Laboratory Parameters of Hemostasis, Adhesion Molecules, and Inflammation in Type 2 Diabetes Mellitus: Correlation with Glycemic Control

Abstract

Background: Type 2 diabetes mellitus (T2DM) is characterized by a prothrombotic state, predisposing to vascular complications. Some related markers, linking thrombophilia to hemostasis and inflammation, however, have been poorly explored in relation to patients’ glycemia. We therefore investigated the association of laboratory hemostatic parameters, circulating adhesion molecules (ADMs), white blood cell (WBC) count, and neutrophil/lymphocyte ratio (NLR) with T2DM and glycemic control. Research design: In this study, 82 subjects, grouped into T2DM patients (n = 41) and healthy individuals (n = 41) were enrolled. To evaluate glycemic control, the T2DM cohort was expanded to 133 patients and sub-classified according to glycated hemoglobin (HbA1c) <7% and ≥ 7% (n = 58 and n = 75, respectively). We assessed glycemia, HbA1c, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), platelet and leukocyte parameters, vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and selectins (E-, P-, L-). Results: PT % activity, PAI-1, VCAM-1, WBC, and neutrophil counts were significantly higher in T2DM patients than in healthy subjects. Poor glycemic control (HbA1c ≥ 7%) was correlated with increased PT activity (p = 0.015), and higher levels of E-selectin (p = 0.009), P-selectin (p = 0.012), and NLR (p = 0.019). Conclusions: Both T2DM and poor glycemic control affect some parameters of hemostasis, inflammation, and adhesion molecules. Further studies are needed to establish their clinical utility as adjuvant markers for cardio-vascular risk in T2DM patients.

Associations between Triglyceride-Glucose Index and Micro- and Macro-Angiopathies in Type 2 Diabetes Mellitus

“…Taken together, the results of the present study could be explained by increased IR and carotid atherosclerosis [6,51]. Insulin resistance was related to endothelial dysfunction, alterations in hemostatic process, and inflammation [51]. These pathogenic changes could increase the risk of CVD [51].…”

“…In a recent study on the Vascular-Metabolic CUN cohort [18], a higher TyG index resulted in a higher risk for incident ischemic stroke, whereas Zheng et al did not find an association between the TyG index and CVA events [33]. Taken together, the results of the present study could be explained by increased IR and carotid atherosclerosis [6,51]. Insulin resistance was related to endothelial dysfunction, alterations in hemostatic process, and inflammation [51].…”

“…Insulin resistance was related to endothelial dysfunction, alterations in hemostatic process, and inflammation [51]. These pathogenic changes could increase the risk of CVD [51].…”

Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases

“…Clinical studies have evidenced an impaired endothelium-dependent dilatation in both T2D patients [180] and related high-risk conditions, including obesity, prediabetes or first-degree familial history of diabetes [181][182][183]. According to current understanding, endothelial dysfunction is associated with oxidative stress and reduced nitric oxide bioavailability, increased anticoagulant properties and platelet aggregation, increased expression of adhesion molecules (i.e., P-and E-selectin, intercellular adhesion molecule-1 (ICAM-1) and leukocyte adhesion molecules [i.e., vascular cell adhesion molecule-1 (VCAM-1), increased secretion of proinflammatory chemokines (monocyte chemotactic protein (MCP-1), and cytokines (i.e., IL-1b, IL-6, IL-8, TNF-a)] [184,185]. A systematic review and meta-analysis [186] reported that a regular consumption of EVOO (approximately between 1 and 50 mg daily) could favorably affect circulating inflammatory biomarkers, known as acute-phase reactants, and the flow-mediated vasodilation, thus contributing to the CVD protective effects of the MedDiet, observed in epidemiological studies [37,38].…”

Abnormal Peripheral Neutrophil Transcriptome in Newly Diagnosed Type 2 Diabetes Patients

“…Neutrophils are the most abundant type of white blood cell and are reported as active players in inflammation of obesity-related insulin resistance [2]. Additionally, neutrophil count, a marker of subclinical inflammation, has been shown to significantly increase in type 2 diabetes compared with healthy subjects [3][4][5]. Neutrophil-lymphocyte ratio significantly increases in prediabetes and diabetes and may be a predictive marker for prediabetes and diabetes mellitus [6].…”