Signs of dysregulated fibrinolysis precede the development of type 2 diabetes mellitus in a population-based study

Autor: Lars Johansson, Jan W. Eriksson, Mats Eliasson, Bernt Lindahl, Jenny Hernestål-Boman, Jan-Håkan Jansson, Margareta Norberg
Rok vydání: 2012
Předmět:
Blood Glucose
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
Time Factors
Vasterbotten Intervention Programme
endocrine system diseases
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Von Willebrand factor
Tissue plasminogen activator
chemistry.chemical_compound
Diabetes mellitus type 2
Risk Factors
Odds Ratio
Prospective Studies
Original Investigation
biology
Incidence
Fibrinolysis
Public Health
Global Health
Social Medicine and Epidemiology
Fasting
Middle Aged
Up-Regulation
Coagulation
Plasminogen activator inhibitor-1
Disease Progression
Female
Cardiology and Cardiovascular Medicine
Population study
medicine.drug
Adult
medicine.medical_specialty
Risk Assessment
Predictive Value of Tests
Internal medicine
Diabetes mellitus
Plasminogen Activator Inhibitor 1
medicine
Humans
Sweden
Västerbotten Intervention Programme
Chi-Square Distribution
business.industry
nutritional and metabolic diseases
Type 2 Diabetes Mellitus
medicine.disease
Folkhälsovetenskap
global hälsa
socialmedicin och epidemiologi
Early Diagnosis
Logistic Models
Endocrinology
Diabetes Mellitus
Type 2
chemistry
lcsh:RC666-701
Case-Control Studies
Multivariate Analysis
biology.protein
business
Plasminogen activator
Biomarkers
Zdroj: Cardiovascular Diabetology
Cardiovascular Diabetology, Vol 11, Iss 1, p 152 (2012)
ISSN: 1475-2840
DOI: 10.1186/1475-2840-11-152
Popis: Background Diabetic patients experience stimulated coagulation and dysfibrinolysis, which is associated with an increased risk of cardiovascular events. This imbalance may precede the manifest diagnosis. We investigated whether elevated antigen levels of tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), the tPA/PAI-1 complex, or von Willebrand Factor (VWF) precede type 2 diabetes mellitus (T2DM) diagnosis, and whether this elevation occurs before increased fasting plasma glucose (FPG) or 2-hour plasma glucose (2hPG) in individuals who later develop T2DM. Methods We conducted a prospective incident case-referent study within the Västerbotten Intervention Programme. Cardiovascular risk factor data as well as FPG and 2hPG and blood samples for future research were collected at a baseline health examination between 1989 and 2000, (n= 28 736). During follow-up in January 2001, 157 cases had developed T2DM. Referents without T2DM were matched for sex, age, and year of participation (n=277). Subgroup analysis was performed for cases with normal baseline glucose levels (FPG Results After adjusting for BMI, family history of diabetes, physical activity, smoking, systolic blood pressure and levels of C-reactive protein and triglycerides, independent associations were found between incident T2DM and elevated levels of tPA (OR=1.54, 95% CI 1.06-2.23), PAI-1 (OR=1.61, 95% CI 1.14-2.28), and tPA/PAI-1 complex (OR=2.45, 95% CI 1.56-3.84). In participants with normal glucose levels, PAI-1 (OR=2.06, 95% CI 1.10 - 3.86) exhibited an independent relationship with incident T2DM after the adjustments. Conclusions Elevated levels of fibrinolytic variables precede the manifestation of T2DM after adjusting for metabolic and cardiovascular risk factors and can be detected several years before changes in glucose tolerance.
Databáze: OpenAIRE
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