PROTHROMBOTIC AND ANTITHROMBOTIC FACTORS ARE ELEVATED IN PATIENTS WITH TYPE-1 DIABETES COMPLICATED BY MICROALBUMINURIA

被引:22
作者
LEE, P [1 ]
JENKINS, A [1 ]
BOURKE, C [1 ]
SANTAMARIA, J [1 ]
PATON, C [1 ]
JANUS, E [1 ]
BEST, J [1 ]
机构
[1] ST VINCENTS HOSP,DEPT MED,VICTORIA PARADE,FITZROY,VIC 3065,AUSTRALIA
关键词
TYPE-1; DIABETES; MICROALBUMINURIA; THROMBOSIS; FIBRINOGEN; FACTOR-VIIC; PLASMINOGEN ACTIVATOR INHIBITOR;
D O I
10.1111/j.1464-5491.1993.tb00028.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Increased urinary albumin loss in patients with Type 1 diabetes is associated with accelerated atherosclerosis. Prothrombotic factors known to be associated with cerebrovascular and coronary artery disease in the general population, and antithrombotic factors, were studied in 52 patients with Type 1 diabetes and varying urinary albumin loss and 24 non-diabetic control subjects. Fibrinogen increased from 2.5 g l-1 (95 % confidence interval 2.3-2.8) in control subjects and 2.8 g l-1 (2.6-3.0) in diabetic patients without microalbuminuria to 3.1 g l-1 (2.7-3.5) with microalbuminuria (p < 0.005 vs control; p < 0.001 vs without microalbuminuria). Factor VIIc increased from 81 % (75-86 % in non-diabetic control subjects and 84 % (78-90 %) in diabetic patients without microalbuminuria to 103 % (89-117%) with microalbuminuria (p<0.005 vs control; p < 0.05 vs without microalbuminuria) and 118 % (86-150 %) with albuminuria (p < 0.005 vs control and p < 0.001 vs without microalbuminuria). Levels of the antithrombotic factors protein C, protein S, and antithrombin III also rose in the diabetic patients with evidence of renal damage. Elevation of prothrombotic factors has been associated with increased risk of microvascular disease, whereas elevation of antithrombotic factors has no known protective effect. Therefore, this pattern of alteration of haemostatic factors in diabetic renal disease may contribute to the increased risk of vascular disease associated with both microalbuminuria and albuminuria.
引用
收藏
页码:122 / 128
页数:7
相关论文
共 37 条
[1]  
Borch-Johnsen K., Kreiner S., Proteinuria, a predictor of cardiovascular abnormality in insulin dependent diabetes mellitus, BMJ, 294, pp. 1651-1655, (1987)
[2]  
Parving H-H, Andersen AR, Smidt UM, Oxenboll B., Edsberg B., Christiansen, Diabetic nephropathy and arterial hypertension, Diabetologia, 24, pp. 10-12, (1983)
[3]  
Winocour PH, Durrington PN, Ishola M., Anderson DC, Cohen H., Influence of proteinuria on vascular disease, blood pressure, and lipoproteins in insulin dependent diabetes mellitus, Br Med J, 294, pp. 1648-1651, (1987)
[4]  
Jensen T., Stender S., Deckert T., Abnormalities in plasma concentrations of lipoproteins and fibrinogen in type 1 (insulin‐dependent) diabetic patients with increased urinary albumin excretion, Diabetologia, 31, pp. 142-145, (1988)
[5]  
Vannini P., Ciavarella A., Flammini M., Bargossi AM, Forlani G., Borgnino LC, Et al., Lipid abnormalities in insulin‐dependent diabetic patients with albuminuria, Diabetes Care, 7, pp. 151-154, (1984)
[6]  
Earle K., Walker J., Hill C., Viberti G., Familial clustering of cardiovascular disease in patients with insulin‐dependent diabetes and nephropathy, N Engl J Med, 326, pp. 673-677, (1992)
[7]  
Wiseman M., Viberti G., Mackintosh D., Jarrett RJ, Keen H., Glycaemia, arterial pressure and micro‐albuminuria in Type 1 (insulin‐dependent) diabetes mellitus, Diabetologia, 26, pp. 401-405, (1984)
[8]  
Jones SL, Close CF, Mattock MB, Jarrett RJ, Keen H., Viberti GC, Plasma lipid and coagulation factor concentrations in insulin‐dependent diabetics with microalbuminuria, Br Med J, 298, pp. 487-490, (1989)
[9]  
Watts GF, Naumova R., Slavin BM, Morris RW, Houlston R., Kubal C., Et al., Serum lipids and lipoproteins in insulin‐dependent diabetic patients with persistent microalbuminuria, Diabetic Med, 6, pp. 25-30, (1989)
[10]  
Jenkins AJ, Steele JS, Janus ED, Best JD, Increased plasma apolipoprotein (a) levels in IDDM patients with microalbuminuria, Diabetes, 40, pp. 787-790, (1991)