title: Only minor changes in thrombin generation of children and adolescents with type 1 diabetes mellitus - A case-control study.
abstract: BACKGROUND
  Micro- and macrovascular diseases are frequent complications in patients with diabetes. Hypercoagulability may contribute to microvascular alterations.
  
  
  OBJECTIVE
  In this study, we investigated whether type 1 diabetes in children is associated with a hypercoagulable state by performing a global function test of coagulation - the thrombin generation assay.
  
  
  METHODS
  75 patients with type 1 diabetes aged between 2 and 19years were compared to an age-matched healthy control group. Diabetes patients were divided into high-dose and low-dose insulin cohorts with a cut-off at 0.8Ukg-1d-1.
  
  
  METHODS
  Measurements were performed with platelet poor plasma using Calibrated Automated Thrombography and 1 pM or 5 pM tissue factor. Additionally, we quantified prothrombin fragments F1+2, thrombin-antithrombin complex, prothrombin, tissue factor pathway inhibitor, and antithrombin.
  
  
  RESULTS
  Patients with type 1 diabetes exhibited a significantly shorter of lag time as well as decreased thrombin peak and endogenous thrombin potential compared to control subjects with 5 pM but not with 1 pM tissue factor. In high-dose insulin patients peak thrombin generation was higher and time to peak shorter than in low-dose patients. Thrombin-antithrombin complex was decreased in patients with type 1 diabetes, whereas prothrombin fragments F1+2 was comparable in both groups. Thrombin generation parameters did not correlate with parameters of metabolic control and the duration of diabetes.
  
  
  CONCLUSIONS
  Taken together, we found only minor changes of thrombin generation in children and adolescents with type 1 diabetes which - in contrast to type 2 diabetes - do not argue for a hypercoagulable state.
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria. Electronic address: christina.cimenti@medunigraz.at.
authors: Christina
authors: C
authors: Cimenti
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Axel
authors: A
authors: Schlagenhauf
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Bettina
authors: B
authors: Leschnik
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Elke
authors: E
authors: Fröhlich-Reiterer
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Hildegard
authors: H
authors: Jasser-Nitsche
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Harald
authors: H
authors: Haidl
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Elisabeth
authors: E
authors: Suppan
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Gudrun
authors: G
authors: Weinhandl
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Maximilian
authors: M
authors: Leberl
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Martin
authors: M
authors: Borkenstein
authors: Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
authors: Wolfgang E
authors: WE
authors: Muntean
mesh_terms: D000293:Adolescent; D000328:Adult; D000990:Antithrombin III / Q000378:metabolism; D001777:Blood Coagulation; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D010447:Peptide Hydrolases / Q000097:blood / Q000378:metabolism; D013917:Thrombin / Q000032:analysis / Q000378:metabolism*; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D013917:Thrombin
keywords: Hemostasis - blood coagulation test - diabetes mellitus; Type 1 - child – adolescent