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Procoagulant activity and intimal dysfunction in IDDM

B Myrup1, P Rossing, T Jensen

  • 1Steno Diabetes Center, Gentofte Denmark.

Diabetologia
|January 1, 1995
PubMed
Summary
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Diabetic patients show increased coagulation factor Xa activity, linked to kidney damage and albumin leakage. This suggests a heightened risk of blood clots in diabetes.

Area of Science:

  • Biochemistry
  • Nephrology
  • Hematology

Background:

  • Diabetes mellitus is associated with microvascular complications.
  • Diabetic nephropathy is a common complication, characterized by albuminuria.
  • Coagulation system activation may play a role in diabetic complications.

Purpose of the Study:

  • To assess the biological activity of thrombin and coagulation factor Xa in patients with insulin-dependent diabetes.
  • To investigate the relationship between coagulation activation, albuminuria, and intimal dysfunction.

Main Methods:

  • Assessed thrombin and factor Xa activity in 62 diabetic patients and 14 controls.
  • Categorized patients into four groups based on urinary albumin excretion rate (UAE).
  • Measured prothrombin fragment 1 + 2 levels, antithrombin III, and transcapillary escape rate of albumin (TERA).

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Main Results:

  • Increased biological activity of factor Xa (prothrombin fragment 1 + 2) was observed in all diabetic patient groups compared to controls.
  • No significant difference in antithrombin III levels was found between groups.
  • Elevated TERA in patients with high UAE (group 4) confirmed intimal dysfunction, correlating positively with prothrombin fragment 1 + 2 levels.

Conclusions:

  • Insulin-dependent diabetes is associated with enhanced activity of the coagulation factor Xa.
  • Coagulation activation and intimal dysfunction are present in diabetic nephropathy.
  • These findings suggest a potential link between coagulation abnormalities and the progression of diabetic kidney disease.