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Tissue factor pathway inhibitor (TFPI) release after heparin stimulation is increased in Type 1 diabetic patients with albuminuria
Author(s) -
Leurs P. B.,
Van Oerle R.,
Hamulyak K.,
Wolffenbuttel B. H. R.
Publication year - 2003
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2003.00786.x
Subject(s) - medicine , heparin , albuminuria , tissue factor pathway inhibitor , thrombomodulin , plasminogen activator , endocrinology , anticoagulant , basal (medicine) , von willebrand factor , gastroenterology , diabetes mellitus , tissue factor , platelet , coagulation , thrombin
Aims To study heparin‐stimulated TFPI release in relation to complications in Type 1 diabetic patients. Subjects and methods Nineteen uncomplicated Type 1 diabetic patients (group I) were compared with 18 patients with retinopathy (group II), and nine patients with retinopathy and albuminuria (group III). Blood samples were taken before (basal) and till 30 min after 5000 IU of heparin i.v. (post‐heparin). TFPI activity was measured chromogenically. Von Willebrand factor, tissue plasminogen activator (t‐PA), plasminogen activator inhibitor‐1 (PAI‐1) and thrombomodulin were also measured. Results Basal TFPI activity was higher in group III (121 ± 10%) compared with group II (111 ± 8%) or group I (110 ± 13%) ( P < 0.05), and strongly correlated with albuminuria ( r = 0.66, P < 0.05). At all time points after heparin administration, TFPI activity in group III was significantly higher than in group I. TFPI activity was also higher in group III than in group II 5–30 min post‐heparin. The increase in post‐heparin TFPI activity, measured as the incremental area under the curve, was higher in group III compared with group I (65 ± 7 vs. 59 ± 4; P < 0.05). Of the other parameters, only thrombomodulin was higher in group III (44 ± 24 vs. 26 ± 7 (group II) and 28 ± 9 ng/ml (group I); P < 0.01). Conclusions We conclude that basal and post‐heparin TFPI activity is increased in albuminuric patients. The increase in heparin‐stimulated TFPI release in patients with albuminuria is higher than in patients with retinopathy or without complications. This could be the result of altered endothelial glycosaminoglycan characteristics. Diabet. Med. 20, 16–22 (2003)