Gruden G, Cavallo-Perin P, Romagnoli R, Olivetti C, Frezet D, Pagano G
Institute of Internal Medicine, University of Turin, Italy.
Diabet Med. 1994 Jun;11(5):485-8. doi: 10.1111/j.1464-5491.1994.tb00311.x.
In microalbuminuria there is an increased cardiovascular risk not fully explained by the excess of conventional risk factors. To investigate whether or not microalbuminuria is associated with haemostatic abnormalities in Type 2 diabetic patients, we measured the prothrombin fragment 1 + 2, a marker of thrombin generation, and the thrombin-antithrombin complex, a marker of thrombin neutralization. Plasma levels of prothrombin fragment 1 + 2 and thrombin-antithrombin complex were assayed in 17 microalbuminuric patients (albumin excretion rate, AER 20-200 micrograms min-1) and in 17 comparable normoalbuminuric (AER < 20 micrograms min-1) Type 2 diabetic patients. Plasma prothrombin fragment 1 + 2 was significantly higher in microalbuminuric than in normoalbuminuric patients (1.09 +/- 0.06 vs 0.86 +/- 0.04 nM, p = 0.003). Individual values of F1 + 2 were above the upper limit of the normal range in 8/17 microalbuminuric and in none of the normoalbuminuric Type 2 diabetic patients. Plasma thrombin-antithrombin complex values were not significantly different in the two groups and were not correlated with AER. These results suggest that microalbuminuria is associated with a prethrombotic state and a relatively defective thrombin neutralization. Coagulation abnormalities might be part of the cardiovascular risk in microalbuminuric patients.
在微量白蛋白尿患者中，心血管风险增加，而传统危险因素增多并不能完全解释这一现象。为了研究微量白蛋白尿是否与2型糖尿病患者的止血异常有关，我们检测了凝血酶生成标志物凝血酶原片段1+2以及凝血酶中和标志物凝血酶-抗凝血酶复合物。对17例微量白蛋白尿患者（白蛋白排泄率，AER 20 - 200微克/分钟）和17例可比的正常白蛋白尿（AER < 20微克/分钟）2型糖尿病患者的血浆凝血酶原片段1+2和凝血酶-抗凝血酶复合物水平进行了检测。微量白蛋白尿患者的血浆凝血酶原片段1+2显著高于正常白蛋白尿患者（1.09±0.06对0.86±0.04 nM，p = 0.003）。17例微量白蛋白尿患者中有8例F1+2的个体值高于正常范围上限，而正常白蛋白尿2型糖尿病患者均未出现这种情况。两组的血浆凝血酶-抗凝血酶复合物值无显著差异，且与AER无关。这些结果表明，微量白蛋白尿与血栓前状态及相对缺陷的凝血酶中和有关。凝血异常可能是微量白蛋白尿患者心血管风险的一部分。
