title: Coagulation profile in diabetes and its association with diabetic microvascular complications.
abstract: OBJECTIVE
  To investigate the haemostatic parameters and to assesss their relationship with microvascular complications in type 2 diabetes mellitus.
  
  
  METHODS
  Coagulation and fibrinolysis parameters were measured in 60 type 2 diabetic patients (M:F 1:1) with (n=40) and without (n=20) diabetic microvascular complications and in 30 nondiabetic healthy subjects (M:F 1:1).
  
  
  RESULTS
  The mean age of diabetic patients and healthy controls was 56.9 +/- 8.78 and 53.2 +/- 7.58 respectively (p = 0.05). The plasma levels of PAI-1 (22.6 +/- 6.85 vs 44.8 +/- 20.8, p = 0.00), serum fibrinogen (227.5 +/- 22.8 vs. 252.75 +/- 40.23, p = 0.002) and vWF activity (99.4 +/- 28.18 vs. 144.78 +/- 36.21, p = 0.00) were found to be increased in diabetics compared to healthy controls. Plasma PAI-1 levels (37.15 +/- 15.18 vs 48.65 +/- 22.29, p = 0.0) and vWF activity (123.19 +/- 29.63 vs. 155.57 +/- 34.61, p = 0.007) were significantly increased in diabetic patients with microvascular complications than those without microvascular complications.Amongst the diabetic patients, protein S activity (63.05 +/- 16.85 vs. 51.59 +/- 10.7, p = 0.002) was significantly lower in patients with microvascular complications than in patients without these complications. Diabetic retinopathy was associated with decreased protein S levels (63.05 +/- 16.85 vs. 48.48 +/- 8.72, p = 0.005) and vWF activity (123.19 +/- 29.63 vs. 151.85 +/- 29.74, p = 0.009). Diabetic nephropathy was associated with increased PAI-1 levels (39.55 +/- 13.20 vs. 51.69 +/- 26.53, p = 0.02) and vWF activity (134.99 +/- 32.54 vs. 157.57 +/- 37.37, p = 0.007). Diabetic neuropathy did not show any significant relationship with any of the haemostatic variables.
  
  
  CONCLUSIONS
  Hypercoagulable state as indicated by decreased fibrinolysis and increased coagulability is responsible as one of the factors for the development of microvascular complications of diabetes mellitus.
authors.affiliation: Department of Medicine, VMMC and Safdarjang Hospital, New Delhi.
authors.forename: Ritu
authors.initials: R
authors.lastname: Madan
authors.forename: B
authors.initials: B
authors.lastname: Gupt
authors.forename: Sumita
authors.initials: S
authors.lastname: Saluja
authors.forename: U C
authors.initials: UC
authors.lastname: Kansra
authors.forename: B K
authors.initials: BK
authors.lastname: Tripathi
authors.forename: B P
authors.initials: BP
authors.lastname: Guliani
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001780:Blood Coagulation Tests; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000150:complications; D003929:Diabetic Neuropathies / Q000097:blood / Q000150:complications / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005342:Fibrinolysis / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood
chemical_list: D001779:Blood Coagulation Factors; D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen