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The effect of near‐normoglycaemic control on plasma levels of coagulation factor VII and the anticoagulant proteins C and S in insulin‐dependent diabetic patients
Author(s) -
Schernthaner Guntram,
Vukovich Thomas,
Knöbl Paul,
Hay Ulrike,
Müller Mathias M.
Publication year - 1989
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1989.tb07752.x
Subject(s) - factor vii , medicine , protein c , endocrinology , diabetes mellitus , metabolic control analysis , insulin , cholesterol , coagulation , tissue factor , protein s , risk factor
Summary The present prospective follow‐up study was made to study the effect of glycaemic regulation on levels of factor VII, protein C and protein S in 15 insulin‐dependent diabetic patients without manifestations of vascular disease. Patients were tested before and after 8 weeks of ‘metabolic’ intervention, whereby a near‐normoglycaemic state was achieved. At baseline, values of cross‐linked fibrin degradation products (XL‐FDP) and levels of ‘total’ protein S were significantly increased and protein C values were decreased in the diabetic patients when compared to control subjects, whereas levels of factor VII and ‘free’ protein S were near normal. After ‘metabolic’ intervention a decrease of all haemostatic parameters were recorded, however XL‐FDP levels did not decline to control levels and the imbalance of factor VII and protein C persisted. When patients with newly diagnosed diabetes ( n = 8) were compared to those with long‐term disease ( n = 7) higher levels of factor VII, protein C and protein S were recorded in the latter group before and after metabolic intervention; at baseline the differences reached statistical significance for factor VII and protein S, and remained significant for factor VII after metabolic intervention. Before and after intervention XL‐FDP levels were higher in patients with newly diagnosed disease than in patients with long‐term diabetes. The correlation analysis revealed positive correlations of factor VII, protein C and protein S to cholesterol and triglycerides, of protein S to all glycaemic control parameters, negative correlations of protein C to glucose, and of XL‐FDP to factor VII, protein C and protein S. The results indicate an imbalance of haemostasis towards thrombophilicity in insulin‐dependent diabetic patients, not completely correctable by glycaemic control.