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2型糖尿病人群的凝血和氧化应激血浆水平

Coagulation and oxidative stress plasmatic levels in a type 2 diabetes population.

作者信息

Barillari Giovanni, Fabbro Elisabetta, Pasca Samantha, Bigotto Enrico

机构信息

Department of Transfusion Medicine, Center for Hemorrhagic and Thrombotic Diseases, Udine, Italy.

出版信息

Blood Coagul Fibrinolysis. 2009 Jun;20(4):290-6. doi: 10.1097/MBC.0b013e328329e49b.

Abstract

Type 2 diabetes mellitus (DM2) is a metabolic disorder characterized by relative insulin deficiency, insulin resistance and hyperglycemia. DM2 improperly managed can cause severe complications such as renal failure, blindness or arterial disease. In addition to serious complications due to DM2, in the past 20 years, several studies have demonstrated the association between DM2, insulin resistance and prothrombotic risk. In our study, we wanted to evaluate the correlation between coagulation factor levels, oxidative plasmatic levels and DM2. We considered 20 DM2 patients (65% women and 35% men), 40-65 years of age, who had a BMI between 25 and 40 kg/m2 and followed a diet with or without oral antidiabetic treatment and 20 controls, blood donors, 15 men (75%) and five women (25%), who had a BMI between 25 and 40 kg/m2 and their age was between 40 and 65 years. Plasmatic levels of oxidative stress markers (tumor necrosis factor-alpha, nitrotyrosine, oxidized low-density lipoprotein) and coagulation markers (factors VII, VIII, IX, XI, XII, antithrombin III and fibrinogen) of both populations were analyzed following statistic criteria. The analyzed data of this study related to oxidative stress and coagulation factors proved that the differences observed between diabetic patients and controls were not statistically significant (P < 0.05) for tumor necrosis factor-alpha, nitrotyrosine, oxidized low-density lipoprotein, factor VII and factor XI; conversely for factor VIII, factor IX, factor XII, antithrombin III and fibrinogen, the results gave a difference statistically significant (P < 0.01). In patients with DM2, factor VIII increased from 79 to 103%, factor IX from 88 to 103%, factor XII from 87 to 105% and finally, antithrombin III from 81 to 103%. Different results between literature and our study could be due to fact that the patients considered were in the early stage of diabetes when endothelial damage is absent and vascular complications are not clinically expressed. In this study, it is still shown that DM2 is a multifactor disease and its physiopathologic mechanisms are not completely known today.

摘要

2型糖尿病(DM2)是一种代谢紊乱疾病,其特征为相对胰岛素缺乏、胰岛素抵抗和高血糖。DM2若管理不当可导致严重并发症,如肾衰竭、失明或动脉疾病。除了DM2引发的严重并发症外,在过去20年里,多项研究已证实DM2、胰岛素抵抗与血栓形成风险之间存在关联。在我们的研究中,我们想评估凝血因子水平、氧化血浆水平与DM2之间的相关性。我们纳入了20名年龄在40至65岁之间、体重指数(BMI)在25至40kg/m²之间、接受或未接受口服抗糖尿病治疗且遵循特定饮食的DM2患者(65%为女性,35%为男性),以及20名对照者,即献血者,其中15名男性(75%)和5名女性(25%),其BMI在25至40kg/m²之间,年龄在40至65岁之间。按照统计标准分析了这两组人群氧化应激标志物(肿瘤坏死因子-α、硝基酪氨酸、氧化型低密度脂蛋白)和凝血标志物(因子VII、VIII、IX、XI、XII、抗凝血酶III和纤维蛋白原)的血浆水平。本研究中与氧化应激和凝血因子相关的分析数据表明,糖尿病患者与对照组之间在肿瘤坏死因子-α、硝基酪氨酸、氧化型低密度脂蛋白、因子VII和因子XI方面观察到的差异无统计学意义(P<0.05);相反,对于因子VIII、因子IX、因子XII、抗凝血酶III和纤维蛋白原,结果显示差异具有统计学意义(P<0.01)。在DM2患者中,因子VIII从79%升至103%,因子IX从88%升至103%,因子XII从87%升至105%,最后,抗凝血酶III从81%升至103%。文献与我们研究结果不同可能是因为所纳入的患者处于糖尿病早期,此时不存在内皮损伤且血管并发症未在临床上表现出来。在本研究中,仍表明DM2是一种多因素疾病,其病理生理机制目前尚未完全明确。

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