Thrombin generation and factor VIII:C levels in patients with type 1 diabetes complicated by nephropathy.
The association between plasma coagulant activity and the presence of diabetic nephropathy was investigated in 31 patients with Type 1 diabetes, 12 with and 19 without nephropathy, and in 11 healthy subjects. Thrombin generation was assessed by computer assisted chromogenic method and expressed as time (in seconds) to 50% maximal thrombin activity (T50). Factor VIII:C levels related to thrombin activity, glycaemic control, and renal function. Median (IQ) FVIII:C concentration was increased in patients with nephropathy (1590 (1130-1900) IU l-1) compared to those without renal disease and with controls (960 (750-1090); 1020 (810-1100) IU l-1, p < 0.01, respectively). There were no significant differences in T50 values between the groups. FVIII:C correlated with age in all subjects and in the diabetic group (r = 0.33, p = 0.036; r = 0.39, p = 0.031) and inversely with T50 in all subjects and in controls (r = -0.35, p = 0.02; r = -0.62, p = 0.04). In all subjects and in patients, FVIII:C was related to urinary albumin excretion and creatinine clearance. FVIII:C and T50 were not related to HbA1c. The results show that FVIII:C levels are increased in Type 1 diabetes complicated by nephropathy and are related to degree of renal impairment but not levels of glycaemia. No associated enhancement of plasma procoagulant activity was detected.
Ibbotson
S H
SH
Academic Unit of Medicine, Leeds General Infirmary, UK.
Rayner
H
H
Stickland
M H
MH
Davies
J A
JA
Grant
P J
PJ
D000328:Adult; D000419:Albuminuria; D001794:Blood Pressure; D002784:Cholesterol / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000097:blood* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000503:physiopathology; D005169:Factor VIII / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013917:Thrombin / Q000032:analysis / Q000378:metabolism*; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D005169:Factor VIII; D002784:Cholesterol; D013917:Thrombin