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Tissue factor pathway inhibitor and other endothelium-dependent hemostatic factors in elderly individuals with normal or impaired glucose tolerance and type 2 diabetes
- Source :
- Diabetes Care, 25(8), 1340-1345. American Diabetes Association, Diabetes Care, 25(8), 1340-1345. AMER DIABETES ASSOC
- Publication Year :
- 2002
-
Abstract
- OBJECTIVE—Impaired glucose tolerance (IGT) is believed to be a prediabetic phase that precedes the development of type 2 diabetes. In elderly subjects, IGT and diabetes are both independently associated with the occurrence of cardiovascular disease. Endothelial damage precedes atherosclerotic changes of the vascular wall. Therefore, several markers of endothelial dysfunction were examined in elderly subjects with IGT and elderly patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—Von Willebrand factor (vWF), tissue plasminogen activator (t-PA), plasminogen activator inhibitor type-1 (PAI-1), and thrombomodulin were studied as markers of endothelial dysfunction in a population-based study of elderly subjects with normal glucose tolerance (NGT) or IGT and type 2 diabetes. In addition to these endothelium-dependent factors, we also investigated tissue factor pathway inhibitor (TFPI) activity in relation to metabolic parameters and cardiovascular risk factors. RESULTS—All data were adjusted for age. Increased levels of vWF antigen, t-PA antigen, and PAI-1 activity were seen in the IGT and diabetic group compared with the NGT group. TFPI activity and thrombomodulin levels were increased in all elderly subjects, and no differences were seen between the groups. There was a positive association between HbA1c and TFPI activity and vWF antigen. Fasting blood glucose levels correlated with vWF antigen, t-PA antigen, and PAI-1 activity, whereas urine albumin excretion correlated with TFPI activity, vWF antigen, and PAI-1 activity. Serum insulin levels correlated strongly not only with vWF antigen and t-PA antigen but also with PAI-1 activity. This correlation did not change after further adjustment for serum glucose and HbA1c, which may suggest that in the elderly subjects, impaired fibrinolysis is probably associated with insulin resistance. There were no associations between the endothelium-dependent hemostatic factors and lipids, except for a negative correlation between HDL cholesterol and thrombomodulin. CONCLUSIONS—In elderly subjects with IGT, several endothelium-dependent hemostatic factors are already consistently increased, indicating endothelial damage in this stage.
- Subjects :
- VONWILLEBRAND-FACTOR
Blood Glucose
Male
medicine.medical_specialty
VON-WILLEBRAND-FACTOR
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
Lipoproteins
Thrombomodulin
Type 2 diabetes
PLASMINOGEN-ACTIVATOR INHIBITOR-1
Impaired glucose tolerance
chemistry.chemical_compound
Insulin resistance
Tissue factor pathway inhibitor
NIDDM
Internal medicine
Diabetes mellitus
von Willebrand Factor
Internal Medicine
medicine
Humans
HUMAN-PLASMA
ALBUMIN EXCRETION
Aged
Advanced and Specialized Nursing
Hemostasis
business.industry
Insulin
Glucose Tolerance Test
Middle Aged
medicine.disease
INSULIN
Endocrinology
chemistry
Diabetes Mellitus, Type 2
CARDIOVASCULAR-DISEASE
Plasminogen activator inhibitor-1
Tissue Plasminogen Activator
cardiovascular system
RISK-FACTORS
Female
Endothelium, Vascular
Insulin Resistance
business
Biomarkers
FIBRINOLYTIC-ACTIVITY
Subjects
Details
- ISSN :
- 01495992
- Volume :
- 25
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Diabetes care
- Accession number :
- edsair.doi.dedup.....729f8eac07d93eb32070962dc8a1af05