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Prothrombin fragment 1 + 2 and antithrombin III-thrombin complex in microalbuminuric type 2 diabetic patients
G Gruden1, P Cavallo-Perin, R Romagnoli
1Institute of Internal Medicine, University of Turin, Italy.
Abstract:
In microalbuminuria there is an increased cardiovascular risk not fully explained by the excess of conventional risk factors. To investigate whether or not microalbuminuria is associated with haemostatic abnormalities in Type 2 diabetic patients, we measured the prothrombin fragment 1 + 2, a marker of thrombin generation, and the thrombin-antithrombin complex, a marker of thrombin neutralization. Plasma levels of prothrombin fragment 1 + 2 and thrombin-antithrombin complex were assayed in 17 microalbuminuric patients (albumin excretion rate, AER 20-200 micrograms min-1) and in 17 comparable normoalbuminuric (AER < 20 micrograms min-1) Type 2 diabetic patients. Plasma prothrombin fragment 1 + 2 was significantly higher in microalbuminuric than in normoalbuminuric patients (1.09 +/- 0.06 vs 0.86 +/- 0.04 nM, p = 0.003). Individual values of F1 + 2 were above the upper limit of the normal range in 8/17 microalbuminuric and in none of the normoalbuminuric Type 2 diabetic patients. Plasma thrombin-antithrombin complex values were not significantly different in the two groups and were not correlated with AER. These results suggest that microalbuminuria is associated with a prethrombotic state and a relatively defective thrombin neutralization. Coagulation abnormalities might be part of the cardiovascular risk in microalbuminuric patients.
Insights
Microalbuminuria in Type 2 diabetes is linked to a prethrombotic state, indicated by higher thrombin generation markers. This suggests coagulation abnormalities may contribute to increased cardiovascular risk.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Hematology
Background:
- Microalbuminuria in Type 2 diabetes is associated with elevated cardiovascular risk.
- This risk is not fully explained by conventional risk factors alone.
Purpose of the Study:
- To investigate the association between microalbuminuria and hemostatic abnormalities in Type 2 diabetic patients.
- To assess thrombin generation and neutralization markers in relation to albumin excretion rate.
Main Methods:
- Measured plasma levels of prothrombin fragment 1 + 2 (thrombin generation marker).
- Measured plasma levels of thrombin-antithrombin complex (thrombin neutralization marker).
- Compared levels between 17 microalbuminuric and 17 normoalbuminuric Type 2 diabetic patients.
Main Results:
- Plasma prothrombin fragment 1 + 2 was significantly higher in microalbuminuric patients (p = 0.003).
- Elevated prothrombin fragment 1 + 2 levels were observed in 8/17 microalbuminuric patients.
- Thrombin-antithrombin complex levels did not differ significantly between groups.
Conclusions:
- Microalbuminuria in Type 2 diabetes is associated with a prethrombotic state.
- A potential defect in thrombin neutralization may exist in microalbuminuric patients.
- Coagulation abnormalities could contribute to the increased cardiovascular risk observed.