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8 - The levels of Antithrombin III and D-Dimer as indicator of coagulation and fibrinolytic activity in diabetes mellitus
Işık Türkalp, Naciye Erzengin, Hilal Sekban
Objective: This study was done in order to investigate coagula¬tion and fibrinolytic activity in patients with diabetes mellitus, in addition to detect the relationship between glycometabolic control and coagulation activity and fibrinolysis in diabetics.
Study design: We determined levels of ATH III, D-dimer, and FDP in 20 healthy subjects and 35 diabetic patients with complications and we examined the correlations between HbAlc and ATH III and D-dimer.
Results: Compared to the control subjects, we found signifi¬cantly increased ATH III and D-dimer levels in patienlts with diabetes mellitus (p<0.0060 and p<0.001, respectively). Clini¬cally relevant increases in FDP levels were observed in diabe¬tics (p<0.050). In patients with good and poor glucose control, we noted significant differences between HbAlc and fasting blood sugar (p<0.000 and p<0.000, respectively). There was a moderate correlation between HbAlc and ATH III in all diabe¬tics (r-0.49, p<0.03) ; similarly a moderate correlation betwe¬en HbAlc and ATH III was found in patients with poor glucose control (r=0.47, p <0.048). Parallel to this finding, we detected higher ATH III levels in patients with poor glucose control (%112.83±23 versus %100.71±19). No statistically significant relationship was found between HbAlc and D-dimer levels. D- dimer levels in patients with good and poor glucose control were 0.47±0.27 pg/ml and 0.56±0.40 pg/ml, respectively. In patients with complications of diabetes mellitus, a slight corre¬lation was noted between age and D-dimer levels (r-0.4167, p<0.013), whereas there was no correlation between age and ATH III.
Conclusion: In view of our results, we concluded that coagula¬tion and fibrinolytic activity increased in patients with diabetes mellitus, with even more increases in coagulation activity in those with poor glucose control. The relationship between the glycometabolic control and fibrinolytic activity could not be demonstrated using HbAlc levels.
Keywords: Antitrombin III, d-dimer, diabetes mellitus.
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