GLYCOMETABOLIC CONTROL, LIPIDS, AND COAGULATION PARAMETERS IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

被引:15
作者
DONDERS, SHJ
LUSTERMANS, FAT
VANWERSCH, JWJ
机构
[1] DE WEVER HOSP, HAEMATOL LAB, POB 4446, 6401 CX HEERLEN, NETHERLANDS
[2] DE WEVER HOSP, DEPT INTERNAL MED, 6401 CX HEERLEN, NETHERLANDS
关键词
NON-INSULIN-DEPENDENT DIABETES-MELLITUS; LIPIDS; LIPOPROTEIN(A); COAGULATION;
D O I
10.1007/BF02592301
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Diabetes mellitus and hyperlipidemia are associated with coronary heart disease and with hypercoagulability, another independent risk factor for coronary heart disease. In 65 non-insulin-dependent diabetes mellitus patients [41 females, 24 males, median age 66 years (range 43 - 81 years)] treated with antidiabetic agents glycometabolic control (HbA1c), lipids (Quetelet index and blood lipids), and several coagulation parameters were studied in comparison with a reference group. Serum triglycerides were elevated [median (interquartile range) 2.3 (1.3) mmol/l vs. 1.6 (0.7) mmol/l in the controls (P < 0.001)], whereas the median lipoprotein(a) concentration was 65 (157) mg/l in the diabetic patients versus 44 (114) mg/l in the control group (not significantly different). Median high-density lipoprotein-cholesterol concentrations were slightly decreased in the diabetic patients: 1.2 (0.3) mmol/l compared with 1.3 (0.4) mmol/I in the control group (P < 0.02). Elevated levels of fibrinogen, fibrin monomers, thrombin-antithrombin III complex, and factor VIIIc were found in the diabetic patients and factor VII in male diabetic patients. These elevated coagulation parameters are indicators of an activated coagulation system in this patient group. By Spearman's rank test, only HbA1c values correlated with antithrombin III (r = 0.27, P < 0.03) and showed a tendency towards a correlation with lipoprotein(a) (r = 0.23, P < 0.07). Triglycerides correlated with the Quetelet index (r = 0.27, P < 0.03), high-density lipoprotein-cholesterol (r = -0.41, P < 0.001), and factor VII (r = 0.35, P < 0.01), whereas serum cholesterol concentrations correlated with factor VII (r = 0.27, P < 0.04) and with fibrin monomers (r = 0.29, P < 0.03). In this group of 65 non-insulin-dependent diabetes mellitus patients we found a characteristic adverse lipid profile in association with signs of an activated coagulation system. Glycometabolic control appeared to have no major influence on the degree of activation of the coagulation system in these patients. This study supports the more aggressive approach advised in the treatment of hyperlipidemia in diabetic patients.
引用
收藏
页码:155 / 159
页数:5
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