title: Plasma levels of thrombomodulin, plasminogen activator inhibitor-1 and fibrinogen in elderly, diabetic patients with depressive symptoms.
abstract: BACKGROUND
  Diabetes, depression and aging have been associated with pro-inflammatory and prothrombotic state.
  
  
  OBJECTIVE
  The aim of the study was to determine the plasma levels of thrombomodulin, plasminogen activator inhibitor-1 (PAI-1) and fibrinogen in elderly diabetic patients with and without depressive symptoms and to examine factors (including thrombomodulin, PAI-1, fibrinogen levels) associated with depressive symptoms in elderly patients with type 2 diabetes (T2DM).
  
  
  METHODS
  A total of 276 T2DM elders were evaluated: 82 subjects with depressive symptoms and 194 controls. Data were collected concerning biochemical parameters and biomarkers.
  
  
  RESULTS
  Plasma thrombomodulin, PAI-1 and fibrinogen were elevated in patients with depressive symptoms compared to controls. Thrombomodulin level was correlated with fibrinogen and PAI-1 levels. All parameters were correlated with the Geriatric Depression Scale-30 score. The univariate logistic regression models revealed that variables which increased the likelihood of diagnosis of depressive symptoms in elderly patients with T2DM were: female sex, smoking habit, longer duration of T2DM, hyperlipidemia, neuropathy, increased number of co-morbidities, higher BMI, and higher levels of total and LDL cholesterol, thrombomodulin, PAI-1 and fibrinogen. In addition, the multivariable analysis indicated that female sex, smoking habit, increased number of co-morbidities, higher BMI, and higher levels of LDL cholesterol and thrombomodulin are the predisposing factors for depressive symptoms.
  
  
  CONCLUSIONS
  Elderly diabetic patients with depressive symptoms have higher levels of thrombomodulin, PAI-1 and fibrinogen. Further prospective larger studies are needed to provide potential directions for the research, treatment and prevention of co-morbid depression and diabetes.
authors.affiliation: Department of Internal Medicine and Diabetology, Medical University of Lodz, 251 Pomorska Street, 92-213, Lodz, Poland. magoca@poczta.onet.pl.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Gorska-Ciebiada
authors.affiliation: Department of Internal Medicine and Diabetology, Medical University of Lodz, 251 Pomorska Street, 92-213, Lodz, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Saryusz-Wolska
authors.affiliation: Department of Internal Medicine and Diabetology, Medical University of Lodz, 251 Pomorska Street, 92-213, Lodz, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Borkowska
authors.affiliation: Department of General and Oncological Pneumology, Medical University of Lodz, 22 Kopcinskiego Street, 90-153, Lodz, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Ciebiada
authors.affiliation: Department of Internal Medicine and Diabetology, Medical University of Lodz, 251 Pomorska Street, 92-213, Lodz, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Loba
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003863:Depression / Q000097:blood / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D018180:Thrombomodulin / Q000097:blood*
chemical_list: D015415:Biomarkers; D008078:Cholesterol, LDL; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; C546931:THBD protein, human; D018180:Thrombomodulin; D005340:Fibrinogen
keywords: Depressive symptoms; Diabetes; Fibrinogen; PAI-1; Thrombomodulin