Telejko B, Zonenberg A, Borejszo I, Kinalska I
Klinika Endokrynologii Akademii Medycznej w Białymstoku.
Pol Arch Med Wewn. 1998 Aug;100(2):133-8.
The aim of our study was to estimate selected parameters of hemostasis and fibrinolysis in diabetic patients with vascular complications and obesity. The investigation was carried out in 23 type 1 diabetic subjects aged 17-56 ys, in 25 type 2 diabetic patients aged 41-69 ys and in 38 healthy persons: 16 "young"--aged 32.5 +/- 13.2 ys and 22 "old"--aged 56.2 +/- 9.4 ys. The following parameters were determined: glycaemia, HbA1c, blood level fibrinogen, euglobulin clot lysis time, plasminogen activator inhibitor (PAI-1) activity, microalbuminuria, triglyceride, total, HDL- and LDL-cholesterol concentration. Plasma fibrinogen level was elevated in type 2 diabetic subjects, and the highest concentrations were noted in patients with retinopathy or arterial hypertension, in overweight persons and--surprisingly--in type 1 diabetic subjects with nephropathy and coronary vascular disease (CVD). There were also positive correlations between fibrinogen level and systolic blood pressure (r = 0.3413, p < 0.02), diastolic blood pressure (r = 0.3809, p < 0.002) and microalbuminuria (r = 0.3552, p < 0.05). The mean euglobulin clot lysis time was prolonged in type II diabetics in comparison to the control group, especially in obese subjects. The highest activity of PAI-1 was found in overweight controls (28.87 +/- 6.24 Au/ml, p < 0.002). PAI-1 activity was also slightly increased in type 1 diabetic patients, especially with the symptoms of diabetic neuropathy, nephropathy or CHD, in comparison to the other groups. Our results seem to confirm the disturbed balance between coagulation and fibrinolysis--towards and increased risk of a prothrombotic state --in both--obese and diabetic patients--especially with advanced vascular complications.
我们研究的目的是评估患有血管并发症和肥胖症的糖尿病患者的止血和纤维蛋白溶解的选定参数。该研究针对23名年龄在17 - 56岁的1型糖尿病患者、25名年龄在41 - 69岁的2型糖尿病患者以及38名健康人进行：16名“年轻人”，年龄为32.5±13.2岁，22名“老年人”，年龄为56.2±9.4岁。测定了以下参数：血糖、糖化血红蛋白、血液纤维蛋白原水平、优球蛋白凝块溶解时间、纤溶酶原激活物抑制剂（PAI - 1）活性、微量白蛋白尿、甘油三酯、总胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇浓度。2型糖尿病患者的血浆纤维蛋白原水平升高，在患有视网膜病变或动脉高血压的患者、超重者以及——令人惊讶的是——患有肾病和冠状动脉血管疾病（CVD）的1型糖尿病患者中发现了最高浓度。纤维蛋白原水平与收缩压（r = 0.3413，p < 0.02）、舒张压（r = 0.3809，p < 0.002）和微量白蛋白尿（r = 0.3552，p < 0.05）之间也存在正相关。与对照组相比，II型糖尿病患者的平均优球蛋白凝块溶解时间延长，尤其是在肥胖受试者中。超重对照组中PAI - 1的活性最高（28.87±6.24 Au/ml，p < 0.002）。与其他组相比，1型糖尿病患者中PAI - 1的活性也略有增加，尤其是伴有糖尿病神经病变、肾病或冠心病症状的患者。我们的结果似乎证实了肥胖和糖尿病患者（尤其是患有晚期血管并发症的患者）凝血和纤维蛋白溶解之间的平衡受到干扰，导致血栓前状态风险增加。
