PAI-1 and factor VII activity are higher in IDDM patients with microalbuminuria.
Microalbuminuria is associated with an increased risk of cardiovascular disease (CVD) in insulin-dependent diabetes mellitus (IDDM) patients, but the pathophysiological basis of this association is not clear. To see whether or not hemostatic dysfunctions might contribute to explain this association, we measured tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), factor VII activity, plasma fibrinogen, and plasma endothelin-1 (ET-1) in 13 microalbuminuric (albumin excretion rate [AER], 20-200 micrograms/min) and in 13 comparable normoalbuminuric (< 20 micrograms/min) IDDM patients. t-PA and ET-1 were similar in the two groups, whereas PAI-1 activity (5.65 +/- 1.92 vs. 0.85 +/- 0.58 IU/ml, P < 0.05), factor VII (87.85 +/- 4.94 vs. 76.54 +/- 2.31%, P < 0.05), and plasma fibrinogen (3.38 +/- 0.21 vs. 2.65 +/- 0.13 g/l, P < 0.05) were significantly higher in microalbuminuric than in normoalbuminuric patients. Plasma fibrinogen was related to AER (r2 = 0.23, P < 0.05), whereas triglycerides and factor VII were related to PAI-1 (r2 = 0.39, P < 0.001 and r2 = 0.10, P < 0.05). These results suggest that microalbuminuria is associated with a hypercoagulative and hypofibrinolytic state. Hemostatic dysfunctions might be a pathogenetic link between microalbuminuria and CVD.
Gruden
G
G
Institute of Internal Medicine, University of Turin, Italy.
Cavallo-Perin
P
P
Bazzan
M
M
Stella
S
S
Vuolo
A
A
Pagano
G
G
D000328:Adult; D000419:Albuminuria / Q000097:blood*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D016232:Endothelins / Q000097:blood; D005167:Factor VII / Q000378:metabolism*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism*; D012044:Regression Analysis; D010959:Tissue Plasminogen Activator / Q000378:metabolism
D016232:Endothelins; D017395:Plasminogen Activator Inhibitor 1; D005167:Factor VII; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator