MicroRNA 155, Factor XIII and Type 2 Diabetes Mellitus and Coronary Heart Disease

There is a rise in the number of individuals diagnosed with type 2 diabetes mellitus (T2DM) in South Africa. Cardiovascular disease is among the macrovascular complication of type 2 diabetes mellitus and accounts for the high mortality rate in patients with T2DM. The disease is characterized by insulin resistance, hyperglycaemia, oxidative stress, inflammation, hypofibrinolysis and hypercoagulation. The impairment of fibrinolysis, hyperactivation of coagulation and the inflammatory pathways result in an increased risk of developing coronary heart disease. Factor XIII-A is one of the key coagulation factors that play a crucial role in the last stage of the coagulation cascade, and it has been shown to play a critical role in the development of thrombotic diseases. In addition, several studies show the influence of FXIII-A polymorphisms on thrombotic diseases. The influence of genetic variations such as single nucleotide variants and gene expression regulators (micro-RNAs) are important factors involved in the hyperactivation of coagulation and hypofibrinolysis. Thus, this review aims to summarise key aspects of coagulation, FXIII-A expression, potential FXIII-A genetic variations and epigenetic mediators (micro-RNA-155) in T2DM and patients with coronary artery disease.