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Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk
OBJECTIVE: To investigate the effect of low blood glucose on thrombin generation and fibrin clot properties in type 2 diabetes (T2DM). METHODS: In 165 patients with T2DM and high cardiovascular risk, we measured ex vivo plasma fibrin clot permeation [K(s)], turbidity and efficiency of fibrinolysis i...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4432887/ https://www.ncbi.nlm.nih.gov/pubmed/25928628 http://dx.doi.org/10.1186/s12933-015-0207-2 |
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author | Gajos, Grzegorz Konieczynska, Malgorzata Zalewski, Jaroslaw Undas, Anetta |
author_facet | Gajos, Grzegorz Konieczynska, Malgorzata Zalewski, Jaroslaw Undas, Anetta |
author_sort | Gajos, Grzegorz |
collection | PubMed |
description | OBJECTIVE: To investigate the effect of low blood glucose on thrombin generation and fibrin clot properties in type 2 diabetes (T2DM). METHODS: In 165 patients with T2DM and high cardiovascular risk, we measured ex vivo plasma fibrin clot permeation [K(s)], turbidity and efficiency of fibrinolysis including clot lysis time [t(50%)], together with thrombin generation and platelet activation markers in relation to fasting blood glucose. RESULTS: As compared to patients in medium (4.5-6.0 mmol/l, n = 52) and higher (>6.0 mmol/l, n = 75) glucose group, subjects with low glycemia (<4.5 mmol/l, n = 38) had lower K(s) by 11% (p < 0.001) and 8% (p = 0.01), respectively, prolonged t(50%) by 10% (p < 0.001) and 7% (p = 0.016), respectively, and higher peak thrombin generation by 21% and 16%, respectively (p < 0.001 for both). There were no significant differences in K(s) and t(50%) between patients in medium and higher glucose group. In the whole group, a J-shape relationship was observed between glycemia and the following factors: peak thrombin generation, K(s) and t(50%). Only in patients with HbA1c < 6.0% (42 mmol/mol) (n = 26) fasting glucose positively correlated with K(s) (r = 0.53, P = 0.006) and inversely with t(50%) (r = −0.46, P = 0.02). By multiple regression analysis, after adjustment for age, fibrinogen, HbA1c, insulin treatment and T2DM duration, fasting glycemia was the independent predictor of K(s) (F = 6.6, df = 2, P = 0.002), t(50%) (F = 8.0, df = 2, P < 0.001) and peak thrombin generation (F = 13.5, df = 2, P < 0.0001). CONCLUSIONS: In T2DM patients fasting glycemia <4.5 mmol/l is associated with enhanced thrombin formation and formation of denser fibrin clots displaying lower lysability, especially when strict glycemia control was achieved (HbA1c<6.0%). |
format | Online Article Text |
id | pubmed-4432887 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-44328872015-05-16 Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk Gajos, Grzegorz Konieczynska, Malgorzata Zalewski, Jaroslaw Undas, Anetta Cardiovasc Diabetol Original Investigation OBJECTIVE: To investigate the effect of low blood glucose on thrombin generation and fibrin clot properties in type 2 diabetes (T2DM). METHODS: In 165 patients with T2DM and high cardiovascular risk, we measured ex vivo plasma fibrin clot permeation [K(s)], turbidity and efficiency of fibrinolysis including clot lysis time [t(50%)], together with thrombin generation and platelet activation markers in relation to fasting blood glucose. RESULTS: As compared to patients in medium (4.5-6.0 mmol/l, n = 52) and higher (>6.0 mmol/l, n = 75) glucose group, subjects with low glycemia (<4.5 mmol/l, n = 38) had lower K(s) by 11% (p < 0.001) and 8% (p = 0.01), respectively, prolonged t(50%) by 10% (p < 0.001) and 7% (p = 0.016), respectively, and higher peak thrombin generation by 21% and 16%, respectively (p < 0.001 for both). There were no significant differences in K(s) and t(50%) between patients in medium and higher glucose group. In the whole group, a J-shape relationship was observed between glycemia and the following factors: peak thrombin generation, K(s) and t(50%). Only in patients with HbA1c < 6.0% (42 mmol/mol) (n = 26) fasting glucose positively correlated with K(s) (r = 0.53, P = 0.006) and inversely with t(50%) (r = −0.46, P = 0.02). By multiple regression analysis, after adjustment for age, fibrinogen, HbA1c, insulin treatment and T2DM duration, fasting glycemia was the independent predictor of K(s) (F = 6.6, df = 2, P = 0.002), t(50%) (F = 8.0, df = 2, P < 0.001) and peak thrombin generation (F = 13.5, df = 2, P < 0.0001). CONCLUSIONS: In T2DM patients fasting glycemia <4.5 mmol/l is associated with enhanced thrombin formation and formation of denser fibrin clots displaying lower lysability, especially when strict glycemia control was achieved (HbA1c<6.0%). BioMed Central 2015-05-01 /pmc/articles/PMC4432887/ /pubmed/25928628 http://dx.doi.org/10.1186/s12933-015-0207-2 Text en © Gajos et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Investigation Gajos, Grzegorz Konieczynska, Malgorzata Zalewski, Jaroslaw Undas, Anetta Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk |
title | Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk |
title_full | Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk |
title_fullStr | Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk |
title_full_unstemmed | Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk |
title_short | Low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk |
title_sort | low fasting glucose is associated with enhanced thrombin generation and unfavorable fibrin clot properties in type 2 diabetic patients with high cardiovascular risk |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4432887/ https://www.ncbi.nlm.nih.gov/pubmed/25928628 http://dx.doi.org/10.1186/s12933-015-0207-2 |
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