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.
Academic Unit of Medicine, Leeds General Infirmary, UK.
S H
SH
Ibbotson
H
H
Rayner
M H
MH
Stickland
J A
JA
Davies
P J
PJ
Grant
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