Plasma prekallikrein as a risk factor for diabetic retinopathy.
BACKGROUND
The aim of the study was to verify the hypothesis that in diabetes there is an increased activation of coagulation system leading in consequence to diabetic retinopathy.


METHODS
Thirty three healthy subjects (controls, 16 males and 17 females) and 35 patients with diabetes type 1 (15 males and 20 females) were examined. We monitored plasma prekallikrein (PPK), glycemia, fructosamine, glycosylated hemoglobin, activated partial thromboplastin time (PTT), INR, fibrinolysis in euglobulins time (FET), level of antithrombin III (AT III), fibrinogen (Fb) and fibrinogen degradation products (FDP).


RESULTS
In diabetic patients without retinopathy, PKK concentration was 16% higher (p <0.005), in patients with background retinopathy 33% higher (p <0.001), and in patients with proliferative retinopathy PKK concentration was 50% higher (p <0.001) than in controls. In the subgroup of patients with proliferative retinopathy PTT was significantly shorter (p <0.001), and FET was significantly longer (p <0.001) than in control. In patients with diabetes higher FDP concentrations were found than in controls (p <0.05). Significant correlations were found between PPK and fructosamine levels in all diabetic patients (R(S)=+0.57 p <0.001), in diabetic patients without retinopathy (R(S)=+0.61, p <0.05), and in diabetic patients with retinopathy (R(S)=+0.62, p <0.005). We found negative correlation between PPK concentration and PTT (R(S)=-0.43, p <0.001) and positive correlation between PPK concentration and FET (R(S)=+0.59, p <0.00001) in the entire study group.


CONCLUSIONS
The occurrence of diabetic retinopathy is connected with higher levels of plasma prekallikrein.
Kedzierska
Karolina
K
Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland.
Ciechanowski
Kazimierz
K
Gołembiewska
Edyta
E
Safranow
Krzysztof
K
Ciechanowicz
Andrzej
A
Domański
Leszek
L
Myślak
Marek
M
Róźański
Jacek
J
D000328:Adult; D000368:Aged; D001777:Blood Coagulation / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D003930:Diabetic Retinopathy / Q000097:blood*; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011288:Prekallikrein / Q000378:metabolism*; D012307:Risk Factors; D013223:Statistics as Topic
D011288:Prekallikrein