title: Soluble tissue factor is a candidate marker for progression of microvascular disease in patients with Type 2 diabetes.
abstract: OBJECTIVE
  To determine the relationship between abnormalities in blood coagulation and prevalent or incident cardiovascular complications in Type 2 diabetes.
  
  
  METHODS
  Prospective cohort study of 128 patients with Type 2 diabetes in whom blood samples were collected at baseline and after 1 year of follow-up. All cardiovascular complications at baseline and follow-up were recorded. Forty-three healthy, age-matched subjects served as a control group.
  
  
  RESULTS
  Logistic analysis revealed an independent relationship between soluble tissue factor (TF) and microvascular disease [per pg mL(-1) TF: Exp(B) = 1.008; CI(95%)1.002-1.014], or neurogenic disease [Exp(B) = 1.006; CI(95%)1.001-1.011]. The highest levels of soluble TF were observed in patients with microvascular and neurogenic disease (P < 0.001). Patients with Type 2 diabetes having a soluble TF concentration >300 pg mL(-1) are at a 15-fold higher risk for the presence of microvascular disease and at a 10-fold higher risk for the presence of neurogenic disease compared with the patients with concentrations below 100 pg mL(-1). Soluble TF was correlated with tissue type plasminogen activator, von Willebrand factor antigen, systolic blood pressure and age. Levels of F1' + 2, D-dimer, FVIII activity, t-PA and vWFag were not different among patients with micro-, macro- or neurogenic complications compared with patients without those complications. Forty-eight new micro-, macro- and/or neurogenic complications were diagnosed after 1 year follow-up. With the exception of higher F1 + 2 levels after 1 year all other markers remained unchanged. A trend toward higher soluble TF levels was observed in patients with new microvascular events (P = 0.056).
  
  
  CONCLUSIONS
  Soluble TF is associated with existing microvascular and neurogenic complications in patients with Type 2 diabetes and is a candidate marker for progression of microvascular disease.
authors.affiliation: Department of Internal Medicine, Slotervaart Hospital, Amsterdam, the Netherlands.
authors.forename: D W
authors.initials: DW
authors.lastname: Sommeijer
authors.forename: H R
authors.initials: HR
authors.lastname: Hansen
authors.forename: R
authors.initials: R
authors.lastname: van Oerle
authors.forename: K
authors.initials: K
authors.lastname: Hamulyak
authors.forename: A P
authors.initials: AP
authors.lastname: van Zanten
authors.forename: E
authors.initials: E
authors.lastname: Meesters
authors.forename: H M H
authors.initials: HM
authors.lastname: Spronk
authors.forename: H
authors.initials: H
authors.lastname: ten Cate
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013925:Thromboplastin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D013925:Thromboplastin