Coagulation and fibrinolysis in diabetes.
The accelerated development of atherothrombotic cardiovascular disease in type 2 diabetes mellitus may be enhanced by the presence of a prothrombotic state. This prothrombotic state includes a diminished fibrinolytic capacity and an increased coagulability. Impaired fibrinolytic capacity appears to be a hallmark of the metabolic syndrome of type 2 diabetes and can be a direct consequence of visceral obesity. In addition, a chronic low inflammatory state with hyperinsulinemia and dyslipidemia may further influence the hemostatic balance. The characteristic dyslipidemia of type 2 diabetes, coined the atherogenic lipoprotein profile, with raised plasma levels of fasting and postprandial triglyceride lipoproteins, atherogenic low-density lipoproteins, and low high-density lipoproteins, is involved in promoting a hypercoagulable state. Lifestyle and pharmacologic interventions that reduce cardiovascular risk in the general population and that may improve the metabolic syndrome may also reduce the prothrombotic state.
Banga
J D
JD
Section of Vascular Medicine, Division of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. j.banga@azu.nl
D001161:Arteriosclerosis / Q000209:etiology / Q000503:physiopathology*; D001777:Blood Coagulation / Q000502:physiology*; D001792:Blood Platelets / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005342:Fibrinolysis / Q000502:physiology*; D006487:Hemostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000502:physiology; D050356:Lipid Metabolism; D024821:Metabolic Syndrome / Q000503:physiopathology; D009765:Obesity / Q000503:physiopathology; D013927:Thrombosis / Q000209:etiology / Q000503:physiopathology*
D007328:Insulin