The Correlation Between Estimated Glucose Disposal Rate and Coagulation Indexes in Type 2 Diabetes Mellitus

Abstract

Purpose To study the correlation between estimated glucose disposition rate (eGDR) and coagulation parameters in type 2 diabetes patients (T2DM). Materials and Methods A total of 948 patients suffering from T2DM were enrolled for this research. Various blood coagulation parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB) were assessed. Body mass index (BMI), hypertension, and the levels of glycated hemoglobin (HbA1c) were used to calculate the patients’ eGDRs. All patients were sorted into two groups: those with high eGDRs (eGDR≥7.5) and those with low eGDRs (eGDR<7.5). The patients were then separated into groups of men and women. The connection between eGDR and coagulation indexes was examined using Spearman correlation, Pearson correlation, and multiple linear regression analysis. Results In comparison to the high-eGDR group, reduced PT and APTT levels with increased FIB levels were observed in the low-eGDR group ( P =0.006, P <0.001, and P = 0.035, respectively). The eGDR showed a positive relation with APTT (r = 0.142, P < 0.001), a negative relation with FIB (r = −0.082, P = 0.012), and no correlation with PT (r =0.064, P =0.050) in the all patients. As well as, the eGDR demonstrated a positive relation with APTT (r = 0.173, P < 0.001), a negative relation with FIB (r = −0.093, P = 0.03), and no relation with PT (r = 0.045, P = 0.300) in the male subgroups. Additionally, this correlation persisted following the adjustment of other factors in multilinear regression analysis. However, the female subgroup demonstrated no correlation among eGDR and PT, APTT or FIB (r = 0.086, P = 0.083, r = 0.097, P = 0.05;r = −0.058, P = 0.240, respectively). Conclusion Our study is the first to prove that eGDR demonstrates a correlation with coagulation indexes in T2DM patients. And, this correlation is gender-specific.

Novel ray of hope for diabetic wound healing: Hydrogen sulfide and its releasing agents

“…Vascular damage and blood transport disorders make it difficult for drugs to reach the wound through blood circulation [37] . Hyperglycemia can lead to hyperfibrinogenemia in diabetic patients, activating the coagulation cascade, thereby increasing thrombin formation and fibrinogen degradation products [38] . Local tissue edema, hypoxia, and high glucose environment are suitable for bacterial growth [2] .…”

Hemostatic tests in patients with type 2 diabetes mellitus

“…(18,19) El TP es una prueba hemostásica que evalúa los factores que intervienen en la vía extrínseca y la vía común de la coagulación. Diferentes estudios analizaron esta prueba, sin embargo, como muestra la tabla 1, existió heterogeneidad entre resultados, ya que en ciertas investigaciones los valores mostraron una disminución, (16,21,22) en otro los valores se encontraron dentro del rango referencial (17) y en un caso diferente se mostraron elevados, (23) por lo tanto, su valor clínico en pacientes con DM2 es poco significativo. Es recomendable tomar en cuenta aspectos antes de analizar el TP, por ejemplo, la extensión temporal de la enfermedad, ya que, al estar en constante inflamación y producción de factores coagulativos, eventualmente, su producción se vuelve deficiente, lo que podría prologar los tiempos de TP.…”

“…(24) Por otra parte, un componente que influye en agregación plaquetaria y la reología sanguínea es el fibrinógeno. (13,21) De acuerdo a la tabla 1, niveles elevados han sido encontrados en pacientes diabéticos a diferencia de los controles, posiblemente por el incremento en la producción de factores proagregantes y disminución de factores antiagregantes a través de una estimulación hepática por la hiperglicemia. (14) Es por ello que, se ha considerado al fibrinógeno como un biomarcador proinflamatorio, que, a su vez, contribuye al desarrollo de enfermedades cardiovasculares.…”

“…(14) Es por ello que, se ha considerado al fibrinógeno como un biomarcador proinflamatorio, que, a su vez, contribuye al desarrollo de enfermedades cardiovasculares. (21,24) Según investigaciones expuestas en la tabla 1, el PAI-1 tuvo niveles mucho mayores en pacientes con DM2…”