Vambergue A, Rugeri L, Gaveriaux V, Devos P, Martin A, Fermon C, Fontaine P, Jude B
Department of Endocrinology and Diabetology, Clinique Marc Linquette, CHRU, Lille, France.
Thromb Res. 2001 Mar 1;101(5):367-75. doi: 10.1016/s0049-3848(00)00424-2.
Changes of the tissue factor (TF) pathway of blood coagulation have been described in diabetes and could be involved in its vascular complications. In order to evaluate the influence of the type of diabetes and of the obesity index and age on these changes, factor VII coagulant activity, factor VII antigen, activated factor VII, monocyte TF expression, and plasma Tissue Factor Pathway Inhibitor (TFPI) were examined in 18 Type 1 and 16 Type 2 diabetic patients compared to non-diabetic control subjects matched for age, sex, and obesity index (Types 1 and 2 controls, respectively). Multicomplicated patients were excluded. FVIIc, FVIIAg, and FVIIa were higher in Type 2 diabetic patients and controls than in Type 1 diabetic patients and controls (P< .03). However, FVIIc and FVIIAg were lower in diabetic patients than in their matched controls (P< .03). Monocyte expression of TF was not different between Types 1 and 2 diabetic patients and their matched controls except for LPS-stimulated monocyte TF activity which was lower in Type 2 diabetic patients than in Type 2 controls (P< .05). Plasma TFPI was slightly but significantly higher in Type 1 diabetic patients than in Type 1 controls (P= .01) and was correlated to glycemia. However, both in Type 2 diabetic patients and controls, TFPI was higher than in Type 1 controls and was correlated with BMI (P< .0003). These results indicate that in not multicomplicated patients, the increase of FVII and TFPI was highly dependent on obesity index and age rather than on diabetes by itself.
糖尿病患者凝血组织因子（TF）途径已发生变化，这可能与其血管并发症有关。为了评估糖尿病类型、肥胖指数和年龄对这些变化的影响，我们检测了18例1型糖尿病患者和16例2型糖尿病患者的凝血因子VII活性、凝血因子VII抗原、活化凝血因子VII、单核细胞TF表达以及血浆组织因子途径抑制物（TFPI），并与年龄、性别和肥胖指数相匹配的非糖尿病对照受试者（分别为1型和2型对照）进行比较。排除了患有多种并发症的患者。2型糖尿病患者及其对照的FVIIc、FVIIAg和FVIIa高于1型糖尿病患者及其对照（P<0.03）。然而，糖尿病患者的FVIIc和FVIIAg低于其匹配的对照（P<0.03）。1型和2型糖尿病患者及其匹配对照的单核细胞TF表达没有差异，但脂多糖刺激的单核细胞TF活性在2型糖尿病患者中低于2型对照（P<0.05）。1型糖尿病患者的血浆TFPI略高于1型对照且具有显著性差异（P = 0.01），并且与血糖相关。然而，2型糖尿病患者及其对照的TFPI均高于1型对照，且与BMI相关（P<0.0003）。这些结果表明，在未患多种并发症的患者中，FVII和TFPI的升高高度依赖于肥胖指数和年龄，而非糖尿病本身。
