Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands.
J Thromb Haemost. 2019 Nov;17(11):1886-1897. doi: 10.1111/jth.14573. Epub 2019 Aug 9.
It is insufficiently understood if there is an association between diabetes and VT, and what the underlying mechanism would be.
We aimed to study the association between glucose concentrations with several coagulation factors in the general population.
This is a cross-sectional analysis of baseline measurements within 5778 participants of the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study of individuals 45 to 65 years. Associations between fasting glucose and HbA1c concentrations, and postprandial glucose response and factor (F) VIII, FIX, FXI, and fibrinogen levels were examined using linear regression analyses and by calculating mean levels per category of glucose concentrations while adjusting for confounding factors.
Per each mmol/L higher fasting glucose concentration we observed higher levels of fasting FVIII (5.33%, 95% CI: 4.00-6.65), FIX (6.19%, 95% CI: 5.15-7.23), and FXI (2.11%, 95% CI: 1.20-3.02). Results for fasting HbA1c and postprandial glucose response were similar. Participants with an impaired fasting glucose, high fasting glucose, and diabetes mellitus had higher mean levels of FVIII, FIX, and FXI than those with a normal glucose metabolism, with the highest differences in the levels of FVIII, FIX, and FXI between a high fasting glucose and a normal glucose metabolism. All associations attenuated after adjustment for total body fat, yet all of the above associations remained after adjustment for the confounding factors, except for fibrinogen when contrasted to glucose.
Concentrations of fasting glucose and HbA1c and postprandial glucose response were positively associated with FVIII, FIX, and FXI, and to some extent also with fibrinogen.
目前对于糖尿病与 VT 之间是否存在关联,以及潜在的机制是什么,人们的了解还不够充分。
我们旨在研究一般人群中血糖浓度与几种凝血因子之间的关系。
这是对荷兰肥胖症流行病学研究(NEO)中 5778 名参与者的基线测量值进行的横断面分析,这是一项针对 45 至 65 岁人群的基于人群的队列研究。使用线性回归分析和按血糖浓度类别计算平均水平(同时调整混杂因素),研究空腹血糖和 HbA1c 浓度以及餐后血糖反应与因子(F)VIII、FIX、FXI 和纤维蛋白原水平之间的关系。
我们发现,每升高 1mmol/L 的空腹血糖,我们观察到空腹 FVIII(5.33%,95%CI:4.00-6.65)、FIX(6.19%,95%CI:5.15-7.23)和 FXI(2.11%,95%CI:1.20-3.02)水平更高。空腹 HbA1c 和餐后血糖反应的结果相似。与葡萄糖代谢正常的参与者相比,空腹血糖受损、高空腹血糖和糖尿病患者的 FVIII、FIX 和 FXI 平均水平更高,其中高空腹血糖与葡萄糖代谢正常之间的 FVIII、FIX 和 FXI 水平差异最大。在调整了全身脂肪后,所有关联均减弱,但在调整了混杂因素后,除了与葡萄糖相比时纤维蛋白原外,所有上述关联仍然存在。
空腹血糖和 HbA1c 浓度以及餐后血糖反应与 FVIII、FIX 和 FXI 呈正相关,在一定程度上也与纤维蛋白原相关。