Plasma fibrinogen in NIDDM: the Rotterdam study

Area of Science:

• Cardiovascular Research
• Endocrinology
• Gerontology

Background:

• Non-insulin-dependent diabetes mellitus (NIDDM) is a growing public health concern, particularly in the elderly population.
• Plasma fibrinogen is a key protein in the coagulation cascade and a potential risk factor for cardiovascular disease.
• Understanding factors influencing plasma fibrinogen levels in elderly individuals with NIDDM is crucial for risk stratification and management.

Observation:

• A cross-sectional study of 2,971 elderly subjects (mean age 70.8 years) from the Rotterdam Study was conducted.
• Plasma fibrinogen levels were measured and compared between subjects with and without NIDDM.
• The influence of diabetes therapy, metabolic control, and other factors on plasma fibrinogen was evaluated.

Findings:

• No significant difference in plasma fibrinogen levels was observed between elderly subjects with and without NIDDM (2.84 vs. 2.81 mg, P=0.5).
• After adjusting for covariates, subjects receiving insulin therapy exhibited significantly higher plasma fibrinogen levels compared to those not on antidiabetes medication or without diabetes.
• Specifically, age- and sex-adjusted fibrinogen levels were 3.23 mg in insulin-treated NIDDM patients versus 2.82 mg in non-diabetic individuals (P < 0.005).
• Adjustment for fructosamine levels partially attenuated these differences, indicating a role for metabolic control.

Implications:

• Elevated plasma fibrinogen in insulin-treated NIDDM patients may indicate poorer glycemic control.
• These findings highlight the importance of monitoring fibrinogen levels in specific NIDDM subgroups.
• Further research is warranted to elucidate the precise mechanisms linking insulin therapy, metabolic control, and elevated fibrinogen in NIDDM.