Glycometabolic Control and Fibrinolysis in Diabetic Patients

Wersch, J. W. J. Van; Westerhuis, L. W. J. J. M.; Venekamp, W.J.R.R.

doi:10.1159/000216134

Cited by 9 publications

(5 citation statements)

References 5 publications

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“…Diabetic vasculopathy has been demonstrated in type 1 and type 2 diabetes and in the latter setting might be a consequence of impaired fibrinolysis and/or of endothelial damage mediated by hyperglycemia, accelerated atherosclerosis, and vasoactive cytokines and growth factors. [10][11][12][13][14][15] A few limitations of this analysis are worthy of note. First, incomplete or inaccurate reporting on birth certificates is an inherent concern in studies using birth certificate data, such as those analyzed here.…”

Section: Discussionmentioning

confidence: 99%

Maternal Risk Factors for Term Neonatal Seizures: Population-Based Study in Colorado, 1989—2003

Hall¹,

Wadwa

Goldenberg³

et al. 2006

J Child Neurol

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Neonatal seizures in term infants are rare but have important potential implications for brain development. Risk factors for neonatal seizures in term infants have been less well defined than those among preterm infants. To evaluate the relationship between maternal risk factors and neonatal seizures in the first 72 hours of life in term infants, a case-control study using the Colorado Birth Certificate Registry was conducted. Term neonates in all hospitals in Colorado with and without seizures in the first 72 hours were studied. After adjusting for vaginal delivery in the setting of herpes infection and post-term delivery, preexisting diabetes in the mother (odds ratio 4.30, 95% confidence interval 1.64-11.27, P < .01) and fetal distress (odds ratio 5.88, 95% confidence interval 4.60-7.13, P < .0001) were independent risk factors for neonatal seizures in term infants. These findings are confirmatory of previous reports that maternal preexisting diabetes and fetal distress increase the risk of neonatal seizure in term infants. Although we cannot establish the pathophysiology of neonatal seizures from this analysis, hypoxic-ischemic brain injury and hypoglycemia in infants of diabetic mothers are known causes of neonatal seizures that can be represented in this analysis by fetal distress and maternal preexisting diabetes, respectively. Maternal diabetic vasculopathy can also be a contributing factor.

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Section: Discussionmentioning

confidence: 99%

Maternal Risk Factors for Term Neonatal Seizures: Population-Based Study in Colorado, 1989—2003

Hall¹,

Wadwa

Goldenberg³

et al. 2006

J Child Neurol

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“…Moreover, we could re cently demonstrate in a paper published in this journal [27] that such levels have not been seen in our diabetic patient group. If correlated to the glycometabolic control pa rameter HbAi, there could be found a signif icant elevation of the mean FM values with increasing HbAi levels.…”

Section: Discussionmentioning

confidence: 50%

“…Finally, if the present knowledge about coagulation and fi brinolysis in diabetes mellitus can be shortly summarized as stated by Ostermann and van de Loo [1] -activation of the platelets, eleva tion of factor VIII, decrease of AT-III, en hancement of fibrinolysis in good glycome tabolic control (HbAi < 10%) -and clearly stay behind fibrinolysis in poor glycometa bolic control (HbAi > 10%) [27] we have added now to this knowledge the insight of increased coagulation activation as indi cated by the FM levels in dependence of the glycometabolic control state. These results might be compatible with a more causal rela tionship between coagulation activation and poor metabolic control state in diabetics on the one hand and the secondary sequelae of the disease on the other.…”

Section: Discussionmentioning

confidence: 96%

Coagulation Activation in Diabetes mellitus

Wersch

Westerhuis²,

Venekamp³

1990

Pathophysiol Haemos Thromb

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One hundred and fourty-eight insulin-dependent diabetic patients were available for this study; 56 males and 92 females. For the investigation of coagulation activation we determined activated partial thromboplastin time, thrombin time, and fibrinogen besides fibrin monomers and thrombin-antithrombin III complexes (TAT-III). We assessed large percentages of increased fibrinogen levels but non-significant increases of the mean values in comparison with the reference group. The values for thrombin time were significantly prolonged, although relatively small percentages were exceeding the reference range. For the activated partial thromboplastin time, the values exceeded the upper reference limit, and the mean values were significantly higher than those of the reference group. Also for the fibrin monomers we obtained often enhanced values, and, moreover, the values were significantly higher as compared with the reference subjects. The amount of TAT-III concentrations above the reference range was much smaller than for the fibrin monomers and the TAT-III levels were not significantly enhanced. The results presented here are indicative of coagulation activation in diabetics, as indicated by the fibrin monomers and more or less by the TAT-III levels. Moreover, there could be demonstrated a positive correlation between fibrin monomer levels and HbA₁ concentrations.

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“…There were no similar studies before. However, a study conducted by Wersh et al [23] found correlations between the PAI-1 concentration and the glycated hemoglobin levels, only in patients with T2DM.…”

Section: Discussionmentioning

confidence: 94%

Association of Plasminogen Activator Inhibitor-1 and Cardiovascular Events Development in Patients with Prediabetes

Laryushina

Parakhina

Turgunova

et al. 2021

Open Access Maced J Med Sci

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Background. Plasminogen activator inhibitor-1(PAI-1) is a marker of endothelial dysfunction(ED) and a predictor of both the development of type 2 diabetes mellitus, and a cardiovascular event(CVE). Its role in the CVE development was sufficiently studied in patients without carbohydrate metabolism disorders, and understudied in patients with prediabetes. Aim: the research interest is the study of PAI-1 in patients with prediabetes and its effect on the CVE development. Materials and methods. The case-control study of 168 patients aged from 18 to 65 was carried out among the local population from January to December 2019.After clinical examination, patients were divided into 3 groups: group 1 (n=55)– patients with prediabetes and with CVE; group 2 (n=93) - patients with prediabetes and without CVE; the control group n=20. Results. Differences in PAI-1 level were found in groups 1 (Me=30718.6 pg/ml) and 2 (Me=24692.0 pg/ml; p≤0.001), even greater differences were found in both groups compared to the control one (p≤0.001). The correlation analysis has found in both group influence such IR indicators as fasting glucose, IR-HOMA index, glucagon, C-peptide to elevation of PAI-1. These findings indicate that with an elevation of the PAI-1 level, the concentration of fasting glucose, glucagon, C-peptide and scores of IR-HOMA index increase in both group. The Binary regression analysis has demonstrated, that an elevation of the PAI-1 biomarker increases the likelihood of CVE by 3.3 fold in patients with prediabetes (p≤0.01). In addition to, a model has been derived for assessing the risk of cardiovascular events in patients with prediabetes. Conclusions. Elevation of PAI-1 concentration is associated with insulin resistance which leads to ED, and further development risk of CVE in patients with prediabetes.

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Glycometabolic Control and Fibrinolysis in Diabetic Patients

Cited by 9 publications

References 5 publications

Maternal Risk Factors for Term Neonatal Seizures: Population-Based Study in Colorado, 1989—2003

Maternal Risk Factors for Term Neonatal Seizures: Population-Based Study in Colorado, 1989—2003

Coagulation Activation in Diabetes mellitus

Association of Plasminogen Activator Inhibitor-1 and Cardiovascular Events Development in Patients with Prediabetes

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