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Elevated factor VIII activity and factor VIII-related antigen in diabetic children without vascular disease
Insights
In diabetic children without vascular disease, higher urinary sugar and HbA1 levels correlate with increased factor VIII coagulant activity (VIII C). Even with short diabetes duration, alterations in the factor VIII complex are detectable.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Vascular Biology
Background:
- Insulin-dependent diabetes mellitus (IDDM) is associated with vascular complications.
- Factor VIII complex (coagulant activity and related antigen) plays a role in hemostasis and thrombosis.
- Early detection of vascular risk factors in diabetic children is crucial.
Purpose of the Study:
- To investigate alterations in factor VIII coagulant activity (VIII C) and factor VIII-related antigen (VIII R:Ag) in children with IDDM.
- To determine if these alterations correlate with glycemic control (HbA1 levels, urinary sugar excretion) and diabetes duration.
- To assess for changes in the factor VIII complex in diabetic children without clinical signs of vascular disease.
Main Methods:
- Study included 86 children (age 4-17) with IDDM, all without signs of vascular disease.
- Children were grouped by urinary sugar excretion, HbA1 levels, and diabetes duration (1-12 years).
- Factor VIII coagulant activity (VIII C) and factor VIII-related antigen (VIII R:Ag) were measured.
Main Results:
- Children with high urinary sugar excretion and high HbA1 levels showed significantly higher VIII C compared to those with lower levels.
- VIII R:Ag was significantly higher in children with the longest diabetes duration versus the shortest.
- No significant differences in VIII C were found based on diabetes duration, nor in VIII R:Ag based on urinary sugar or HbA1 levels.
Conclusions:
- Alterations in the factor VIII complex can be detected in children with IDDM even in the absence of vascular disease.
- Elevated VIII C is associated with poorer glycemic control (high urinary sugar, high HbA1).
- Increased VIII R:Ag may be linked to longer diabetes duration, suggesting potential long-term hemostatic changes.
Abstract:
Factor VIII coagulant activity (VIII C) and factor VIII-related antigen (VIII R:Ag) were studied in 86 insulin-dependent diabetic children. All children were without signs of vascular disease based on a negative funduscopy, negative fluorescein angiography, normal serum creatinine levels, and absence of proteinuria. Age ranged from 4 to 17 yr; duration of clinical diabetes ranged from 1 to 12 yr. The children were grouped according to their urinary sugar excretion, the HbA1 levels, and the duration of clinical diabetes. The group with high urinary sugar excretion and the group with high HbA1 levels had a significantly higher VIII C than the group with low urinary sugar excretion and the group with low HbA1 levels. VIII C levels did not differ significantly in the groups with a different duration of clinical diabetes, but VIII R:Ag was significantly higher in the group with the longest duration of diabetes as compared with the group with the shortest duration. VIII R:Ag levels did not differ significantly in the groups with different degrees of urinary sugar excretion or different HbA1 levels. The results show that in children without vascular disease, and even in children with a short duration of diabetes, alterations of the factor VIII complex can be demonstrated.