Department of Medicine, Mardan Medical Complex, Bacha Khan Medical College, Mardan, Pakistan.
Pro-Gene Diagnostics and Research Laboratory Mardan, Pakistan.
J Pak Med Assoc. 2024 Aug;74(8):1441-1448. doi: 10.47391/JPMA.10403.
To determine how plasma fibrinogen levels impact the severity of microvascular complications in people with type 2 diabetes while focussing on the molecular mechanisms of fibrinogen's role in such complications.
The analytical, cross-sectional study was conducted from September 2022 to March 2023 at the Department of Medicine, Mardan Medical Complex and Teaching Hospital, Khyber Pakhtunkhwa, Pakistan, and comprised adult patients of either gender who had been diagnosed with type 2 diabetes and microvascular complications. Each patient was subjected to an evaluation of microvascular complications, including diabetic retinopathy, nephropathy and neuropathy, using validated diagnostic criteria and clinical examinations. Data was analysed using SPSS 26.
Of the 174 patients 97(%) were males and 77(%) were females. Retinopathy was found in 57(32.7) patients with median age 53 years (interquartile range: 46-63 years). Nephropathy was found in 55(31.6%) subjects with median age 54 years (interquartile range: 50-61 years). Neuropathy was found in 62(35.6%) patients with median age 53 years (interquartile range: 48-58 years). Diabetic neuropathy was significantly associated with elevated plasma fibrinogen levels and various biomarkers, such as creatinine, urea, fasting blood glucose, glycated haemoglobin and estimated average glucose (p<0.05). Diabetic retinopathy was significantly linked with higher levels of fibrinogen, which manifested through symptoms, like floaters or dark spots, impaired colour vision, difficulty seeing at night, blurred or fluctuating vision and vision loss (p<0.05). Diabetic nephropathy and the progression of its severity was significantly associated with increased fibrinogen levels, as well as markers, like albuminuria, creatinine, urea, fasting blood glucose, glycated haemoglobin and estimated average glucose (p<0.05).
Elevated plasma fibrinogen levels in patients with type 2 diabetes significantly correlated with increased microvascular complications, underscoring the importance of monitoring and managing fibrinogen levels to mitigate diabetes-associated vascular pathologies.
研究血浆纤维蛋白原水平对 2 型糖尿病患者微血管并发症严重程度的影响，并重点探讨纤维蛋白原在这些并发症中的作用机制。
本分析性、横断面研究于 2022 年 9 月至 2023 年 3 月在巴基斯坦开伯尔-普赫图赫瓦省马尔丹医疗综合体和教学医院内科进行，纳入了经诊断患有 2 型糖尿病和微血管并发症的成年男女患者。每位患者均通过经过验证的诊断标准和临床检查，对微血管并发症（包括糖尿病视网膜病变、肾病和神经病变）进行评估。采用 SPSS 26 对数据进行分析。
174 例患者中，97(%)为男性，77(%)为女性。57(32.7)例患者患有视网膜病变，中位年龄为 53 岁（四分位距：46-63 岁）。55(31.6%)例患者患有肾病，中位年龄为 54 岁（四分位距：50-61 岁）。62(35.6%)例患者患有神经病变，中位年龄为 53 岁（四分位距：48-58 岁）。糖尿病神经病变与血浆纤维蛋白原水平升高及多种生物标志物（如肌酐、尿素、空腹血糖、糖化血红蛋白和平均估计血糖）显著相关（p<0.05）。糖尿病视网膜病变与纤维蛋白原水平升高显著相关，表现为漂浮物或暗点、色觉受损、夜间视力障碍、视力模糊或波动、视力丧失等症状（p<0.05）。糖尿病肾病及其严重程度的进展与纤维蛋白原水平升高以及白蛋白尿、肌酐、尿素、空腹血糖、糖化血红蛋白和平均估计血糖等标志物显著相关（p<0.05）。
2 型糖尿病患者血浆纤维蛋白原水平升高与微血管并发症增加显著相关，这突显了监测和管理纤维蛋白原水平以减轻糖尿病相关血管病变的重要性。
