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Plasma thrombomodulin: a marker for microvascular complications in diabetes mellitus
Abstract:
Thrombomodulin (TM), a marker of endothelial cell damage was studied in 183 patients with diabetes mellitus and different stages of complications. Thrombomodulin plasma levels correlated with duration of diabetes in patients with type I and type II diabetes. Thrombomodulin levels were higher in patients with increasing numbers of complications (nephropathy, retinopathy, arterio-occlusive disease, neuropathy). Neither the presence of retinopathy, nor neuropathy alone significantly increased plasma thrombomodulin in patients with similar urinary albumin concentration. The plasma level of thrombomodulin was more prominent in hypertensive than normotensive patients. Multivariate analysis showed that albuminuria is the factor which influences the most the increase of thrombomodulin in serum of diabetic patients.
Insights
Thrombomodulin (TM) levels increase with diabetes duration and complications. Albuminuria is the primary driver of elevated TM in diabetic patients, indicating endothelial cell damage.
Area of Science:
- Endocrinology
- Nephrology
- Vascular Biology
Background:
- Endothelial cell damage is a key factor in diabetic complications.
- Thrombomodulin (TM) is a sensitive marker of endothelial dysfunction.
Purpose of the Study:
- To investigate the relationship between plasma thrombomodulin levels and the duration and severity of complications in patients with diabetes mellitus.
- To identify factors influencing thrombomodulin levels in diabetic patients.
Main Methods:
- Studied 183 patients with Type I and Type II diabetes mellitus.
- Assessed plasma thrombomodulin levels in relation to diabetes duration, presence of complications (nephropathy, retinopathy, arterio-occlusive disease, neuropathy), hypertension, and urinary albumin concentration.
- Utilized multivariate analysis to determine key influencing factors.
Main Results:
- Plasma thrombomodulin levels correlated positively with diabetes duration in both Type I and Type II diabetes.
- Higher thrombomodulin levels were observed with an increasing number of diabetic complications.
- Elevated thrombomodulin was more pronounced in hypertensive versus normotensive diabetic patients.
- Albuminuria emerged as the most significant factor influencing serum thrombomodulin increase in diabetic patients.
Conclusions:
- Plasma thrombomodulin is a valuable indicator of endothelial cell damage in diabetes.
- Albuminuria is a critical determinant of elevated thrombomodulin, highlighting its role in diabetic vascular complications.
- Monitoring thrombomodulin may aid in assessing the risk and progression of diabetic microvascular and macrovascular diseases.