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Hyperfibrinogenaemia did not improve after treating hyperglycaemia in Chinese type 2 diabetic patients
1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT. gtc_ko@hotmail.com
Insights
In type 2 diabetes patients, fibrinogen levels significantly increased over time. Elevated triglyceride levels, not glycemic control, independently predicted these fibrinogen changes.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Clinical Biochemistry
Background:
- Diabetic patients exhibit elevated cardiovascular risk.
- Fibrinogen is a known predictor of vascular complications in diabetes.
Purpose of the Study:
- To investigate changes in fibrinogen concentration in newly diagnosed type 2 diabetes patients.
- To identify factors predicting fibrinogen level alterations in this population.
Main Methods:
- Prospective study of 101 newly diagnosed type 2 diabetes patients and 30 controls.
- Fibrinogen levels were measured at baseline and after a mean follow-up of 2.38 years.
- Multivariate analysis was used to identify predictors of fibrinogen changes.
Main Results:
- Diabetic patients showed an 18.5% increase in fibrinogen concentration over the follow-up period (P < 0.001).
- Control subjects had no significant change in fibrinogen levels.
- Changes in plasma triglyceride levels were the only independent predictor of fibrinogen changes (P = 0.011).
- Improved glycemic control did not correlate with reduced fibrinogen concentration.
Conclusions:
- Fibrinogen levels increase over time in patients with newly diagnosed type 2 diabetes.
- Plasma triglyceride levels are a significant predictor of fibrinogen changes in diabetic patients.
- Glycemic control alone does not appear to influence fibrinogen levels in this cohort.
Abstract:
Diabetic patients have higher cardiovascular risk than non-diabetic subjects, and fibrinogen has been reported to be one of the independent predictors for diabetic vascular complications. We examined 101 subjects (24 men, 77 women) who were newly diagnosed with type 2 diabetes. Thirty non-diabetic subjects were recruited as controls. The mean (standard deviation, SD) baseline fibrinogen concentrations in men and women were 3.87 (1.17) and 3.42 (1.00) g/L, respectively (not significantly different). Of these 101 subjects, 70 were treated with diet alone and 31 were treated with oral agents. After a mean (SD) follow-up period of 2.38 (0.63) years, there was an 18.5% increase in the fibrinogen concentration from 3.53 (1.06) g/L at baseline to 3.97 (1.07) g/L at follow-up (P < 0.001). The normal subjects had a mean (SD) follow-up period of 1.17 (0.38) years, and showed no significant change in their fibrinogen concentrations from 3.49 (0.90) g/L at baseline to 3.15 (0.61) g/L at follow-up. In the 101 diabetic subjects, only changes in plasma triglyceride correlated with the changes in fibrinogen concentration. Using multivariate analysis with age, sex, duration of diabetes, baseline and changes in body mass index, blood pressure, glycaemic and lipid parameters as independent variables (R2 = 0.106, F= 6.840, P = 0.011), triglyceride (beta = 0.282, P = 0.011) was identified as the only independent variable that predicted the changes in the fibrinogen concentrations. Improved glycaemic control was not accompanied by a reduction in plasma fibrinogen concentration.