Coagulation and fibrinolysis in diabetes mellitus. Special reference to diabetic nephropathy.

Abstract

Diabetes mellitus is one of the common diseases which often involve thrombi formation in major and microcirculation.Although these thrombi might be caused by a hypercoagulable and hypofibrinolytic state in this disease, precise mechanism is not get clearly understood.In this study, we measured Fibrinopeptide A (FPA) and Fibrinopeptide B1542 using radioimmunoassay in patients with diabetes mellitus. In the plasma of diabetic patients, FPA and FPB p 15. 42 were elevated, although fibrinogen, FDP, a2-PI and ATIII levels remained the same. Fasting blood sugar levels did not correlate to plasma FPA and FPBa15-42. Fibrinogen levels in patients with diabetic nephropathy (Group I) were statistically higher than those in patients without nephropathy (Group II). Urinary FPA, FPB, 315-42 and FDP levels in group I were higher than those in group II. Urinary FPA had an inverse relationship to 24 hours creatinine clearance.After administration of heparin to patients with high urinary FPA and FDP excretion, we observed a remarkable reduction of urinary FPA and FDP levels but no changes in urinary protein, plasma FPA and serum FDP. These data suggest that (1) blood sugar per se does not cause