Disturbances of the coagulating equilibrium of blood in diabetes mellitus.
The diabetes mellitus is accompanied in its evolution by ample disturbances of the blood's fluid-coagulating equilibrium, which contribute to the initiation and development of the micro and macro-vascular complications. The early and accelerated atherosclerosis in diabetes mellitus obliged the medical world to the necessity to solve the pathogenic implied mechanisms: knowing them allowed us to apply a therapy that can prevent or improve the associated vascular pathology. The intense research made in the last decades mentioned that, in diabetes mellitus, all the stages of the hemostasis are affected, noticing the diminution of the fibrinolysis. The growth of the production of pro-aggregating factors unleashed from the platelets or other cells--TXA2. PAF, and the lowering of the synthesis of the protector endothelial factors--PGI2, NO--are followed by the intensifying adhesion and aggregation growth of the platelets at the injured endothelium, with the worsening of the atherosclerosis injuries. Furthermore, the activated platelets are keeping and are augmenting other steps of the hemostasis--first of all the coagulation, in this way contributing to the stage of hypercoagulability in diabetes mellitus. The deficit of plasminogen activators and the growth of the synthesis of fibrinolysis inhibitors also keep the stage of hypercoagulability, underlined by the growth of plasmatic concentration of the fibrinogen, especially PAI-1. There still are controversies concerning the stage of hypercoagulability whether it is primary in diabetes or it is an answer-reaction to the endothelial damages and the high level of glycaemia. The role of the coagulation-fibrinolyses-thrombocytus-prostaglandins-CFTP in the initiating and development of the micro and macro-vascular complications, as well as in the acceleration of the atheriosclerosis process in diabetes mellitus, is nowadays certitude. More difficult is the attempt to identify the pathogenic mechanisms in which the CFTP sector interferes: the research in this domain still begins under the sign of incertitude.
Sfredel
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V
Department of Physiology and Pathophysiology, University of Medicine and Pharmacy, 4 Petru Rareş St, 1100 Craiova, Romania.
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Dănoiu
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D000818:Animals; D016718:Arachidonic Acid / Q000378:metabolism*; D001779:Blood Coagulation Factors; D001792:Blood Platelets / Q000502:physiology*; D003920:Diabetes Mellitus / Q000097:blood*; D004730:Endothelium, Vascular / Q000002:abnormalities* / Q000502:physiology; D005342:Fibrinolysis; D006801:Humans
D001779:Blood Coagulation Factors; D016718:Arachidonic Acid