Elevated plasma factor VIII and von Willebrand factor in women with type 2 diabetes

Abstract

The association between type 2 diabetes and cardiovascular disease is long recognized. Although perturbations of haemostatic markers have been shown to be associated with macrovascular disease in patients with type 2 diabetes, it is unclear whether these are primarily due to endothelial dysfunction or a result of inflammation. The present study was undertaken to elucidate whether elevated levels of factor VIII (FVIII) and von Willebrand factor (vWF) in women with type 2 diabetes represent endothelial dysfunction, inflammation or an alternate mechanism. Sixty-four women with type 2 diabetes were evaluated using ultrasonography Doppler for carotid intima-media thickness (IMT) and were classified as group A--having no (<1 mm), group B - mild (≥1 mm and no plaque) and group C--moderate (≥1 mm and presence of plaque and stenosis) macrovascular disease. Several haemostatic markers including, FVIII, vWF and fibrinogen were assessed. In addition, thrombomodulin, a marker for endothelial damage, and high-sensitivity C-reactive protein (hsCRP), an inflammatory marker, were also measured. A significant association of elevated FVIII was found in group B and C patients (i.e. patients with IMT ≥1 mm and with plaque). Elevated fibrinogen and vWF levels were also found but confined to group C patients. No significant difference among subgroups was found for any other variable evaluated (hsCRP, thrombomodulin and FVII). In conclusion, plasma FVIII levels are elevated in women with type 2 diabetes and macrovascular disease. It also appears that this is not mediated by inflammation or endothelial injury and is likely to be due to an alternate mechanism.

Von Willebrand Factor Regulation in Patients with Acute and Chronic Cerebrovascular Disease: A Pilot, Case–Control Study

“…Elevated levels of VWF in patients with chronic cerebrovascular disease compared with healthy controls presented herein is similar to the findings of a previous study, which showed that subjects with carotid plaques have elevated VWF levels [35]. In addition, a recent report shows that atherosclerotic geometries exacerbate pathological thrombus formation post-stenosis in a VWF-dependent manner [36].…”

Influence of ABO type on global coagulation assay results: effect of coagulation factor VIII

“…This likely explains the association of FVIII levels with C-reactive protein levels. With regard to the association between FVIII and blood glucose levels, some studies have shown that high blood glucose levels in patients with diabetes are associated with elevated FVIII levels [36,37] . However, the detailed mechanism underlying the association between glucose and FVIII levels remains unknown.…”

Relationship between the von Willebrand Factor Plasma Concentration and Ultrasonographic Doppler Findings in Pregnancies Complicated by Hypertensive Disorders: A Pilot Study

“…All these changes may lead to increased vessel resistance in Doppler ultrasound measurements. Soares et al [25] evaluated women with type 2 diabetes using ultrasonography Doppler for assessment of carotid intima-media thickness. Elevated vWf plasma concentration was found only in patients with moderate macrovascular disease (≥1 mm and presence of plaque and stenosis) but was not detected in women without or with mild macrovascular disease.…”