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Tissue factor pathway inhibitor activity in patients with IDDM
P B Leurs1, R van Oerle, K Hamulyak
1Department of Internal Medicine, University Hospital, Maastricht, The Netherlands.
Diabetes
|January 1, 1995
Summary
Tissue factor pathway inhibitor (TFPI) activity is elevated in patients with insulin-dependent diabetes mellitus (IDDM), particularly after heparin. This suggests TFPI may indicate early endothelial dysfunction in diabetes.
Area of Science:
- Endocrinology
- Vascular Biology
- Hemostasis
Background:
- Vascular endothelial dysfunction is a key complication of diabetes.
- Endothelium-dependent hemostatic parameters are potential markers for this dysfunction.
Purpose of the Study:
- To investigate tissue factor pathway inhibitor (TFPI) activity in patients with insulin-dependent diabetes mellitus (IDDM) without vascular complications.
- To compare TFPI activity before and after heparin administration in IDDM patients and healthy controls.
- To assess the effect of acute hyperglycemia on TFPI activity.
Main Methods:
- Studied TFPI activity using both clotting and chromogenic assays.
- Administered intravenous heparin to IDDM patients and controls.
- Measured TFPI activity in healthy men during acute hyperglycemia.
Main Results:
- IDDM patients showed significantly higher TFPI activity before heparin (chromogenic assay).
- The post-heparin increase in TFPI activity was significantly greater in IDDM patients (both assays).
- A positive correlation was found between TFPI activity and glycated hemoglobin levels.
Conclusions:
- Chronic hyperglycemia affects TFPI activity in diabetic subjects, even without evident vascular complications.
- Altered TFPI activity, especially post-heparin, may serve as an early indicator of endothelial dysfunction in diabetes.