Literature DB >> 21955218

Thrombin generation in type 2 diabetes with albuminuria and macrovascular disease.

Leyla Ay1, Florian Hoellerl, Cihan Ay, Johanna-Maria Brix, Silvia Koder, Gerit-Holger Schernthaner, Ingrid Pabinger, Guntram Schernthaner.   

Abstract

BACKGROUND: Albuminuria is an indicator of cardiovascular morbidity and mortality in patients with type 2 diabetic mellitus (T2DM).
MATERIALS AND METHODS: In our cross-sectional study, we measured thrombin generation (TG), a key process in haemostasis and a tool to detect an individual's coagulation potential, in normo-, micro- and macroalbuminuria in T2DM with and without macrovascular disease (MVD). The TG-assay was performed, and the TG-curve [including the lag phase, peak thrombin and area under the curve (AUC)] was analysed.
RESULTS: A total of 160 patients (62 women; mean age ± SD: 67 ± 11 years) with T2DM and normo-, micro- or macroalbuminuria were investigated. Of those, 90 (56%) patients had normoalbuminuria, 40 (25%) microalbuminuria and 30 (19%) macroalbuminuria. The AUC between the groups of patients with normo-, micro- and macroalbuminuria was statistically significantly different [3297 (2785; 3764) vs. 3222 (2381; 3678) vs. 3726 (3153; 4235) nM Thrombin; P = 0AE019]. T2DM patients with MVD (n = 121) had a significantly shorter lag phase [12 (9; 16) vs. 20 (15; 25) min; P < 0AE001], a significantly higher peak thrombin [233 (130; 339) vs. 133 (82; 187) nM; P < 0AE001] and a significantly higher AUC [3464 (2969; 3868) vs. 3091 (2384; 3619) nM Thrombin; P = 0AE01] than T2DM patients without MVD (n = 39), indicating an earlier and higher thrombin generation.
CONCLUSION: Our results support the hypothesis that TG may be involved in the pathogenesis of MVD in diabetic nephropathy as for the first time, we could show that patients with T2DM in different stages of diabetic nephropathy had disturbances in thrombin generation.
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation.

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Year:  2011        PMID: 21955218     DOI: 10.1111/j.1365-2362.2011.02602.x

Source DB:  PubMed          Journal:  Eur J Clin Invest        ISSN: 0014-2972            Impact factor:   4.686


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