The Contact Phase of Blood Coagulation in Diabetes Mellitus and in Patients with Vasculopathy

Christe, M; Gattlen, P; Fritschi, J; Lämmle, Bernhard; Berger, W; Marbet, G A; Duckert, F

doi:10.1055/s-0038-1661181

Cited by 18 publications

(13 citation statements)

References 1 publication

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“…Our study confirms earlier observations [3,12] that variables of the contact phase of coagulation may exhibit different patterns in diabetics with different complications. A discriminant function with Cl-inhibitor concentration, HK activity and fibrinogen as most decisive variables strongly separated diabetics with neuropathy from those without complications or with angiopathy alone.…”

Section: Discriminant Analysis Between the Clinical Groupssupporting

confidence: 92%

“…In a previous study from our laboratory concerning different hemostatic functions of plasma and platelets in patients with diabetes mellitus and their c o n t r i b u t i o n to diabetic complications such as neuropathy, micro-and m a c r o a n g i o p a t h y and n e p h r o p a t h y [2,3,7], we found that high prekallikrein values seemed to characterize a small group of patients with sensomotor neuropathy. The aim of the present study was to investigate the relationship between diabetic complications, especially neuropathy, and the contact-activation phase of coagulation.…”

Section: Introductionmentioning

confidence: 99%

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Patterns of contact phase proteins indicating neuropathy in diabetic patients

Meier¹,

Marbet²,

Berger

et al. 1990

Blut

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In 42 outpatients of the diabetology division, coagulation and fibrinolysis variables were determined in order to detect typical patterns of results with which it was possible to discriminate between three groups with different diabetic complications (17: no complication, 7: angiopathy alone, 18: neuropathy with or without other complications). There was a statistically significant discriminatory function involving C1-inhibitor concentration, high molecular weight kininogen coagulant activity and fibrinogen as the most decisive variables. The neuropathy group was appropriately separated from the others with an 81% correct reclassification. Heparin cofactor II, histidine-rich glycoprotein, alpha 2-macroglobulin, pre-kallikrein and factor XII had no discriminative power.

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Section: Discriminant Analysis Between the Clinical Groupssupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Patterns of contact phase proteins indicating neuropathy in diabetic patients

Meier¹,

Marbet²,

Berger

et al. 1990

Blut

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“…Plasma concentrations of fibronectin and vWf are considered markers of endothelial injury and associated with glomerular disease in diabetes [37±40]. a-2 macroglobulin is increased in patients with diabetic complications [41,42]. Moreover, fibrinogen, vWf, F VII:C, and factor VIII (a liver synthesized protein bound to vWf in the circulation) are associated with a higher incidence of ischaemic heart disease.…”

Section: Discussionmentioning

confidence: 99%

Transcapillary escape rate and albuminuria in Type II diabetes. Effects of short-term treatment with low-molecular weight heparin (Short Communication)

Nielsén¹,

Schmitz²,

Bacher

et al. 1999

Diabetologia

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Type II (non-insulin-dependent) diabetic patients with abnormal urinary albumin excretion rate (UAE), even in the microalbuminuric range (UAE 20±200 mg/min), have an increased prevalence of vascular disease and risk of cardiovascular events compared with patients with normoalbuminuria (UAE < 20 mg/min) [1±5]. The association has raised the hypothesis that patients with increased albuminuria do not only have glomerular disease but also extensive vascular damage [6,7]. Increased transcapillary escape rate of albumin (TER alb ) [i. e. the fraction Diabetologia (1999) Summary The relation between urinary albumin excretion rate (UAE), transcapillary escape rate of albumin (TER alb ), haemostatic factors, ambulatory blood pressure, and metabolic variables was investigated in 45 Type II (non-insulin-dependent) diabetic patients without overt nephropathy or uncontrolled blood pressure. We enrolled 44 patients in a placebo controlled study to test the effects of 3 week long treatment with low-molecular weight heparin (tinzaparin) on the same variables. BMI, 24 h systolic and diastolic blood pressure, plasma concentrations of triglycerides, fasting glucose, factor VIII, von Willebrand factor (vWf), fibrinogen, a-2 macroglobulin, and fibronectin were notably higher in patients with increased albuminuria compared with normoalbuminuric patients, whereas the TER alb was similar in the two groups. TER alb correlated with fasting plasma glucose. UAE correlated more closely than TER alb with 24 h ambulatory blood pressure, vWf, and factor VIII. Urinary albumin excretion rate was unchanged during tinzaparin [28.9 ± 5.6 vs 28.1 ± 6.0 mg/min (geometric mean (antilog SD)] vs placebo (18.0 ± 5.4 vs 17.6 ± 5.3 mg/min), and no change was found in TER alb [6.3 ± 1.6 vs 6.0 ± 1.5 %/h (means ± SD), and 6.3 ± 1.5 vs 5.6 ± 1.8 %/h; tinzaparin versus placebo, respectively]. Only minor changes were observed in blood pressure, lipids, glycaemic control and haemostatic factors. This study shows no correlation between albuminuria and transcapillary escape rate in Type II diabetic patients without overt nephropathy or uncontrolled blood pressure. UAE is related to markers of atherosclerosis, endothelial injury and dysfunction, and haemostatic factors. Moreover, UAE correlates much more than TER alb with 24 h ambulatory blood pressure, von Willebrand factor, and factor VIII. Finally, short-term treatment with tinzaparin does not change the transvascular or glomerular leakage of albumin. These results indicate that TER alb is not a sensitive marker of microvascular dysfunction in such patients and that factors other than abnormal glycosaminoglycan metabolism may contribute to the vascular damage of these patients. [Diabetalogia (1999)

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“…In recent years, a growing number of studies has focussed attention on fibrinogen in diabetes, suggesting its role as a marker of cardiovascular risk also in this disease. An association between initial hyperfibrinogenaemia and the subsequent occurrence of macroangiopathy, as well as the evidence that a high fibrinogen concentration enhances the risk of cardiovascular disease in diabetic patients, have been reported [3][4][5]. The demonstration that diabetes and parental history of diabetes are strongly and positively associated with fibrinogen levels has also been made [6].…”

Section: Fibrinogen and Diabetesmentioning

confidence: 99%