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Antithrombin III deficiency in diabetes mellitus: influence on vascular degenerative complications
Insights
Diabetics often have lower levels of Antithrombin III (At III), a key clotting inhibitor. This deficiency may contribute to blood clotting issues and diabetic retinopathy.
Area of Science:
- Biochemistry
- Hematology
- Endocrinology
Background:
- Antithrombin III (At III) is a crucial natural inhibitor of blood coagulation.
- Diabetes mellitus is associated with various vascular complications.
Purpose of the Study:
- To investigate plasma Antithrombin III (At III) levels in diabetic patients.
- To explore the relationship between At III levels, clotting abnormalities, and diabetic retinopathy.
Main Methods:
- Plasma At III levels were quantified using single radial immunodiffusion.
- Platelet counts and fibrinogen degradation products were assessed.
- Diabetic retinopathy prevalence was compared between groups with differing At III levels.
Main Results:
- Diabetic patients exhibited significantly lower plasma At III levels compared to controls (26.6 vs. 31.0 mg/100 ml).
- Elevated fibrinogen degradation products and a positive correlation between platelet count and At III levels suggest chronic disseminated intravascular clotting.
- Low At III levels were associated with a higher incidence of diabetic retinopathy (50.6% vs. 32.4%).
Conclusions:
- Reduced plasma At III levels in diabetes likely result from increased consumption.
- At III deficiency may promote intravascular clotting and exacerbate vascular degenerative complications, including diabetic retinopathy.
Abstract:
Plasma Antithrombin III (At III), a natural inhibitor of coagulation, was determined using a single radial immunodiffusion technique. In 116 diabetics, plasma At III levels were significantly decreased (26.6 +/- 0.4 mg/100 ml) compared with those in 64 controls (31.0 +/- 0.3 mg/100 ml, P less than 0.001). An elevation of plasma fibrinogen degradation products in 42 per cent of our patients, and a positive linear relationship between platelet counts and At III levels ( r = 0.29, P less than 0.01), provided additional evidence for chronic disseminated intravascular clotting in diabetes mellitus. Diabetic retinal complications were more frequent in patient with low plasma At III levels (50.6 per cent of cases) than in those exhibiting At III concentrations within a normal range: 32.4 per cent of cases (X2 = 6.09, P less than 0.02). It is postulated that the low levels of At III encountered in diabetes result from excessive consumption, and that the deficiency may be responsible for the onset and/or aggravation of intravascular clotting. At III deficiency may therefore contribute to vascular degenerative complications, particularly those leading to diabetic retinopathy.