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Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus

OJECTIVES: Thrombotic and antifibrinolytic influence of Diabetes mellitus type 1 (T1DM) on haemostasis have been well demonstrated. There has been no research assessing the influence of poor glycemic control on thrombus formation under flow conditions in vitro or in pregnant type 1 diabetic women to...

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Autores principales: Osiński, Maciej, Mantaj, Urszula, Kędzia, Małgorzata, Gutaj, Paweł, Wender-Ożegowska, Ewa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544075/
https://www.ncbi.nlm.nih.gov/pubmed/33031385
http://dx.doi.org/10.1371/journal.pone.0237843
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author Osiński, Maciej
Mantaj, Urszula
Kędzia, Małgorzata
Gutaj, Paweł
Wender-Ożegowska, Ewa
author_facet Osiński, Maciej
Mantaj, Urszula
Kędzia, Małgorzata
Gutaj, Paweł
Wender-Ożegowska, Ewa
author_sort Osiński, Maciej
collection PubMed
description OJECTIVES: Thrombotic and antifibrinolytic influence of Diabetes mellitus type 1 (T1DM) on haemostasis have been well demonstrated. There has been no research assessing the influence of poor glycemic control on thrombus formation under flow conditions in vitro or in pregnant type 1 diabetic women to date. PATIENTS/METHODS: This study compared singleton pregnant T1DM women (n = 21) and control pregnant subjects without any metabolic disease (n = 15). The T1DM group was divided into two subgroups of sufficient (SGC-DM; Hb(A1c) ≤6,5%,n = 15) and poor glycaemic control (PGC-DM; Hb(A1c) >6,5%,n = 6). Evaluation of the whole blood thrombogenicity we assessed using T-TAS(®) at a shear rate of 240 s-1 (Total-Thrombus Analysis System, Zacros, Japan). RESULTS: Blood clot formation initiation time (T10) was significantly shortened in PGC-DM subgroup when compared to SGC-DM subgroup (p = 0,03). The area under the curve (AUC30) of blood clot time formation and the MPV (mean platelet volume) values were substantially higher in the PGC-DM subgroup in comparison to the SGC-DM group (p = 0,03). Negative correlations were noted between Hb(A1c) and T10 values (p = 0,02) and between T10 and MPV values in the T1DM group (p = 0,04). CONCLUSIONS: Poor glycaemic control in T1DM subjects triggers a shift towards a prothrombotic and antifibrinolytic state. This phenomenon can be detected using the novel system for quantitative assessment of the platelet thrombus formation process under flow conditions in vitro. The alteration of T-TAS values in PGC-DM subgroup proves that a poor glycemic control-related shift of the equilibrium toward thrombogenesis occurs in this group of patients. Our findings need a further elucidation in research on more massive data sets to be confirmed.
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spelling pubmed-75440752020-10-19 Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus Osiński, Maciej Mantaj, Urszula Kędzia, Małgorzata Gutaj, Paweł Wender-Ożegowska, Ewa PLoS One Research Article OJECTIVES: Thrombotic and antifibrinolytic influence of Diabetes mellitus type 1 (T1DM) on haemostasis have been well demonstrated. There has been no research assessing the influence of poor glycemic control on thrombus formation under flow conditions in vitro or in pregnant type 1 diabetic women to date. PATIENTS/METHODS: This study compared singleton pregnant T1DM women (n = 21) and control pregnant subjects without any metabolic disease (n = 15). The T1DM group was divided into two subgroups of sufficient (SGC-DM; Hb(A1c) ≤6,5%,n = 15) and poor glycaemic control (PGC-DM; Hb(A1c) >6,5%,n = 6). Evaluation of the whole blood thrombogenicity we assessed using T-TAS(®) at a shear rate of 240 s-1 (Total-Thrombus Analysis System, Zacros, Japan). RESULTS: Blood clot formation initiation time (T10) was significantly shortened in PGC-DM subgroup when compared to SGC-DM subgroup (p = 0,03). The area under the curve (AUC30) of blood clot time formation and the MPV (mean platelet volume) values were substantially higher in the PGC-DM subgroup in comparison to the SGC-DM group (p = 0,03). Negative correlations were noted between Hb(A1c) and T10 values (p = 0,02) and between T10 and MPV values in the T1DM group (p = 0,04). CONCLUSIONS: Poor glycaemic control in T1DM subjects triggers a shift towards a prothrombotic and antifibrinolytic state. This phenomenon can be detected using the novel system for quantitative assessment of the platelet thrombus formation process under flow conditions in vitro. The alteration of T-TAS values in PGC-DM subgroup proves that a poor glycemic control-related shift of the equilibrium toward thrombogenesis occurs in this group of patients. Our findings need a further elucidation in research on more massive data sets to be confirmed. Public Library of Science 2020-10-08 /pmc/articles/PMC7544075/ /pubmed/33031385 http://dx.doi.org/10.1371/journal.pone.0237843 Text en © 2020 Osiński et al http://creativecommons.org/licenses/by/4.0/ 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 author and source are credited.
spellingShingle Research Article
Osiński, Maciej
Mantaj, Urszula
Kędzia, Małgorzata
Gutaj, Paweł
Wender-Ożegowska, Ewa
Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus
title Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus
title_full Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus
title_fullStr Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus
title_full_unstemmed Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus
title_short Poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus
title_sort poor glycaemic control contributes to a shift towards prothrombotic and antifibrinolytic state in pregnant women with type 1 diabetes mellitus
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7544075/
https://www.ncbi.nlm.nih.gov/pubmed/33031385
http://dx.doi.org/10.1371/journal.pone.0237843
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