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ADAMTS13 and von Willebrand factor concentrations in patients with diabetes mellitus

Mika Skeppholm1, Anders Kallner, Majid Kalani

  • 1Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Divisions of Cardiovascular Medicine, Sweden. mika.skeppholm@ds.se

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|October 8, 2009
PubMed

Insights

In diabetes mellitus patients, lower ADAMTS13 activity contributes to elevated von Willebrand factor (VWF). Dalteparin treatment increased VWF but did not affect ADAMTS13 levels, suggesting VWF elevation is not ADAMTS13-mediated.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Hematology

Background:

  • Diabetes mellitus is associated with elevated von Willebrand factor (VWF), a key protein in hemostasis.
  • ADAMTS13 is the primary metalloprotease responsible for VWF degradation.
  • The interplay between VWF and ADAMTS13 in diabetes, particularly with peripheral artery occlusive disease (PAOD), requires further investigation.

Purpose of the Study:

  • To investigate the role of ADAMTS13 activity and antigen in patients with diabetes mellitus, with and without PAOD.
  • To examine the effect of dalteparin treatment on VWF and ADAMTS13 levels in these patient groups.
  • To explore the potential link between ADAMTS13 function and microangiopathy in diabetes.

Main Methods:

  • VWF antigen and ADAMTS13 antigen and activity were measured in patients with diabetes mellitus (n=23) and diabetes mellitus + PAOD (n=65).
  • Measurements were taken before and after treatment with dalteparin or placebo.
  • Comparisons were made with healthy controls.

Main Results:

  • Patients with diabetes mellitus showed significantly higher VWF antigen and lower ADAMTS13 activity compared to controls.
  • In diabetes mellitus + PAOD patients, VWF antigen was elevated, but ADAMTS13 levels did not differ significantly from controls.
  • Dalteparin treatment significantly increased VWF antigen but did not alter ADAMTS13 activity or antigen.
  • The ADAMTS13 activity/antigen ratio was reduced only in the diabetes mellitus group.

Conclusions:

  • Reduced ADAMTS13 activity may contribute to elevated VWF in diabetes mellitus.
  • While VWF increases with dalteparin treatment, this effect appears independent of changes in ADAMTS13.
  • ADAMTS13 may play a role in microangiopathy associated with diabetes mellitus, particularly in patients without PAOD.

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