title: D-dimer identifies stages in the progression of diabetes mellitus from family history of diabetes to cardiovascular complications.
abstract: OBJECTIVE
  The aim of the study was to ascertain whether there is variation in the fibrinolytic/coagulation component of diabetes associated with disease progression to macrovascular complications and whether D-dimer can discriminate such variation.
  
  
  METHODS
  A total of 343 participants were selected based on clinical status and divided into 7 groups: control, family history of diabetes, pre-diabetes with/without CVD, diabetes with/without CVD and CVD only. Plasma D-dimer was tested. Statistical analysis was performed on log normalised data by ANOVA, Fisher's LSD post hoc test. After the initial analysis, data were classified and re-analysed by quartiles, interquartile range and 95(th) percentile.
  
  
  RESULTS
  An overall significant difference between groups (p<0.002) and a steady rise in D-dimer levels that became increasingly higher than control as the disease progressed from pre-diabetes to cardiovascular complications was observed. A statistically significant difference was observed between control versus diabetes (p<0.0005). Analysis of data by quartiles and percentiles gave qualitatively similar results, but a greater significant difference between control versus pre-diabetes at 3rd quartile and interquartile range (p<0.014).
  
  
  CONCLUSIONS
  We report changes in D-dimer levels that may indicate diabetes disease progression to macrovascular complications. Using D-dimer in conjunction with other biomarkers to identify stages of disease progression, commencing from pre-diabetes and continuing to development of asymptomatic and clinical cardiovascular disease in diabetes mellitus, is worthy of consideration.
authors: School of Community Health, Charles Sturt University, Albury, Australia.
authors: Ezekiel U
authors: EU
authors: Nwose
authors: Ross S
authors: RS
authors: Richards
authors: Herbert F
authors: HF
authors: Jelinek
authors: Philip G
authors: PG
authors: Kerr
mesh_terms: D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications*; D048909:Diabetes Complications / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D