Association of D-dimer with microalbuminuria in patients with type 2 diabetes mellitus.
BACKGROUND
Microalbuminuria has been reported to be related to incidence of cardiovascular complications in diabetes. No consistent findings have been obtained on the relationships of microalbuminuria with blood coagulation and fibrinolysis. The purpose of this study was to determine whether microalbuminuria is associated with blood markers reflecting coagulation and fibrinolysis activities in patients with type 2 diabetes.


METHODS
The relationships of albumin excretion rate (AER) with atherosclerosis-related variables, including blood coagulation and fibrinolysis markers, were investigated in patients with type 2 diabetes who showed normoalbuminuria (AER: less than 20 microg/min) and microalbuminuria (AER: 20 microg/min or higher and less than 200 microg/min).


RESULTS
AER was significantly correlated with body mass index (BMI), maximum intima-media thickness of common carotid arteries, blood HDL cholesterol, uric acid, creatinine and D-dimer. On the other hand, AER showed no significant correlation with blood platelets, fibrinogen, thrombin-antithrombin III complex, plasmin-alpha2 plasmin inhibitor complex and plasminogen activator inhibitor-1. In multiple regression analysis, using age, sex, BMI, pulse pressure, hemoglobin A1c, HDL cholesterol, uric acid, creatinine, D-dimer and history of anti-thrombotic therapy as explanatory variables, only D-dimer showed a significant correlation with AER. The mean level of log-converted D-dimer after adjustment for age and sex was significantly higher in subjects with microalbuminuria than in those with normoalbuminuria.


CONCLUSIONS
D-dimer is associated with microalbuminuria in patients with diabetes and this suggests that glomerular dysfunction is in part mediated by hypercoagulability.
Wakabayashi
Ichiro
I
Department of Environmental and Preventive Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan. wakabaya@hyo-med.ac.jp
Masuda
Hiroshi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000097:blood*; D050197:Atherosclerosis / Q000097:blood; D015415:Biomarkers; D015992:Body Mass Index; D002339:Carotid Arteries / Q000648:ultrastructure; D008076:Cholesterol, HDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000652:urine; D003928:Diabetic Nephropathies / Q000097:blood / Q000652:urine; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005342:Fibrinolysis; D006801:Humans; D007678:Kidney Glomerulus / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D019851:Thrombophilia / Q000097:blood / Q000209:etiology; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D008076:Cholesterol, HDL; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D014527:Uric Acid; D003404:Creatinine