Mechanisms of Hypercoagulation and Aberrant Clot Lyses in Type 2 Diabetes

Pretorius, Etheresia

doi:10.1007/978-3-319-60324-7_17

Cited by 3 publications

(2 citation statements)

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“…Type 2 diabetes mellitus (T2DM) patients are at significant risk of developing cardiovascular disease due to the impact of blood glucose elevation on the coagulation system, through a series of actions [1]. First, the increase of blood glucose could induce endothelial abnormalities and stimulate incomplete activation of the coagulation cascade [2].…”

Section: Introductionmentioning

confidence: 99%

The acute effect of a moderate intensity ergocycle exercise on the coagulation parameters in type 2 diabetes mellitus patients: a feasibility study

Arovah

Kushartanti

2020

Clinical Diabetology

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Background. Type 2 diabetes mellitus (T2DM) patients experience higher atherothrombotic risks that could lead to cardiovascular diseases, due to increases in coagulation activities. The role of exercise in altering coagulation activities among T2DM patients is still inconclusive. This feasibility study aimed to evaluate the immediate effect of a moderate intensity ergocycle exercise, primary on the coagulation parameters and secondary on the systemic inflammation and blood glucose, in otherwise healthy T2DM patients. Methods. Ten T2DM patients (64 ± 7 year, 40% female) performed a 30-minute moderate-intensity ergocycle exercise at 50-60% of heart rate reserved. Coagulation parameters (activated partial thromboplastin time [aPTT], prothrombin time [PT] and platelet count), erythrocyte sedimentation rate, and blood glucose were assessed before the exercise (T0), immediately after the exercise (T1), and 30 minutes post exercise (T2). One-way repeated measured ANOVA was used to assess the outcomes over time. Results. All participants completed and adhered to the exercise protocol. There were increases in aPTT and PT but decreases in platelet count at T1 and T2 compared to at T0 (P < 0.05), indicating reduction in the coagula-tion activities. Those values, however, were still within normal ranges. The erythrocyte sedimentation rates were unaffected, while blood glucose decreased from 202 ± 35 mg/dL at T0 to 173 ± 33 mg/dL and 158 ± 30 mg/dL at T1 and T2 (P < 0.01). Conclusion. The 30-minute moderate-intensity ergocycle decreases coagulation activities and blood glucose but does not affect erythrocyte sedimentation rates in T2DM patients. Future studies should focus on the chronic adaptation of the coagulation parameters after ergocycle training among a T2DM patients with coagulation impairments.

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Section: Introductionmentioning

confidence: 99%

The acute effect of a moderate intensity ergocycle exercise on the coagulation parameters in type 2 diabetes mellitus patients: a feasibility study

Arovah

Kushartanti

2020

Clinical Diabetology

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“…Furthermore, The Insulin Resistance Atherosclerosis Study (2002) confirmed the association of chronic inflammation with development of T2DM, as well as the relationship between the resultant insulin resistance and progression of atherosclerosis [ 4 ]. It is well known that a dysregulated low-grade systemic inflammatory milieu is present in T2DM, including C-reactive protein (CRP), tissue factor, interleukins (IL-1β, IL-6 and IL-8) and tumour necrosis factor alpha (TNF-α) [ 5 – 8 ]. These elevated circulating inflammatory markers are associated with dyslipidaemia and atherosclerosis (albeit markers of many other inflammatory diseases [ 9 ]), and are thought to be potential predictors of the development of T2DM [ 4 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Platelet activity and hypercoagulation in type 2 diabetes

Pretorius

Thomson

Adams

et al. 2018

Cardiovasc Diabetol

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100

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BackgroundA strong correlation exists between type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), with CVD and the presence of atherosclerosis being the prevailing cause of morbidity and mortality in diabetic populations. T2DM is accompanied by various coagulopathies, including anomalous clot formation or amyloid fibrin(ogen), the presence of dysregulated inflammatory molecules. Platelets are intimately involved in thrombus formation and particularly vulnerable to inflammatory cytokines.MethodsThe aim of this current study was therefore to assess whole blood (hyper)coagulability, platelet ultrastructure and receptor expression, as well as the levels of IL-1β, IL-6, IL-8 and sP-selectin in healthy and diabetic individuals. Platelet morphology was assessed through scanning electron microscopy (SEM), while assessment of GPIIb/IIIa receptor expression was performed with confocal microscopy and flow cytometry with the addition of FITC-PAC-1 and CD41-PE antibodies. IL-1β, IL-6 and IL-8 and sP-selectin levels were assessed using a multiplex assay.ResultsIn T2DM there is significant upregulation of circulating inflammatory markers, hypercoagulation and platelet activation, with increased GPIIb/IIIa receptor expression, as seen with flow cytometry and confocal microscopy. Analyses showed that these receptors were additionally shed onto microparticles, which was confirmed with SEM.ConclusionsCumulatively, this provides mechanistic evidence that pathological states of platelets together with amyloid fibrin(ogen) in T2DM, might underpin an increased risk for cardiovascular events.

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