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Thromb Haemost 2000; 84(02): 223-227
DOI: 10.1055/s-0037-1614000
Review Article
Schattauer GmbH

Normalisation of Tissue Factor Pathway Inhibitor Activity after Glycaemic Control Optimisation in Type 1 Diabetic Patients

Mercedes Rigla
2   From the Department of Endocrinology and Nutrition, Universitat Autònoma de Barcelona, Spain
,
Jose Mateo
1   Department of Haematology, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Spain
,
Jordi Fontcuberta
1   Department of Haematology, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Spain
,
Juan Carlos Souto
1   Department of Haematology, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Spain
,
Alberto de Leiva
2   From the Department of Endocrinology and Nutrition, Universitat Autònoma de Barcelona, Spain
,
Antonio Pérez
2   From the Department of Endocrinology and Nutrition, Universitat Autònoma de Barcelona, Spain
› Author AffiliationsWe thank Teresa Urrutia and Rosa Felices for their technical assistance and Justa Úbeda, Esther Martín and Miguel A. María for their valuable collaboration. We are also grateful to Miss Christine O’Hara for English language revision.
Further Information

Publication History

Received 20 September 1999

Accepted after resubmission 13 March 2000

Publication Date:
14 December 2017 (online)

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Summary

Increased plasma concentrations of various markers of endothelial damage have been observed in type 1 diabetic patients, particularly in those with microangiopathy. Objective. To evaluate the effect of nearnormalisation of glycaemic control on different markers of endothelial injury involved in haemostasis in poorly-controlled type 1 diabetic patients. Material and Methods. TFPI, thrombomodulin (TM), plasminogen activator inhibitor, tissue-type plasminogen activator and von Willebrand factor were measured in 14 poorly-controlled type 1 diabetic patients free of diabetes-related complications (8 men, 6 women; mean age 29.8 ± 9.9 years) before (baseline) and after 3 months of intensive therapy and in 14 sex-, age-and BMI-matched control subjects. Results. After a mean follow-up of 107 ± 49 days (56-210), Hb A1c decreased from 11.2 ± 2.3 to 6.7 ± 0.7% (p <0.0001). TFPI activity at baseline was higher than in the control group (126.9 ± 34 vs 92.0 ± 13%, p <0.005) and decreased after good glycaemic control was achieved (p <0.005), becoming similar to that in the control group (91.0 ± 16.5%). The TFPI descent correlated with the variations observed in HbA1c (p <0.05; r = 0.54). TM levels at baseline were significantly higher than in the control group (42.3 ± 9.1 vs 29.00 ± 10.9; p <0.005) and did not change. The remaining parameters studied were similar between patients and controls and did not change after glycaemic optimisation. Conclusions. Optimisation of glycaemic control normalises the increased activity of TFPI but not the higher TM levels observed in poorly-controlled type 1 diabetic patients without chronic complications.

Key words

Type 1 diabetes - endothelial markers - TFPI - glycaemic control
 

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