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CC BY-NC-ND 4.0 · J Lab Physicians 2016; 8(02): 101-105
DOI: 10.4103/0974-2727.180790
Original Article

Is There a Tendency for Thrombosis in Gestational Diabetes Mellitus?

Suheyla Gorar
Department of Endocrinology and Metabolism, Antalya Training and Research Hospital, Antalya, Turkey
,
Bulent Alioglu
Department of Pediatric Hematology, Director of Hematology Laboratories, Ankara Training and Research Hospital, Ankara, Turkey
,
Esranur Ademoglu
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
,
Seyit Uyar
Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey
,
Handan Bekdemir
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
,
Zehra Candan
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
,
Beylan Saglam
Department of Pediatric Hematology, Hematology Laboratories, Ankara Training and Research Hospital, Ankara, Turkey
,
Gonul Koc
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
,
Cavit Culha
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
,
Yalcin Aral
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey
› Institutsangaben Financial support and sponsorship: Nil.
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ABSTRACT

Context: Impact of gestational diabetes mellitus (GDM) on the coagulation system, dynamics involved at a pathophysiological level and the exact mechanism remain unclear.

Aims: To evaluate the association between diabetes-related parameters and hemostatic factors to search for a tendency of thrombosis in GDM.

Settings and Design: Nineteen pregnant women who had GDM, 16 healthy pregnant and 13 healthy nonpregnant controls admitted to the Endocrinology outpatient clinics were enrolled in the study.

Subjects and Methods: Fasting and postprandial glucose, hemoglobin A1c and insulin levels, and insulin resistance; fructosamine, thrombin activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor Type-1 (PAI-1), tissue-type plasminogen activator (t-PA), fibrinogen, plasminogen and hemoglobin levels, platelet counts, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were studied.

Statistical Analysis Used: One-way analysis of variance, Kruskal–Wallis, and post hoc Tukey honestly significant difference or Conover’s nonparametric multiple comparison tests for comparison of the study groups.

Results: PT and aPTT were significantly lower in GDM patients compared to controls (P < 0.05), whereas fibrinogen and plasminogen levels were significantly higher in this group compared to both nonpregnant and healthy pregnant controls (P < 0.05 for each). TAFI, TFPI, PAI-1, and tissue t-PA levels were not significantly different among groups.

Conclusions: Our findings indicate tendency to develop thrombosis in GDM similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between GDM and hemostasis.

Key words:

Gestational diabetes mellitus - hemostatic factors - thrombosis


Publikationsverlauf

Artikel online veröffentlicht:
19. April 2020

© 2016.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • REFERENCES

  • 1 Mitanchez D, Yzydorczyk C, Simeoni U. What neonatal complications should the pediatrician be aware of in case of maternal gestational diabetes? World J Diabetes 2015;6:734-43.
  • 2 Lemkes BA, Hermanides J, Devries JH, Holleman F, Meijers JC, Hoekstra JB. Hyperglycemia: A prothrombotic factor? J Thromb Haemost 2010;8:1663-9.
  • 3 Collis RE, Collins PW. Haemostatic management of obstetric haemorrhage. Anaesthesia 2015;70 Suppl 1:78-86, e27-8.
  • 4 Alzahrani SH, Ajjan RA. Coagulation and fibrinolysis in diabetes. Diab Vasc Dis Res 2010;7:260-73.
  • 5 Abdel Gader AG, Khashoggi TY, Habib F, Awadallah SB. Haemostatic and cytokine changes in gestational diabetes mellitus. Gynecol Endocrinol 2011;27:356-60.
  • 6 Kvasnicka J, Bendl J, Zivný J, Umlaufová A, Maslowská H. Changes in hemostasis and fibrinolysis in gestational diabetes. Cas Lek Cesk 1996;135:106-10.
  • 7 Iwaki T, Urano T, Umemura K. PAI-1, progress in understanding the clinical problem and its aetiology. Br J Haematol 2012;157:291-8.
  • 8 Bellart J, Gilabert R, Fontcuberta J, Carreras E, Miralles RM, Cabero L. Coagulation and fibrinolysis parameters in normal pregnancy and in gestational diabetes. Am J Perinatol 1998;15:479-86.
  • 9 Liu BY, Jian YL, Zhong M, Yu YH, Wang Q, Zhang J. Value of coagulation function and fibrinolytic system assessment in patients with gestational diabetes mellitus. Nan Fang Yi Ke Da Xue Xue Bao 2007;27:35-7.
  • 10 Morimitsu LK, Fusaro AS, Sanchez VH, Hagemann CC, Bertini AM, Dib SA. Fibrinolytic dysfunction after gestation is associated to components of insulin resistance and early type 2 diabetes in latino women with previous gestational diabetes. Diabetes Res Clin Pract 2007;78:340-8.
  • 11 Bekdemir H, Berberoglu Z, Gorar S, Dellal D, Aktas A, Aral Y. Haemostatic changes in gestational diabetes mellitus. Int J Diabetes Dev Ctries 2015 ;35(Suppl 3):S502-6.
  • 12 Bouma BN, Meijers JC. Thrombin-activatable fibrinolysis inhibitor (TAFI, plasma procarboxypeptidase B, procarboxypeptidase R, procarboxypeptidase U). J Thromb Haemost 2003;1:1566-74.
  • 13 Jesty J, Wun TC, Lorenz A. Kinetics of the inhibition of factor Xa and the tissue factor-factor VIIa complex by the tissue factor pathway inhibitor in the presence and absence of heparin. Biochemistry 1994;33:12686-94.
  • 14 Akinci B, Demir T, Saygili S, Yener S, Alacacioglu I, Saygili F, et al. Gestational diabetes has no additional effect on plasma thrombin-activatable fibrinolysis inhibitor antigen levels beyond pregnancy. Diabetes Res Clin Pract 2008;81:93-6.
  • 15 Gumus II, Kargili A, Karakurt F, Kasapoglu B, Derbent A, Kaygusuz I, et al. Levels of thrombin activatable fibrinolysis inhibitor in gestational diabetes mellitus. Gynecol Endocrinol 2013;29:327-30.
  • 16 Watanabe T, Minakami H, Sakata Y, Matsubara S, Sato I, Suzuki M. Changes in activity of plasma thrombin activatable fibrinolysis inhibitor in pregnancy. Gynecol Obstet Invest 2004;58:19-21.
  • 17 Prochazkova J, Slavik L, Ulehlova J, Prochazka M. The role of tissue factor in normal pregnancy and in the development of preeclampsia: A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015;159:192-6.
  • 18 Teng Y, Jiang R, Lin Q, Ding C, Ye Z. The relationship between plasma and placental tissue factor, and tissue factor pathway inhibitors in severe pre-eclampsia patients. Thromb Res 2010;126:e41-5.
  • 19 Godoi LC, Gomes KB, Alpoim PN, Carvalho MD, Lwaleed BA, Sant′Ana Dusse LM. Preeclampsia: The role of tissue factor and tissue factor pathway inhibitor. J Thromb Thrombolysis 2012;34:1-6.
  • 20 Ibeh N, Okocha CE, Aneke CJ, Onah CE, Nwosu AO, Nkwazema KA. Normal pregnancy and coagulation profile: From the first through the third trimester. Niger J Med 2015;24:54-7.