Exp Clin Endocrinol Diabetes 2001; Vol. 109(3): 146-150
DOI: 10.1055/s-2001-14837
Articles

© Johann Ambrosius Barth

Prospective study on plasma clotting parameters in diabetic children - no evidence for specific changes in coagulation system

P. Zeitler, A. Thiede, H. L. Müller
  • Department of Pediatrics, University of Würzburg, Würzburg, Germany
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Summary:

In a prospective study, clotting parameters of 37 children and adolescents with insulin-dependent diabetes mellitus (type 1 diabetes) were compared with those of a healthy control group. In a longitudinal follow-up over two years we found no statistical difference for most of the coagulation parameters investigated, including single factor analysis and coagulation inhibitors. The duration of type 1 diabetes was of no influence on these parameters. The only difference we found between patients and healthy controls was an elevation of PAI-1 in diabetics: median for PAI-1: 2.12 IU/ml in diabetics (range 0.50-8.40 IU/ml) and 0.84 IU/ml in normal controls (range 0.50-1.78 IU/ml). This difference was of statistic significance (p < 0.002) and also found in newly diagnosed patients. During observation time, none of our patients developed thrombosis or signs of vascular disease. - In conclusion, we could not confirm the development of a hypercoagulable state in pediatric diabetics, as it is described for adults with type 1 diabetes mellitus.

References

  • 1 Agewall S, Fagerberg B, Attval S, Ljungman S, Urbanavicius V, Tengborn L, Wikstrand J. Microalbuminuria, insulin sensitivity and haemostatic factors in non-diabetic treated hypertensive men.  Journal of Int Med. 237 195-203 1995; 
  • 2 Altunbas H, Karayalcin U, Undar L. Glycemic control and coagulation inhibitors in diabetic patients.  Haemostasis. 28 (6) 307-312 1998; 
  • 3 Aronson D, Weinrauch L, D'Elia J, Tofler G, Burger A. Circadian patterns of heart rate variability, fibrinolytic activity, and hemostatic factors in type I diabetes mellitus with cardiac autonomic neuropathy.  Am J Cardiol. 84 449-453 1999; 
  • 4 Borkenstein M H, Muntean W E. Elevated factor VIII activity and factor VIII related antigen in diabetic children without vascular disease.  Diabetes. 31 1006-1009 1982; 
  • 5 Calles-Escandon J, Mirza S, Sobel B, Schneider D. Induction of hyperinsulinemia combined with hyperglycemia and hypertriglycerdemia increases plasminogen activitor inhibitor 1 in blood in normal human subjects.  Diabetes. 47 290-293 1998; 
  • 6 Carmassi F, Morale M, Pucetti R, De Negri F, Monzani F, Navalesi R, Mariani G. Coagulation and fibrinolytic system impairment in insulin dependent diabetes mellitus.  Thromb Res. 67 643-654 1992; 
  • 7 Ceriello A. Coagulation activation in diabetes mellitus: The role of hyperglycaemia and therapeutic prospects.  Diabetologia. 36 1119-1125 1993; 
  • 8 Ceriello A, Giacomello R, Stel G, Motz E, Taboga C, Tonutti L, Pirisi M, Falletti E, Bartoli E. Hyperglycemia-induced thrombin formation in diabetes.  Diabetes. 44 924-928 1995; 
  • 9 Festa A, D'Agostino R, Mykkanen L, Tracy R P, Zaccaro D J, Hales C N, Haffner S M. Relative contribution of insulin and ist precursors to fibrinogen and PAI-1 in a large population with different states of glucose tolerance. The insulin atherosclerosis study (IRAS).  Arterioscler Thromb Vasc Biol. 19 (3) 562-568 1999; 
  • 10 Holl R W. et al. . Spätkomplikationen bei Diabetes mellitus.  Monatsschr Kinderheilk 143 ((Suppl 1)) 12-25 1995; 
  • 11 Juhan-Vague I, Roul C, Alessi M C, Ardissone J P, Heim M, Vague P. Increased plasminogen activator inhibitor activity in non insulin dependent diabetic patients - relationship with plasma insulin.  Thromb Haemostasis. 61 370-373 1989; 
  • 12 Knöbl P, Schernthaner G, Schnack C, Pietschmann P, Griesmacher A, Prager R, Müller M. 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; 
  • 13 Koert M, Nowak-Göttl U, Kreuz W, Grüttner H P, Kornhuber B, Breddin H K. 15 parameters of coagulation and fibrinolysis in children with type I diabetes mellitus (onset period).  Klin Päd. 203 429-432 1991; 
  • 14 Lee A J, MacGregor A S, Hau C M, Price J F, Rumley A, Lowe G D, Fowkes F G. The role of haematological factors in diabetic peripheral arterial disease: The Edinburgh artery study.  Br J Haematol. 105 (3) 648-654 1999; 
  • 15 Matsuda T, Morishita E, Jokaji H, Asakura H, Saito M, Yoshida T, Takemoto K. Mechanism on disorders of coagulation and fibrinolysis in diabetes.  Diabetes. 45 (3) S109-S110 1996; 
  • 16 Myrup B, Rossing P, Jensen T, Gram J, Kluft C, Jespersen J. Procoagulant activity and intimal dysfunction in IDDM.  Diabetologia. 38 73-78 1995; 
  • 17 Neri S, Bruno C M, Raciti C, D'Angelo G, D'Amico R, Cristaldi R. Alteration of oxide reductive and haemostatic factors in type 2 diabetes.  J Int Med. 236 495-500 1994; 
  • 18 Nordt T K, Klassen K J, Schneider D J, Sobel B E. Augmentation of synthesis of plasminogen activator inhibitor type-1 in arterial endothelial cells by glucose and ist implications for local fibrinolysis.  Arterioscler Thromb. 13 1822-1828 1993; 
  • 19 Schneider D J, Absher P M, Neimane D, Russel J, Sobel B. Fibrinolysis and atherogenesis in the JCR : LA-cp rat in relation to insulin and triglyceride concentrations in blood.  Diabetologia. 41 (2) 141-147 1998; 
  • 20 Sobel B. Insulin resistance and thrombosis: A cardiologist's view.  Am J Cardiol. 84 (1A) 37J-41J 1999; 

Dr. Petra Zeitler

Pediatric Hospital

University of Würzburg

Josef-Schneider-Str. 2

D-97080 Würzburg

Phone: +49-0931-201-3736

Fax: +49-0931-201-3798

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