Procoagulant activity and intimal dysfunction in IDDM |
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Authors: | Dr B Myrup P Rossing T Jensen J Gram C Kluft J Jespersen |
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Institution: | (1) Section of Thrombosis Research, South Jutland University Center, Esbjerg, Denmark;(2) The Gaubius Laboratory, PG-TNO, Leiden, The Netherlands;(3) Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark |
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Abstract: | Summary The biological activity of thrombin and coagulation factor Xa was assessed in 62 insulin-dependent diabetic patients. A group
of non-diabetic subjects of comparable age and urinary albumin excretion rate (<30 mg/24 h) served as control subjects (group
1,n=14). The patients were divided into three groups according to urinary albumin excretion rate. In group 2, albumin excretion
rate was less than 30 mg/24 h (n=17), in group 3 albumin excretion rate was in the range 30–300 mg/24 h (n=20) and in group 4 albumin excretion rate was greater than 300 mg/24 h (n=25). Compared to non-diabetic control subjects an increase in the biological activity of factor Xa was observed in all groups
of diabetic patients (prothrombin fragment 1+2 levels were 1.14±0.38 nmol/l in group 2,p<0.005; 1.06±0.45 nmol/l in group 3,p<0.05 and 1.03±0.31 nmol/l in group 4,p<0.05 vs 0.75±0.34 nmol/l in group 1). No difference in the level of antithrombin III was seen between the groups. We reconfirmed
the presence of intimal dysfunction in diabetic nephropathy demonstrated by elevated transcapillary escape rate of albumin
in group 4 compared with group 2 (8.9±2.0% vs 7.0±1.9%,p<0.05). An overall positive correlation between transcapillary escape rate and prothrombin fragment 1+2 was found (r=0.36,p<0.005). However, in the groups with elevated albumin excretion rate such a correlation was not significant (group 3:r=0.15,p=0.54; group 4:r=0.03,p=0.86) while it was sustained in the groups with albumin excretion rate of less than 300 mg/24 h (group 1:r=0.61,p<0.05; group 2:r=0.64,p<0.05). In conclusion, IDDM patients had elevated biological activity of factor Xa, demonstrated by elevated levels of prothrombin
fragment 1+2. This increment could not be explained by a deficiency of antithrombin III. Diabetologia (1995) 38: 73–78] |
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Keywords: | Diabetic nephropathy coagulation fibrinopeptide A prothrombin fragment 1+2 factor Xa antithrombin III |
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