Lodigiani Corrado, Ferrazzi Paola, Di Micco Pierpaolo, Librè Luca, Genovese Stefano, Quaglia Ilaria, Rota Lidia Luciana
Thrombosis Center, Istituto Clinico Humanitas IRCCS, Rozzano (MI), Italy.
J Transl Med. 2009 Jun 26;7:52. doi: 10.1186/1479-5876-7-52.
Diabetes is well known risk factor for thrombotic events. The association between diabetes and venous thromboembolism is still matter of debate. However, during diabetes an acquired thrombophilia is present and is due to the non-enzymatic glycosilation of clotting inhibitors as antithrombin thus leading to hypercoagulable state. A possibile relationship between the presence of FVL gene variant in type 1 or type 2 diabetes has been hypothysed by several reports in the Literature with non-univocal findings.
Retrospectively we analysed nearly 7000 patients referred to our Thrombosis Center for venous thromboembolism (VTE) then we selected 115 patients underwent to the screening for inherited thrombophilia. All selected patients were divided in 2 groups: the first group (group A) included 64 patients with previous VTE and carriers of factor V Leiden, while the second group (group B) included 51 patients with previous VTE and evetually carriers of thrombophilic defects other than factor V Leiden. Patients of group B acted as control group. 75 g oral glucose tolerance Test (OGTT) recommended by WHO was perfomed to all subjects in the study in order to screen subjects with glucose reduced tolerance or subjects with inducible diabetes. Statistical analysis was performed with STATA 6 http://www.stata.com with Student t test for unpaired data, with chi2 test or with Fisher exact test where appropriated; differences were considered to be significant if p < 0.05.
We did not find sifferences between glycaemia at baseline and after OGTT between patients with VTE carriers of FVL compared to non-carriers of FVL. We found a relevant increase in the prevalence of IGT and diabetes between patients with VTE carriers of FVL compared to non-carriers of FVL although this increase did not raise statistical significance.
our data pointed out an interesting aspect of the linking between FVL gene variant, diabetes and atherothrombosis and other vascular complications, although data on larger population are needed; this aspect may be another relevant topic of research based because also a link between the pathogenesis of venous thrombosis and atherothrombosis has been recently reported in the Literature.
糖尿病是众所周知的血栓形成事件的危险因素。糖尿病与静脉血栓栓塞之间的关联仍存在争议。然而,在糖尿病期间,会出现一种获得性易栓症,这是由于凝血抑制剂如抗凝血酶的非酶糖基化,从而导致高凝状态。文献中的几份报告曾假设1型或2型糖尿病中FVL基因变异的存在可能存在某种关系,但结果并不一致。
我们回顾性分析了近7000名因静脉血栓栓塞(VTE)转诊至我们血栓中心的患者,然后选择了115名接受遗传性易栓症筛查的患者。所有入选患者分为两组:第一组(A组)包括64名既往有VTE且为因子V莱顿携带者的患者,而第二组(B组)包括51名既往有VTE且最终为除因子V莱顿以外的易栓缺陷携带者的患者。B组患者作为对照组。对研究中的所有受试者进行了世界卫生组织推荐的75克口服葡萄糖耐量试验(OGTT),以筛查糖耐量降低或可诱导糖尿病的受试者。使用STATA 6(http://www.stata.com)进行统计分析,对未配对数据采用学生t检验,在适当情况下采用chi2检验或Fisher精确检验;如果p < 0.05,则认为差异具有统计学意义。
我们发现,与FVL非携带者相比,FVL携带者的VTE患者在基线和OGTT后的血糖水平之间没有差异。我们发现,与FVL非携带者相比,FVL携带者的VTE患者中IGT和糖尿病的患病率有显著增加,尽管这种增加没有统计学意义。
我们的数据指出了FVL基因变异、糖尿病与动脉粥样硬化血栓形成及其他血管并发症之间联系的一个有趣方面,尽管需要更多人群的数据;这一方面可能是另一个相关的研究主题,因为最近文献中也报道了静脉血栓形成与动脉粥样硬化血栓形成发病机制之间的联系。