Normalisation of tissue factor pathway inhibitor activity after glycaemic control optimisation in type 1 diabetic patients.

Abstract

UNLABELLED:

Increased plasma concentrations of various markers of endothelial damage have been observed in type I diabetic patients, particularly in those with microangiopathy.

OBJECTIVE:

To evaluate the effect of near-normalisation of glycaemic control on different markers of endothelial injury involved in haemostasis in poorly-controlled type 1 diabetic patients.

MATERIAL AND METHODS:

TFPI, thrombomodulin (TM), plasminogen activator inhibitor, tissue-type plasminogen activator and von Willebrand factor were measured in 14 poorly-controlled type 1 diabetic patients free of diabetes-related complications (8 men, 6 women; mean age 29.8 +/- 9.9 years) before (baseline) and after 3 months of intensive therapy and in 14 sex-, age- and BMI-matched control subjects.

RESULTS:

After a mean follow-up of 107 +/- 49 days (56-210), HbA1c decreased from 11.2 +/- 2.3 to 6.7 +/- 0.7% (p <0.0001). TFPI activity at baseline was higher than in the control group (126.9 +/- 34 vs 92.0 +/- 13%, p <0.005) and decreased after good glycaemic control was achieved (p <0.005), becoming similar to that in the control group (91.0 +/- 16.5%). The TFPI descent correlated with the variations observed in HbA1c (p <0.05; r = 0.54). TM levels at baseline were significantly higher than in the control group (42.3 +/- 9.1 vs 29.00 +/- 10.9; p <0.005) and did not change. The remaining parameters studied were similar between patients and controls and did not change after glycaemic optimisation.

CONCLUSIONS:

Optimisation of glycaemic control normalises the increased activity of TFPI but not the higher TM levels observed in poorly-controlled type I diabetic patients without chronic complications.

• Authors: M Rigla, J Mateo, J Fontcuberta, J C Souto, A de Leiva, A Pérez
• Journal: Thrombosis and haemostasis (Thromb Haemost) Vol. 84 Issue 2 Pg. 223-7 (Aug 2000) ISSN: 0340-6245 [Print] Germany
• PMID: 10959693 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Blood Coagulation Factors
• Blood Glucose
• Cholesterol, LDL
• Fibrinolytic Agents
• Lipids
• Lipoproteins
• Peptide Fragments
• Thrombomodulin
• lipoprotein-associated coagulation inhibitor
• prothrombin fragment 1.2
• Prothrombin

Topics

• Adolescent
• Adult
• Age Factors
• Aged
• Analysis of Variance
• Biomarkers (blood)
• Blood Coagulation Factors (metabolism)
• Blood Glucose (metabolism)
• Cholesterol, LDL (blood)
• Diabetes Mellitus, Type 1 (blood, complications, therapy)
• Endothelium, Vascular (injuries, metabolism, pathology)
• Female
• Fibrinolytic Agents (blood)
• Follow-Up Studies
• Hemostasis
• Humans
• Hyperglycemia (blood, complications, therapy)
• Lipids (blood)
• Lipoproteins (blood, drug effects)
• Male
• Matched-Pair Analysis
• Middle Aged
• Peptide Fragments (blood)
• Prothrombin
• Thrombomodulin (blood)