Harmanci Ayla, Kandemir Nurgun, Dagdelen Selcuk, Gonc Nazli, Buyukasik Yahya, Alikasifoglu Ayfer, Kirazli Serafettin, Ozon Alev, Gurlek Alper
Division of Endocrinology, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey.
J Diabetes Complications. 2006 Jan-Feb;20(1):40-4. doi: 10.1016/j.jdiacomp.2005.05.003.
Hypofibrinolysis is a state that is commonly observed in type 2 diabetic patients, a finding also possibly related to obesity and insulin resistance. There is little information, however, regarding the status of fibrinolytic system in Type 1 diabetes, in particular as reflected by thrombin-activatable fibrinolysis inhibitor (TAFI) activity and global fibrinolytic capacity (GFC). To provide information in this respect, 30 Type 1 diabetic patients (median age=16) and 28 healthy controls (median age=14) were enrolled in this study. The median duration of diabetes was 7 years, and median HbA(1c) was 8.85% (range: 5.5-11.9%) in the diabetic group. None of the patients had macrovascular complications. Microvascular complications were present in a total of eight patients (nephropathy: n=5; retinopathy: n=3). A comparison of the TAFI activity between the patient (median 84.9, range: 71.5-103.3%) and the control groups (median=83.3, range: 63.7-97.4%) yielded no statistically significant difference (P=.950). Similarly, GFC was comparable between the two groups (median=8.22, range: 0.72-22.38 microg/ml, and median=13.32, range: 3.0-23.22 microg/ml, respectively, in the diabetic and control groups, P=.086). TAFI activity did not significantly correlate with age, albumin excretion, fasting plasma glucose, HbA(1c), D-dimer, and fibrinogen by Spearman rank correlation test. There was as a significant inverse correlation between GFC and TAFI activity (r=-.414, P=.006). Contrary to the previous observations in Type 2 diabetes, our data suggest that fibrinolytic activity is not adversely affected by Type 1 diabetes, and it has no relationship with the degree of metabolic control.
纤维蛋白溶解功能减退是2型糖尿病患者中常见的一种状态，这一发现也可能与肥胖和胰岛素抵抗有关。然而，关于1型糖尿病患者纤维蛋白溶解系统的状况，尤其是凝血酶激活的纤维蛋白溶解抑制物（TAFI）活性和整体纤维蛋白溶解能力（GFC）方面的信息却很少。为了提供这方面的信息，本研究纳入了30例1型糖尿病患者（中位年龄 = 16岁）和28例健康对照者（中位年龄 = 14岁）。糖尿病组的糖尿病病程中位数为7年，HbA(1c)中位数为8.85%（范围：5.5 - 11.9%）。所有患者均无大血管并发症。共有8例患者存在微血管并发症（肾病：n = 5；视网膜病变：n = 3）。患者组（中位数84.9，范围：71.5 - 103.3%）与对照组（中位数 = 83.3，范围：63.7 - 97.4%）的TAFI活性比较，差异无统计学意义（P = 0.950）。同样，两组的GFC相当（糖尿病组和对照组的中位数分别为8.22，范围：0.72 - 22.38 μg/ml和中位数13.32，范围：3.0 - 23.22 μg/ml，P = 0.086）。通过Spearman等级相关检验，TAFI活性与年龄、白蛋白排泄、空腹血糖、HbA(1c)、D - 二聚体和纤维蛋白原均无显著相关性。GFC与TAFI活性之间存在显著负相关（r = -0.414，P = 0.006）。与先前对2型糖尿病的观察结果相反，我们的数据表明，1型糖尿病不会对纤维蛋白溶解活性产生不利影响，且与代谢控制程度无关。
