Skip to main content
SpringerLink
Log in

Thrombogenic factors are related to urinary albumin excretion rate in Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic patients

  • Published:
Diabetologia Aims and scope Submit manuscript

Summary

Parameters of haemostasis, endothelial cell markers and lipid peroxide levels were studied in 64 Type 1 (insulin-dependent) and 94 Type 2 (non-insulin-dependent) diabetic patients according to their urinary albumin excretion rate in comparison with age-matched control subjects. We determined plasma levels of fibrinogen (Clauss' method), coagulation factor VII:activity (clotting assay), factor VII antigen, protein C and S antigen, von Willebrand factor antigen,d-dimer concentration (ELISA), and lipid peroxide levels (thiobarbituric acid) in relation to urinary albumin excretion rate (RIA). Significant positive correlations were found between urinary albumin excretion rate and plasma fibrinogen (p<0.005,p<0.02), factor VII activity (p<0.0002,p<0.002), factor VII antigen (p<0.0001,p<0.001), protein C (p<0.003,p<0.05), and lipid peroxides (p<0.02,p<0.004) in Type 1 as well as in Type 2 diabetes. Von Willebrand factor (p<0.001) and protein S (p<0.0005) correlated with albuminuria only in patients with Type 1 diabetes. Although most of the haemostatic abnormalities are already found in normoalbuminuric patients, the significant positive correlations to urinary albumin excretion indicate that endothelial cell damage and coagulation disorders deteriorate with the progression of diabetic nephropathy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Morrish NJ, Stevens LK, Head J, Fuller JH, Jarrett RJ, Keen H (1990) A prospective study of mortality among middle-aged diabetic patients (the London cohort of the WHO Multinational Study of Vascular Disease in Diabetics) I: causes and death rates. Diabetologia 33: 538–541

    CAS  PubMed  Google Scholar 

  2. Morrish NJ, Stevens LK, Head J, Fuller JH, Jarrett RJ, Keen H (1990) A prospective study of mortality among middle-aged diabetic patients (the London cohort of the WHO Multinational Study of Vascular Disease in Diabetics) II: associated risk factors. Diabetologia 33: 542–548

    CAS  PubMed  Google Scholar 

  3. Fuller JH, Keen H, Jarrett RJ et al. (1979) Haemostatic variables associated with diabetes and its complications. BMJ II: 964–966

    Google Scholar 

  4. Schernthaner G, Vukovich T, Gisinger C (1991) Anomalies de l'hemostase au cours du diabete sucre. In: Flammarion Medecine Sciences-Journees de Diabetologie, Paris, France, pp 91–107

    Google Scholar 

  5. Kannel WB, D'Agostino RB, Wilson PW, Belanger AJ, Gagnon DR (1990) Diabetes, fibrinogen and risk of cardiovascular disease: the Framingham experience. Am Heart J 120: 672–676

    CAS  PubMed  Google Scholar 

  6. Meade TW, Mellows S, Brozovic M et al. (1986) Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet II: 533–537

    Google Scholar 

  7. Jensen T, Borch-Johnsen K, Kofoed-Enevoldsen A, Deckert T (1987) Coronary heart disease in young type 1 (insulin-dependent) diabetic patients with and without diabetic nephropathy: incidence and risk factors. Diabetologia 30: 144–148

    Article  CAS  PubMed  Google Scholar 

  8. Mogensen CE (1984) Microalbuminuria predicts clinical proteinuria and early mortality in maturity onset diabetes. N Engl J Med 310: 356–360

    CAS  PubMed  Google Scholar 

  9. Jarrett RJ, Viberti GC, Argyropoulos A, Hill RD, Mahmud U, Murrells TJ (1984) Microalbuminurea predicts mortality in noninsulin dependent diabetes. Diabetic Med 1: 17–19

    CAS  PubMed  Google Scholar 

  10. Schmitz A, Vaeth M (1988) Microalbuminurea: a major risk factor in non-insulin-dependent diabetes: a 10 year follow-up of 503 patients. Diabetic Med 5: 126–134

    CAS  PubMed  Google Scholar 

  11. Mattock MB, Morrish NJ, Viberti G, Keen H, Fitzgerald AP, Jackson G (1992) Prospective study of microalbuminurea as predictor for mortality in NIDDM. Diabetes 41: 736–741

    CAS  PubMed  Google Scholar 

  12. Mogensen CE, Christensen CK, Vittinghus E (1983) The stages in diabetic renal disease with emphasis on the stage of incipient diabetic nephropathy. Diabetes 32 [Suppl 2]: 64–78

    PubMed  Google Scholar 

  13. Clauss A (1957) Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens. Acta Haematol Leipzig 17: 237–240

    CAS  Google Scholar 

  14. Yagi K (1987) Lipid peroxides and human diseases. Chem Phys Lipids 45: 337–351

    CAS  PubMed  Google Scholar 

  15. SAS users guide (1985) SAS Institute, Cary, NC

  16. Sandset PM, Sirnes PA, Abildgaard U (1989) Factor VII and extrinsic pathyway inhibitor in acute coronary disease. Br J Haematol 72: 391–396

    CAS  PubMed  Google Scholar 

  17. Jumming L, Vilcek J (1988) Interleukin 6: a multifunctional cytokine regulating immune reactions and the acute phase protein response. Lab Invest 61: 588–602

    Google Scholar 

  18. Collier A, Rumley A, Rumley AG et al. (1992) Free radical activity and hemostatic factors in NIDDM patients with and without microalbuminurea. Diabetes 41: 909–913

    CAS  PubMed  Google Scholar 

  19. Schmitz A, Ingerslev J (1990) Haemostatic measurements in type 2 diabetic patients with microalbuminurea. Diabetic Med 7: 521–525

    CAS  PubMed  Google Scholar 

  20. Vukovich T, Schernthaner G (1986) Decreased protein C levels in patients with insulin dependent diabetes mellitus. Diabetes 35: 617–619

    CAS  PubMed  Google Scholar 

  21. Schernthaner G, Vukovich T, Knöbl P, Hay U, Müller M (1989) The effect of near normoglycaemic control on plasma levels of coagulation factor VII and the anticoagulants protein C and S in insulin dependent diabetic patients. Br J Haematol 73: 356–359

    CAS  PubMed  Google Scholar 

  22. Vigano S, Mannucci PM, D'Angelo A et al. (1984) Protein C antigen is not an acute phase reactant and is often high in ischemic heart disease and diabetes. Thromb Haemost 52: 263–266

    CAS  PubMed  Google Scholar 

  23. Saito M, Kumabashiri I, Jokaji H et al. (1988) The levels of protein C and protein S in plasma in patients with type II diabetes mellitus. Thromb Res 52: 479–486

    Article  CAS  PubMed  Google Scholar 

  24. Oida K, Takai H, Maeda H et al. (1990) Plasma thrombomodulin concentration in diabetes mellitus. Diabetes Res Clin Pract 10: 193–196

    Article  CAS  PubMed  Google Scholar 

  25. Tanaka A, Ishii H, Hiraishi S, Kazama M, Maezawa H (1991) Increased thrombomodulin values in plasma of diabetic men with microangiopathy. Clin Chem 37: 269–272

    CAS  PubMed  Google Scholar 

  26. Schwarz HP, Heeb MJ, Wence-Drake J, Griffin JH (1985) Identification and quantitation of protein S in human platelets. Blood 66: 1452–1456

    CAS  PubMed  Google Scholar 

  27. Ceriello A, Giuliano D, Quatraro A, Marchi E, Barbanti M, Lefebvre P (1990) Possible role for increased C4 b-binding protein level in acquired protein S deficiency in type 1 diabetes. Diabetes 39: 447–449

    CAS  PubMed  Google Scholar 

  28. Jensen T, Bjerre-Knudsen J, Feldt-Rasmussen B, Deckert T (1989) Features of endothelial cell dysfunction in early diabetic nephropathy. Lancet I: 461–463

    Google Scholar 

  29. Vukovich TC, Schernthaner G, Knöbl PN, Hay U (1989) The effect of near-normoglycaemic control on plasma factor VIII/von Willebrand factor and fibrin degradation products in insulin dependent diabetic patients. J Clin Endocrinol Metab 69: 84–89

    CAS  PubMed  Google Scholar 

  30. Stehouwer CDA, Nauta JJP, Zeldenrust GC, Hackeng WHL, Donker AJM, den Ottolander GJH (1992) Urinary albumin excretion, cardiovascular disease, and endothelial dysfunction in non-insulin-dependent diabetes mellitus. Lancet 340: 319–323

    Article  CAS  PubMed  Google Scholar 

  31. Stringer MD, Görög PG, Freeman A, Kakker VV (1989) Lipid peroxides and atherosclerosis. BMJ 298: 281–284

    CAS  PubMed  Google Scholar 

  32. Warso MA, Lands WEM (1983) Lipid peroxidation in relation to prostacyclin and thromboxane physiology and pathophysiology. Br Med Bull 39: 277–280

    CAS  PubMed  Google Scholar 

  33. Gisinger CH, Jeremy J, Speiser P, Mikhailides D, Dandonda D, Schernthaner G (1988) Effect of vitamin E treatment on platelet thromboxane A2 production in insulin dependent (type 1) diabetic patients: a double blind cross over trial. Diabetes 37: 1260–1264

    CAS  PubMed  Google Scholar 

  34. Schernthaner G, Sinzinger H, Silberbauer K, Freyler H, Mühlhauser I, Kaliman J (1981) Vascular prostacyclin, platelet sensitivity to prostaglandins and platelet specific proteins in diabetes mellitus. Horm Metab Res 11: 33–43

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine II, University of Vienna, Vienna, Austria

    P. Knöbl, P. Pietschmann & R. Prager

  2. Department of Surgery II, University of Vienna, Vienna, Austria

    A. Griesmacher & M. Müller

  3. Department of Medicine 1, Rudolfstiftung Hospital, Juchgasse 25, A-1030, Vienna, Austria

    G. Schernthaner & C. Schnack

Authors
  1. P. Knöbl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Schernthaner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Schnack
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Pietschmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Griesmacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R. Prager
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Knöbl, P., Schernthaner, G., Schnack, C. et al. Thrombogenic factors are related to urinary albumin excretion rate in Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic patients. Diabetologia 36, 1045–1050 (1993). https://doi.org/10.1007/BF02374497

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02374497

Key words

Search

Navigation