分析糖化血红蛋白与各指标之间的相关性。结果与正常非孕组及正常妊娠组比较,GDM组GHbA1c、FⅦc、PAI-1均显著增高（P〈0．01）,t-PA明显下降（P〈0．01）;正常妊娠组AT-Ⅲ较非孕组呈下降趋势,GDM患者AT-Ⅲ水平、PCAT与正常妊娠组无显著差异。全部GDM患者GHbA1c与t-PA呈负相关（r=-0．607．P〈0．01）,与PAI-1呈正相关（r=0．493,P〈0．01）,与FⅦc活性正相关（r=0．421,P〈0．01）。结论糖尿病孕妇存在着明显的血栓前状态,血糖通过影响纤溶凝血系统功能,导致凝血功能异常,在妊娠糖尿病的发生发展中起着重要的作用。提示应密切关注患者糖化血红蛋白及凝血纤溶指标的变化,预防并发症的发生。     

几种凝血/纤溶标志物在部分血栓性疾病中的应用

机体凝血增强、纤溶降低,可能预警血栓形成。相关标志物凝血酶-抗凝血酶复合物(TAT)、纤溶酶-α2纤溶酶抑制剂复合物(PIC)、血栓调节蛋白(TM)、组织纤溶酶原激活物-纤溶酶原激活物抑制剂-1复合物(tPAI-C)、纤维蛋白(原)降解产物(FDP)和D-二聚体(DD)水平异常成为临床上分析血栓性病变的重要参考指标,并在深静脉血栓、心血管疾病、弥散性血管内凝血(DIC)等的应用中获益。这些指标能反映血管内皮受损、血液高凝、纤溶状态,相较于常规指标:凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)等的变化,出现更早、更灵敏,因而对血栓形成的警示更及时,遗漏更少。     

血管内皮损伤标志物在2型糖尿病患者中的变化

目的:探讨2型糖尿病(DM)患者血管内皮损伤标志物的变化。方法:分别测定89例2型DM患者和76例正常对照者血浆可溶性血管内皮细胞蛋白C受体(sEPCR),血管性血友病因子(v WF)和可溶性血栓调节蛋白(sTM),并测定DM患者24h尿白蛋白排泄(UAE),根据尿UAE水平和病程分组进行比较分析。结果:2型DM患者血浆sEPCR、v WF及sTM水平高于正常对照组(P<0.05),并且与其尿UAE水平和病程呈显著正相关。结论:血浆sEPCR、v WF及sTM水平可作为观察2型DM并发血管病变以及严重程度的指标。     

左心室质量与炎症和凝血标志物的关联性——一项动脉粥样硬化的多民族研究(MESA)

左心室质量与炎症和凝血标志物有关。美国科学家研究了无症状人群的左心室质量与C反应蛋白(CRP)、白细胞介素-6(IL-6)、D-二聚体、可溶性细胞间粘附分子-1(sICAM-1)、纤溶酶原激活物抑制物1(PAI-1)、可溶性血栓调节蛋白(sTM)、可溶性肿瘤坏死因子1型受体(sTNFRl)、von Willebrand因子(vWF)、可溶性E-选择素(sE-selectin)、Ⅷ因子、纤     

妊娠女性凝血-抗凝-纤溶系统功能检测的临床应用价值

目的:探讨妊娠期女性凝血、抗凝和纤溶系统功能检测的临床价值。方法:选择2019-01—2019-04期间本院进行产前检查的女性927例(观察组),选取同期本院体检的健康女性270例作为对照组,对以上两组凝血、抗凝和纤溶指标[血浆凝血酶原时间(PT)、部分活化凝血活酶时间(APTT)、血浆凝血酶时间(TT)、纤维蛋白原(FIB)、抗凝血酶原-Ⅲ(AT-Ⅲ)和D二聚体(D-D)]进行检测分析并比较组间差异。结果:观察组血浆PT、APTT、TT、AT-Ⅲ水平均明显低于对照组,而FIB和D-D浓度明显高于对照组(P均0.01),APTT、FIB、AT-Ⅲ和D-D四项指标异常率明显高于对照组(P均0.01),而PT和TT两项指标异常率与对照组差异无统计学意义(P0.05)。结论:妊娠期女性血液呈高凝状态,加强孕妇凝血、抗凝和纤溶系统功能的监测,对及时了解孕妇凝血状态,提升孕妇安全,防治并发症有重要指导意义。     

凝血酶激活的纤溶抑制物: 新的凝血纤溶调控因子

凝血酶激活的纤溶抑制物(Thrombin—activatable fibrinolysis inhibitor，简称TAFI)，作为凝血及纤溶调控因子，是近十年来国外医学界研究的热点之一；TAFI的基础研究是对经典凝血及纤溶调控机制的重要补充；在体内主要由凝血酶、凝血酶调节蛋白、纤溶酶、肝素、胰蛋白酶等物质激活而导致纤溶机制受抑，血栓溶解时间延长，从而增加血栓形成的危险性。TAFI在体内还参与缓激肽、补体等活性物质的调节。动物血栓模型运用TAFI拮抗剂与溶栓剂联合治疗，取得良好效果。国外医学界对TAFI与血液、心血管、内分泌等系统疾病的发病关系已展开广泛研究。     

Alterations of coagulation and fibrinolysis in patients with angioedema due to C1-inhibitor deficiency

Patients with functional deficiency of C1-inhibitor (C1-INH) suffer from recurrent acute attacks (AA) of localized oedema associated with activation of the contact system, complement and fibrinolysis. To unravel further the role of coagulation and fibrinolysis in the pathophysiology of C1-INH deficiency, we performed simultaneous thrombin and plasmin generation measurements in plasma from patients with hereditary angioedema (HAE) due to C1-INH deficiency during AA (n = 23), in remission (R) (n = 20) and in controls (n = 20). During AA thrombin generation after in-vitro activation of plasma was higher than in controls, as demonstrated by shorter thrombin peak-time (P < 0·05), higher thrombin peak-height (P < 0·001) and increased area under the curve (AUC) (P < 0·05). Additionally, elevated levels of prothrombin fragment 1+2 (P < 0·0001) were observed in non-activated plasma from the same patients. In contrast, in activated plasma from patients during AA plasmin generation estimated as plasmin peak-height (P < 0·05) and plasmin potential (P < 0·05) was reduced, but non-activated plasma of the same patients showed elevated plasmin-anti-plasmin (PAP) complexes (P < 0·001). This apparent discrepancy can be reconciled by elevated soluble thrombomodulin (sTM) (P < 0·01) and thrombin activatable fibrinolysis inhibitor (TAFI) in patients during AA providing possible evidence for a regulatory effect on fibrinolysis. Plasminogen activator inhibitor-1 (PAI-1) was reduced in patients during AA indicating, together with the observed reduction of plasmin generation, the consumption of fibrinolytic factors. In conclusion, our results support the involvement of coagulation and fibrinolysis in the pathophysiology of HAE and show the possible application of simultaneous measurement of thrombin and plasmin generation to evaluate different clinical conditions in HAE patients.     

Disturbances of haemostasis in diabetes mellitus

Diabetes mellitus is associated with disturbances in haemostasis that could contribute to the development of thrombotic complications.The present study was undertaken to determine the behavior of coagulation variables and fibrinolytic system in diabetes mellitus. Forty five diabetic patients and forty five matched controls were evaluated by doing the following haemostatic parameter, prothrombin time, partial thromboplastin time, thrombin time, coagulation factors assay II, VII, IX, & plasma fibrinogen, ADP-induced platelet aggregation, protein C, alpha2- antiplasmin, PAI and FDPs. Generally diabetic patients have high levels of fibrinogen, alpha2- antiplasmin, & PAI and lower level of protein C. Other haemostatic parameters did not show statistically significant difference between diabetic patients and control group. Significantly elevated levels of PAI, alpha2- antiplasmin together with low protein C level in diabetic patients may result in the disturbance of haemostatic balance favoring thrombotic events. CONCLUSION: High levels of plasma fibrinogen, alpha2A- antiplasmin with low plasma protein C activity could lead to a prothrombotic tendency in insulin dependent diabetic patients. Moreover, in non-insulin dependent diabetic patients, the above mentioned parameters together with high levels of ADP-induced platelet aggregation and plasminogen activator inhibitor may increase the risk of thrombotic complications. Obesity can be considered as an additional risk factor for development of thrombosis in diabetic patients.     

Disturbances of Haemostasis in Diabetes Mellitus

Diabetes mellitus is associated with disturbances in haemostasis that could contribute to the development of thrombotic complications.The present study was undertaken to determine the behavior of coagulation variables and fibrinolytic system in diabetes mellitus. Forty five diabetic patients and forty five matched controls were evaluated by doing the following haemostatic parameter, prothrombin time, partial thromboplastin time, thrombin time, coagulation factors assay II, VII, IX, & plasma fibrinogen, ADP-induced platelet aggregation, protein C, a₂- antiplasmin, PAI and FDPs. Generally diabetic patients have high levels of fibrinogen, a₂- antiplasmin, & PAI and lower level of protein C. Other haemostatic parameters did not show statistically significant difference between diabetic patients and control group. Significantally elevated levels of PAI, a₂- antiplasmin together with low protein C level in diabetic patients may result in the disturbance of haemostatic balance favoring thrombotic events. Conclusion: High levels of plasma fibrinogen, a₂A- antiplasmin with low plasma protein C activity could lead to a prothrombotic tendency in insulin dependent diabetic patients. Moreover, in non-insulin dependent diabetic patients, the above mentioned parameters together with high levels of ADP-induced platelet aggregation and plasminogen activator inhibitor may increase the risk of thrombotic complications. Obesity can be considered as an additional risk factor for development of thrombosis in diabetic patients.     

Recombinant C1-Inhibitor

Background

Recombinant human C1-inhibitor (rhC1INH; Ruconest?) has been developed for treatment of acute angioedema attacks in patients with hereditary angioedema (HAE) due to heterozygous deficiency of C1INH. Previous reports suggest that administration of plasma-derived C1INH products may be associated with an increased risk for thromboembolic complications.

Objectives

Our aim is to evaluate the effects of rhC1INH on coagulation and fibrinolysis in symptomatic HAE patients.

Methods

Levels of various coagulation and fibrinolytic parameters were determined in pre- and postexposure plasma samples from HAE patients included in a randomized clinical trial. Patients were treated with either saline, or 50 or 100 U/kg rhC1INH for an acute angioedema attack.

Results

Prior to rhC1INH treatment, the majority of patients had low to normal activated partial thromboplastin times (aPTT) and increased levels of prothrombin fragment 1+2, thrombin-antithrombin complexes, D-dimers and plasmin-antiplasmin complexes, all of which indicate activation of both coagulation and fibrinolysis. Infusion of rhC1INH at doses up to 100 U/kg did not affect these parameters except for a dose-dependent prolongation of aPTT, confirming that rhC1INH is an inhibitor of the contact system, and that F1+2 levels decreased.

Conclusion

Coagulation and fibrinolytic systems are activated in HAE patients suffering from an acute angioedema attack. Treatment with rhC1INH at 50 or 100 U/kg had no effect on parameters reflecting activation of these systems except for a significant effect on aPTT, which likely reflects a pharmacodynamic effect of rhC1INH, and a reduction on plasma levels of the prothrombin activation fragment F1+2. We conclude that these results argue against a prothrombotic effect of treatment with this rhC1INH product in HAE patients.     

CD4CD8细胞及凝血调节因子与复发性自然流产的临床研究

目的 研究不明原因反复流产患者蜕膜组织CD4、CD8免疫细胞的局部表达及与TM、PAI-1、F1+2、D-二聚体等凝血相关因子的关联性,为不明原因流产患者治疗提供帮助.方法 采用细胞免疫芯片技术对不明原因流产患者50例子宫蜕膜组织进行CD4、CD8细胞计数并计算CD4/CD8比值;酶联免疫吸附试验方法测定患者血浆血栓调节蛋白(TM)、纤溶酶原激活抑制物-1(PAI-1)、凝血酶原片段F1+2;全自动免疫荧光分析法测定D二聚体(D-dimer,D-D)因子浓度.同时以正常妊娠无流产征兆主动要求人工流产的50人为对照组,比较上述指标在两个群体中的表达,并进行对比分析研究.结果 与对照组比较,患者蜕膜组织CD4水平及CD4/CD8比值均下降,CD8水平呈高表达,血浆TM、PAI-1、F1+2因子呈高表达,D-D呈低表达状态.两组比较差异均有统计学意义(P＜0.05).结论 反复流产患者蜕膜组织局部免疫功能表达异常,血液处于一定程度的高凝状态而纤溶系统受损.修复上述状态可对治疗不明原因反复流产患者提供新思路.     

Blood coagulation and fibrinolysis in patients with Beh?et's disease

In patients with Beh?et's disease, venous thrombosis has often been described as a complication. The pathogenesis of this complication, however, has not been fully understood. In this work, various parameters of blood coagulation and fibrinolysis were studied in 20 patients with Beh?et's disease and 13 sex-matched healthy volunteers. Patients were classified into three subgroups according to the number of clinical signs involved; group I (no sign): 4 patients; group II (one or two signs): 11 patients; group III (more than three signs): 5 patients. Patients with Beh?et's disease, showed an activation of blood coagulation, such as the shortening of prothrombin time (p less than 0.001), decreases in concentrations and activities of plasma antithrombin III (AT-III) (p less than 0.01) and elevated levels of plasma thrombin-antithrombin-III complex (TAT) (p less than 0.01), compared to the control group. Plasma levels (p less than 0.01) and activities (p less than 0.01) of protein C (PC) and total protein S (PS) levels (p less than 0.05) were increased in the patients. Decreased levels of alpha 2-plasmin inhibitor (p less than 0.001) also indicated an activation of fibrinolysis in the patients. When analyzed among the subgroups, patients belong to group II and III showed higher levels of plasma FDP D-dimer (p less than 0.05) and lower levels of plasminogen (p less than 0.05), as compared with patients in group I or control group.(ABSTRACT TRUNCATED AT 250 WORDS)     

2型糖尿病并血管病变患者血浆GSH-Px、SOD、NO、NOS含量的变化

目的:探讨2型糖尿病并血管病变患者血浆谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、一氧化氮(NO)和一氧化氮合酶(NOS)含量变传及临床意义。方法:用化学法测定42例2型糖尿病并血管病变患者血浆GSH-Px、SOD、NO、NOS含量变化,并与50例2型糖尿病不伴血管性病变组和46例健康对照组比较。结果:2型糖尿病并发血管性疾病组血浆GSH-Px、SOD、NO、NOS活性比不伴血管性病变组显著降低(P<0.01),且两组均显著性低于正常对照组(P<0.01)。结论:2型糖尿病患者存在着氧化与抗氧化之间以及内皮细胞分泌NO功能失调,这种失调在2型糖尿病血管并发症发生和发展过程中起重要作用。     

Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus

BACKGROUND: The effect of increasing the intake of dietary fiber on glycemic control in patients with type 2 diabetes mellitus is controversial. METHODS: In a randomized, crossover study, we assigned 13 patients with type 2 diabetes mellitus to follow two diets, each for six weeks: a diet containing moderate amounts of fiber (total, 24 g; 8 g of soluble fiber and 16 g of insoluble fiber), as recommended by the American Diabetes Association (ADA), and a high-fiber diet (total, 50 g; 25 g of soluble fiber and 25 g of insoluble fiber), containing foods not fortified with fiber (unfortified foods). Both diets, prepared in a research kitchen, had the same macronutrient and energy content. We compared the effects of the two diets on glycemic control and plasma lipid concentrations. RESULTS: Compliance with the diets was excellent. During the sixth week, the high-fiber diet, as compared with the the sixth week of the ADA diet, mean daily preprandial plasma glucose concentrations were 13 mg per deciliter [0.7 mmol per liter] lower (95 percent confidence interval, 1 to 24 mg per deciliter [0.1 to 1.3 mmol per liter]; P=0.04) and mean median difference, daily urinary glucose excretion 1.3 g (0.23; 95 percent confidence interval, 0.03 to 1.83 g; P= 0.008). The high-fiber diet also lowered the area under the curve for 24-hour plasma glucose and insulin concentrations, which were measured every two hours, by 10 percent (P=0.02) and 12 percent (P=0.05), respectively. The high-fiber diet reduced plasma total cholesterol concentrations by 6.7 percent (P=0.02), triglyceride concentrations by 10.2 percent (P=0.02), and very-low-density lipoprotein cholesterol concentrations by 12.5 percent (P=0.01). CONCLUSIONS: A high intake of dietary fiber, particularly of the soluble type, above the level recommended by the ADA, improves glycemic control, decreases hyperinsulinemia, and lowers plasma lipid concentrations in patients with type 2 diabetes.     

Plasma biomarkers of acute attacks in patients with angioedema due to C1-inhibitor deficiency

Background: Cl‐inhibitor (C1‐INH) deficiency leads to recurrent attacks of mucocutaneous edema and may be inherited (hereditary angioedema [HAE]) or acquired (acquired angioedema [AAE]), which have the same clinical picture characterized by angioedema involving the skin, gastrointestinal tract, and larynx. Although cutaneous swelling is evident, abdominal angioedema is still a diagnostic challenge and attacks can mimic surgical emergencies. There is currently no laboratory marker for identifying angioedema attacks. Objective: As coagulation and fibrinolysis are activated during angioedema attacks, we assessed if plasma measurements of prothrombin fragment F1 + 2 (marker of thrombin generation) and D‐dimer (marker of fibrin degradation) can be useful for the diagnosis of angioedema because of C1‐INH deficiency, especially in case of hidden locations as abdominal attacks. Methods: In addition to complement, we measured plasma levels of F1 + 2 and D‐dimer in 28 patients with C1‐INH deficiency during acute attacks and remission, 35 patients without C1‐INH deficiency during abdominal colics, and 20 healthy subjects. Results: Plasma F1 + 2 levels were higher in patients with C1‐INH deficiency during remission than in healthy controls (P = 0.001), and further increased during cutaneous and abdominal attacks (P = 0.0001); patients without C1‐INH deficiency had normal F1 + 2 levels during abdominal colics. Plasma D‐dimer levels were higher in patients with C1‐INH deficiency during remission than in controls (P = 0.012) and increased during angioedema attacks, reaching higher levels than in patients without C1‐INH deficiency during colics (P = 0.002). Conclusions: During acute angioedema attacks, patients with C1‐INH deficiency have high prothrombin fragment F1 + 2 and D‐dimer levels, the measurement of which may have an important diagnostic value.     

Methylenetetrahydrofolate reductase polymorphism, type II diabetes mellitus, coronary artery disease, and essential hypertension in the Czech population

Increased plasma concentrations of homocysteine have been found in patients with coronary artery disease (CAD) and essential hypertension (EH) and in patients with diabetic complications. The 677C/T methylenetetrahydrofolate reductase (MTHFR) gene polymorphism is related to the MTHFR enzyme activity and to the plasma homocysteine concentration. This study was designed to investigate an association of this polymorphism with CAD, EH, and type II diabetes mellitus in the Czech population. The MTHFR genotypes were assessed by the polymerase chain reaction-based methodology in a sample of 1199 unrelated Caucasian subjects with CAD, EH, type II diabetes, or a combination of these diseases, and in healthy subjects. Allele frequencies of the MTHFR polymorphism differed considerably between women with and without type II diabetes mellitus (P = 0.00069), with a higher frequency of the C allele in the diabetic women. In addition, the MTHFR T allele frequency was significantly higher in normotensive subjects with CAD compared with normotensive subjects without this disease (P = 0.020). Both associations were confirmed by multiple logistic regressions. In conclusion, while the C allele of the 677C/T MTHFR polymorphism is associated with type II diabetes mellitus in women, the T allele is associated with CAD only in normotensive subjects of Czech origin.