The Hemostatic System in Patients With Type 2 Diabetes With and Without Cardiovascular Disease

Verkleij, Chantal J. N.; Bruijn, Roderick E. de; Meesters, Eelco W.; Gerdes, Victor E. A.; Meijers, Joost C. M.; Marx, Pauline F.

doi:10.1177/1076029610384112

Cited by 26 publications

(27 citation statements)

References 13 publications

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“…In accordance with our findings, Verkleij et al. [25] showed an association of hypercoagulability in T2DM patients with cardiovascular disease by the increased levels of prothrombin fragment 1 + 2 (F1 + 2), an indirect estimate of in vivo thrombin generation. Similarly to our results, recently, Tripodi and colleagues [26] could detect hypercoagulability in patients with T2DM by a thrombin generation assay.…”

Section: Discussionsupporting

confidence: 93%

Thrombin generation in type 2 diabetes with albuminuria and macrovascular disease

Hoellerl

et al. 2011

Eur J Clin Investigation

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Section: Discussionsupporting

confidence: 93%

Thrombin generation in type 2 diabetes with albuminuria and macrovascular disease

Hoellerl

et al. 2011

Eur J Clin Investigation

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“…What is more, hyperglycemia is known to cause increased glycation of proteins and this may also occur in proteins involved in coagulation and fibrinolysis. Verkleij et al [7] showed that glycated TAFI loses its fibrinolytic properties in vitro, although this could not be reproduced in vivo. Fibrin clots from patients with diabetes type 2 are denser as compared with controls and displayed an altered structure, resulting in longer clot lysis time [79].…”

Section: Possible Mechanismsmentioning

confidence: 99%

“…Improved glycemic control was the only significant predictor of a decrease in blood thrombogenicity irrespective of treatment allocation [6]. The contribution of hypercoagulability in DM2 to the development of cardiovascular disease was also illustrated by the increased levels of prothrombin fragment 1 + 2 (F1 + 2) found to be associated with the presence of proven cardiovascular disease in DM2 patients as compared with patients without cardiovascular disease [7].…”

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confidence: 99%

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Hyperglycemia: a prothrombotic factor?

Lemkes¹,

Hermanides²,

DeVries³

et al. 2010

Journal of Thrombosis and Haemostasis

268

213

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Summary. Diabetes mellitus is characterized by a high risk of atherothrombotic events. What is more, venous thrombosis has also been found to occur more frequently in this patient group. This prothrombotic condition in diabetes is underpinned by laboratory findings of elevated coagulation factors and impaired fibrinolysis. Hyperglycemia plays an important role in the development of these hemostatic abnormalities, as is illustrated by the association with glycemic control and the improvement upon treatment of hyperglycemia. Interestingly, stress induced hyperglycemia, which is often transient, has also been associated with poor outcome in thrombotic disease. Similar laboratory findings suggest a common effect of acute vs. chronic hyperglycemia on the coagulation system. Many mechanisms have been proposed to explain this prothrombotic shift in hyperglycemia, such as a direct effect on gene transcription of coagulation factors caused by hyperglycemia-induced oxidative stress, loss of the endothelial glycocalyx layer, which harbours coagulation factors, and direct glycation of coagulation factors, altering their activity. In addition, both chronic and acute hyperglycemia are often accompanied by hyperinsulinemia, which has been shown to have prothrombotic effects as well. In conclusion, the laboratory evidence of the effects of both chronic and acute hyperglycemia suggests a prothrombotic shift. Additionally, hyperglycemia is associated with poor clinical outcome of thrombotic events. Whether intensive treatment of hyperglycemia can prevent hypercoagulability and improve clinical outcome remains to be investigated.

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“…Hemostatic imbalance may contribute to the development of cardiovascular disease in patients with type 2 diabetes mellitus. In patients with diabetes mellitus there is a state of hypofibrinolysis and increased levels of vWF 13 . The elevated levels of vWF are correlated with atherosclerosis and are associated with endothelial dysfunction in type 2 diabetes, as well as the development of diabetes in post-infarction patients 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Correlation between coagulation and inflammation state in patients with diabetes mellitus type 2 in relation to gender differences: Is there any impact of eight-week exercise training?

Trebinjac

Petronić²,

Lalić

et al. 2019

VOJNOSANIT PREGL

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Background/Aim. The hypercoagulable state and inflammation state in diabetics has been widely studied by previous researchers, but there is a lack of research about a possible impact of exercise training on this relationship. The aim of this study was to assess and compare correlation between the coagulation and inflammation status in patients with type 2 diabetes mellitus taking into account the gender differences as well as an impact of the 8-week exercise training on the correlation coefficient and parameters of the inflammation and coagulation state. Methods. A total of 60 patients in stable clinical condition and well-regulated diabetic status passed through all phases of the study. The exercise training included the exercise program as interval training with estimated intensity uphill to 75% of a maximal heart rate in particular individual, 5 times a week for 8 weeks, and walking for 30 minutes with a speed of 5 km/h, 5 times a week for 8 weeks. Further fibrinolytic, coagulation and inflammatory parameters were analyzed before and after the study: D-dimer, von Willebrand factor (vWF), fibrinogen, high sensitivity CRP (hs-CRP), leukocytes, thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and coagulation factors: FII, FV, FVII and FX. Results. Our research showed a statistically significant reduction in the mean vWF levels after intervention both at the males (p < 0.001) and females (p < 0.001). According to a correlation analysis between hs-CRP and fibrinogen, there was a positive correlation as baseline both at the males (p < 0.05, r = 0.492) and females (p < 0.01, r = 0.516) which became weaker in the males (p < 0.01, r = 0.449) and disappeared in the females (p < 0.05, r = 0.059) after intervention. The correlation which existed as baseline in the males between D-dimer and either hs-CRP (p < 0.01, r = 0.633) or fibrinogen (p < 0.01, r = 0.673) as well as the correlation between hs-CRP and FII (p < 0.01, r = 0.728), FV (p < 0.05, r = 0.366), FVII (p < 0.05, r = 0.373) coagulation as well as between D-dimer and FII (p < 0.01, r = 0.851), FVII (p < 0.05, r = 0.367)was absent in the females. Our research demonstrated a weakening correlations in the males after intervention between D-dimer and hs-CRP (p < 0.05, r = 0.378), between hs-CRP and FII (p < 0.01, r = 0.501), FV (p < 0.05, r = 0.298), FVII (p < 0.05, r = 0.351) as well as between D-dimer and FII (p < 0.01, r = 0.759), and FVII (p < 0.05, r = 0.296). The increase of the FX values (p < 0.05) in the females after intervention suggested the possible antiinflammatory effect of exercise training. Conclusion. According to previous research, the higher levels of vWF was associated with a risk of cardiovascular disease in people with type 2 diabetes mellitus and vWF may be a risk factor unique to these populations. We demonstrated that the 8-week exercise training can significantly reduce the value of vWF in the males and females, suggesting a potential beneficial effect on the endothelial function parameters. Our research demonstrated a stronger correlation between the coagulation and inflammation parameters as baseline in the males than in the females with type 2 diabetes mellitus. According to our results, the 8-week exercise training lead to a weakening of the strength of correlation between the coagulation and inflammation parameters in the males and complete disappearance of this correlation in the females, suggesting a unique effect of exercise training that should be explored in future research.

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The Hemostatic System in Patients With Type 2 Diabetes With and Without Cardiovascular Disease

Cited by 26 publications

References 13 publications

Thrombin generation in type 2 diabetes with albuminuria and macrovascular disease

Thrombin generation in type 2 diabetes with albuminuria and macrovascular disease

Hyperglycemia: a prothrombotic factor?

Correlation between coagulation and inflammation state in patients with diabetes mellitus type 2 in relation to gender differences: Is there any impact of eight-week exercise training?

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