title: The relationship among TAFI, t-PA, PAI-1 and F1 + 2 in type 2 diabetic patients with normoalbuminuria and microalbuminuria.
abstract: Disturbances of coagulation and fibrinolysis in type 2 diabetes mellitus (DM2) contribute to increased rates of macrovascular complications such as myocardial infarction and ischemic stroke. The aim of the study was to investigate the relationship among plasminogen activator inhibitor 1 (PAI-1), thrombin-activable fibrinolysis inhibitor (TAFI), tissue plasminogen activator (t-PA), prothrombin fragments 1+2 (F1+2), glycemic control, hypertension, sex and body mass index (BMI) in DM2 patients with normoalbuminuria and microalbuminuria. Forty-two normoalbuminuric (NAU), 42 microalbuminuric (MAU) patients with DM2 and 42 blood donors as control group were enrolled. TAFI, PAI-1, t-PA and F1+2 were assessed by enzyme-linked immunosorbent assay (ELISA) in all patients. TAFI was significantly increased in the MAU group, PAI-1 and F1+2 were increased in both groups and t-PA was not elevated in either group compared to controls. We found positive correlations in the NAU: TAFI and fibrinogen (r=0.65, P=0.02), PAI-1 and triglycerides (r=0.67, P=0.01), in the MAU: TAFI and F1+2 (r=0.48, P=0.02), TAFI and systolic blood pressure (r=0.53, P=0.01), PAI-1 and BMI (r=0.43, P<0.05). We found decreased fibrinolysis in DM2 patients presented with increased PAI-1 in both NAU and MAU. Hypofibrinolysis in MAU is further accented by the elevation of TAFI. TAFI-mediated inhibition of fibrinolysis in DM2 is regulated independently from PAI-1. Patient[Combining Acute Accent]s sex does not affect diabetes-related changes in hemostasis and fibrinolysis.
authors.affiliation: National Center of Hemostasis and Thrombosis, Jessenius Faculty of Medicine, Comenius University, Martin, Slovakia. chudy@jfmed.uniba.sk
authors.forename: Peter
authors.initials: P
authors.lastname: Chudý
authors.forename: Daniela
authors.initials: D
authors.lastname: Kotuličová
authors.forename: Ján
authors.initials: J
authors.lastname: Staško
authors.forename: Peter
authors.initials: P
authors.lastname: Kubisz
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood* / Q000150:complications; D001777:Blood Coagulation; D001794:Blood Pressure; D015992:Body Mass Index; D025901:Carboxypeptidase B2 / Q000097:blood*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis; D006487:Hemostasis; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011516:Prothrombin; D012737:Sex Factors; D018154:Slovakia; D013917:Thrombin / Q000378:metabolism; D010959:Tissue Plasminogen Activator / Q000097:blood*
chemical_list: D010446:Peptide Fragments; D017395:Plasminogen Activator Inhibitor 1; C045879:prothrombin fragment 1.2; D011516:Prothrombin; D005340:Fibrinogen; D025901:Carboxypeptidase B2; D013917:Thrombin; D010959:Tissue Plasminogen Activator