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Exp Clin Endocrinol Diabetes 2004; 112(4): 175-180
DOI: 10.1055/s-2004-817965
Article

J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Enhancement of Fibrinolysis in Poorly Controlled, Hospitalized Type 2 Diabetic Patients by Short-Term Metabolic Control: Association with a Decrease in Plasminogen Activator Inhibitor 1

Y. Aso1 , K.-i. Okumura1 , N. Yoshida1 , K. Tayama1 , Y. Takemura1 , T. Inukai1
  • 1Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Japan
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Publication History

Received: January 9, 2003 First decision: April 14, 2003

Accepted: October 6, 2003

Publication Date:
04 May 2004 (online)

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Abstract

Impaired fibrinolysis in type 2 diabetes may be caused by an increased plasma concentration of plasminogen activator inhibitor 1 (PAI-1), although the effects of short-term hypoglycemic therapy on fibrinolytic activity are poorly understood. This study investigated the effects of metabolic improvement on fibrinolysis activity and plasma concentrations of PAI-1 in poorly controlled, hospitalized type 2 diabetic patients. Forty-eight poorly controlled type 2 diabetic patients were studied; 26 were subsequently treated with sulfonylurea (SU) and 22 with insulin. The plasma concentrations of plasmin-α2-antiplasmin (PAP), a measure of fibrinolytic activity, plasma PAI-1, and fasting triglycerides and glucoses were measured at the beginning and the end of hospitalization. The body mass index and fasting triglyceride decreased significantly after treatment (p < 0.0001). The plasma concentration of PAP increased significantly (p < 0.01), and the plasma PAI-1 decreased by 50 % after treatment. There was an inverse correlation between the changes in the plasma concentrations of PAP and PAI-1 (r= - 0.36, p = 0.023). Treatment with SU or insulin showed an increase in plasma PAP with a concomitant decrease in the plasma PAI-1 with equivalent glycemic control. In poorly controlled type 2 diabetic patients, the plasma PAP concentration can be significantly increased and the plasma PAI-1 antigen significantly reduced, even with short-term metabolic improvements including weight reduction, a better lipid profile, and tighter glycemic control with either SU or insulin therapy, and that enhanced fibrinolysis may be mediated partly through a decrease in the plasma PAI-1 after metabolic control.

Key words

Fibrinolysis - plasminogen activator inhibitor 1 - glycemic control - type 2 diabetes - plasmin-α2-antiplasmin

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M. D. Yoshimasa Aso

Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine

2-1-50 Minami-Koshigaya

Koshigaya, Saitama 343-8555

Japan

Phone: + 81489651111

Fax: + 81 4 89 65 11 27

Email: yaso@dokkyomed.ac.jp

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