The role of hyperglycaemia-induced alterations of antithrombin III and factor X activation in the thrombin hyperactivity of diabetes mellitus.
Factor X concentration and factor X activation, antithrombin III anti-Xa activity and plasma concentration, and fibrinopeptide A were measured in 20 diabetic patients and 20 normal subjects. Although factor X activation (81.3 +/- 2.2 vs 97.3 +/- 2.1%, p less than 0.01; mean +/- SE) and antithrombin III activity (76.5 +/- 2.2 vs 96.3 +/- 1.8%, p less than 0.01) were reduced in the diabetic patients, fibrinopeptide A concentration was increased (3.7 +/- 0.4 vs 1.7 +/- 0.2 ng ml-1, p less than 0.01). The ratio of factor X activation to antithrombin III anti-factor Xa activity was increased in the diabetic patients (1.10 +/- 0.01 vs 1.01 +/- 0.02, p less than 0.01). Induced hyperglycaemia was able to mimic all these abnormalities, without changing factor X or antithrombin III concentration. The results suggest that in vivo hyperglycaemia produces a decrease of factor X activation, but at the same time increases fibrinopeptide A formation due to a greater decrease of antithrombin III anti-Xa activity.
Ceriello
A
A
Cattedra di Diabetologia e Dietoterapia, I Facoltà di Medicina, Università di Napoli, Italy.
Quatraro
A
A
Marchi
E
E
Barbanti
M
M
Dello Russo
P
P
Lefebvre
P
P
Giugliano
D
D
D000328:Adult; D000990:Antithrombin III / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005170:Factor X / Q000378:metabolism*; D015951:Factor Xa / Q000378:metabolism*; D005260:Female; D005344:Fibrinopeptide A / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D008297:Male; D012016:Reference Values; D013917:Thrombin / Q000378:metabolism*
D001786:Blood Glucose; D005344:Fibrinopeptide A; D000990:Antithrombin III; D005170:Factor X; D013917:Thrombin; D015951:Factor Xa