Coagulation factors IX and XI activities are significantly enhanced in type 2 diabetic patients

Nermina Babić, Nesina Avdagic, Asija Zaciragic, Suzana Tihic-Kapidzic, Sabina Zukic, Amela Dervisevic, Miralem Music, Izeta Aganovic, Almira Hadzovic-Dzuvo

Abstract


Objectives: The aim was to examine whether plasma coagulation factors activities are increased in patients with diabetes mellitus type 2 (DM2). Also, we aimed to assess whether any association exists between plasma coagulation factors and cardiometabolic risk factors in these patients.

Methods: This cross-sectional study included 30 DM2 patients and 30 healthy subjects as control group. Plasma fibrinogen concentration and activities of coagulation factors II, V, VII, IX, X, XI and XII were measured.

Results: The activities of coagulation factors IX (145.51±5.27 % of norm; p <0.0005) and XI (136.38±5.08 % of norm; p=0.001) and fibrinogen concentration [10.5 (9.3-13.25) mmol/L; p=0.001] were significantly higher in DM2 patients compared to control (IX - 116.44±3.86 % of norm; XI - 109,27±5,95 % of norm; fibrinogen – 8.8  (7.9-10.2) mmol/L). Plasma activities of factors II, V, VII and X were higher, whereas factor XII activity was lower in diabetic patients than in control subjects, but not statistically significant.

A significant positive correlation between fasting blood glucose and factors IX, X and XI, was observed in DM2 patients. In the same group significant positive correlation was determined between factors II, VII, IX, X and triglycerides and between factor II and total cholesterol.

Conclusion: Procoagulant state in DM2 as evidenced by enhanced activation of coagulation factors IX and XI and elevated fibrinogen concentration, may contribute to the increased risk of thrombosis and vascular complications in DM2 patients. Furthermore, in the prevention of thrombotic complications in patients with diabetes mellitus it is necessery to keep blood glucose and lipids under control.

Key words: coagulation factors, patients with DM2, thrombosis, lipids


Full Text:

PDF

References


Hess K, Marx N, Lehrke M. Cardiovascular disease and diabetes: the vulnerable

Patient. European Heart Journal 2012;14:Suppl B: 4–13.

Hess K. The vulnerable blood. Coagulation and clot structure in diabetes mellitus. Hamostaseologie 2015;35(1):25-33.

Kim JH, Bae HY, Kim SY. Clinical Marker of Platelet Hyperreactivity in Diabetes Mellitus. Diabetes Metab J 2013;37:423-428.

Alzahrani SH, Ajjan RA. Coagulation and fibrinolysis in diabetes. Diabetes &Vascular Disease Research 2010;7 (4):260-273.

Soares AL, Sousa MO, Fernandes APSM, Carvalho MG. Hemostatic changes in patients with type 2 diabetes mellitus. Rev. Bras. Hematol. Hemoter. 2010;32(6):482-488.

Madan R, Gupt B, Saluja S, Kansra UC, Tripathi BK, Guliani BP. Coagulation profile in diabetes and its association with diabetic microvascular complications. J Assoc Physicians India. 2010;58:481-484.

Mudau M, Genis A, Lochner A, Strijdom H. Endothelial dysfunction: the early predictor of atherosclerosis. CVJ Africa 2012;23(4):222-231.

Saboor M, Moinuddin, Ajmal M, Ilyas S. Functional status of vascular endothelium in diabetes mellitus. J Ayub Med Coll Abbottabad. 2014;26 (2):239 243.

Chandler WL, Rodgers GM, Sprouse JT, Thompson AR. Elevated Hemostatic Factor Levels as Potential Risk Factors for Thrombosis. Arch Pathol Lab Med. 2002;126:1405–1414.

Cushman M, O'Meara ES, Folsom AR, Heckbert SR. Coagulation factors IX through XIII and the risk of future venous thrombosis: The Longitudinal Investigation of Thromboembolism Etiology. Blood 2009;114:2878-2883.

Heikal NM, Murphy KK, Crist RA, Wilson AR, Rodgers GM, Smock KJ. Elevated factor IX activity is associated with an increased odds ratio for both arterial and venous thrombotic events. Am J Clin Pathol. 2013;140 (5):680-5.

Babić N, Dervisević A, Huskić J, Musić M. Coagulation factor VIII activity in diabetic patients. Med Glas (Zenica) 2011;8 (1):134-139.

Cucuianu M, Coca M. Thrombotic tendency in diabetes mellitus. Revisiting and revising a study initiated 30 years ago. Rom J Intern Med. 2012;50(2):107-115.

Mard-Soltani M, Dayer MR, Ataie G, Moazedi AA, Dayer MS, Alavi SMR. Coagulation Factors Evaluation in NIDDM Patients. Am. J. Biochem. 2011;1(3):244-254.

Erem C, Hacihasanoğlu A, Celik S, Ovali E, Ersöz HO, Ukinç K, Deger O, Telatar M. Coagulation and fibrinolysis parameters in type 2 diabetic patients with and without diabetic vascular complications. Med Princ Pract. 2005;14 (1):22-30.

Zhao Y, Zhang J, Zhang J, Wu J. Diabetes Mellitus Is Associated with Shortened Activated Partial Thromboplastin Time and Increased Fibrinogen Values. PLoS ONE 2011;6 (1):e16470 http://dx.doi.org/10.1371/journal.pone.0016470

Lemkes B.A., Hermanides J., Devries J.H., Holleman F., Meijers J.C., Hoekstra J.B. Hyperglycemia: a prothrombotic factor?. J Thromb Haemost. 2010;8:1663 1669.

Kafle DR, Shrestha P. Study of fibrinogen in patients with diabetes mellitus. Nepal med Coll J 2010;12 (1 ):34-37.

Kim JA, Kim JE, Song SH, Kim HK. Influence of Blood Lipids on Global Coagulation Test Results. Ann Lab Med. 2015;35(1):15–21.doi: 10.3343/alm.2015.35.1.15


Refbacks

  • There are currently no refbacks.