Good metabolic control is associated with decreased circulating factor VIIa- antithrombin complexes in type 2 diabetes: a cross-sectional study.

IF 8.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2024-11-05 DOI:10.1186/s12933-024-02480-z

Joanna Gastoł, Elżbieta Paszek, Agata Bryk-Wiązania, Bartłomiej Matejko, Anetta Undas

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引用次数: 0

Abstract

Background: Diabetes is associated with a prothrombotic state that contributes to cardiovascular (CV) events in type 2 diabetes (T2DM). Activated factor VII (FVIIa)- antithrombin (AT) complexes are indicative of tissue factor (TF) exposure and have been associated with thromboembolic risk in coronary artery disease. To our knowledge there have been no reports on FVIIa-AT complexes in T2DM, therefore we assessed factors that determine FVIIa-AT complexes in this disease and the impact of higher complexes on a prothrombotic state.

Methods: In 108 T2DM patients (mean age 63.8 years, 52.8% men, median HbA1c of 6.9 [interquartile range 6.1-8.2] %) and 83 age- and sex-matched non-diabetic subjects, we measured FVIIa-AT complexes. Metabolic control of T2DM involved fasting glucose, glycated hemoglobin (HbA1c), albumin/creatinine ratio (ACR), and lipid levels. To characterize a prothrombotic state, we determined thrombin generation parameters, fibrinolysis markers, and plasma fibrin clot properties.

Results: FVII-AT complexes in T2DM patients were similar to controls (73.6 [59.4-91.7] vs. 79.6 [59.2-97.1]pM, respectively, p = 0.30). The T2DM patients with FVIIa-AT in the top vs. the bottom quartile had a larger prevalence of active smoking and insulin use, along with higher fasting glucose (+ 36.4%), HbA1c (+ 27.4%), ACR (+ 72.8%), total cholesterol (+ 34.5%), and LDL-cholesterol (+ 80%). FVIIa-AT complexes showed no associations with in vitro thrombin generation potential, plasma fibrin clot properties, or fibrinolysis variables. On multivariable analysis HbA1c, ACR, and total cholesterol remained independently associated with FVIIa-AT complexes in T2DM.

Conclusions: This is the first study to show that in T2DM higher FVIIa-AT complexes are associated with markers of dyslipidemia and glycemia control, indicating that TF-induced coagulation activation could be suppressed by achieving treatment targets.

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良好的代谢控制与 2 型糖尿病患者循环中 VIIa 因子-抗凝血酶复合物的减少有关：一项横断面研究。

背景：糖尿病与促血栓形成状态有关，这种状态会导致 2 型糖尿病（T2DM）患者发生心血管（CV）事件。活化因子Ⅶ（FVIIa）-抗凝血酶（AT）复合物是组织因子（TF）暴露的标志，与冠状动脉疾病的血栓栓塞风险有关。据我们所知，目前还没有关于 T2DM 中 FVIIa-AT 复合物的报道，因此我们评估了决定这种疾病中 FVIIa-AT 复合物的因素以及较高复合物对血栓前状态的影响：我们在 108 名 T2DM 患者（平均年龄 63.8 岁，52.8% 为男性，中位 HbA1c 为 6.9 [四分位间范围 6.1-8.2] %）和 83 名年龄和性别匹配的非糖尿病受试者中测量了 FVIIa-AT 复合物。T2DM 的代谢控制包括空腹血糖、糖化血红蛋白（HbA1c）、白蛋白/肌酐比值（ACR）和血脂水平。为了描述血栓前状态，我们测定了凝血酶生成参数、纤溶标志物和血浆纤维蛋白凝块特性：结果：T2DM 患者的 FVII-AT 复合物与对照组相似（分别为 73.6 [59.4-91.7] vs. 79.6 [59.2-97.1]pM, p = 0.30）。患有 FVIIa-AT 的 T2DM 患者中，前四分位数与后四分位数相比，主动吸烟和使用胰岛素的比例更高，空腹血糖（+ 36.4%）、HbA1c（+ 27.4%）、ACR（+ 72.8%）、总胆固醇（+ 34.5%）和低密度脂蛋白胆固醇（+ 80%）也更高。FVIIa-AT复合物与体外凝血酶生成潜能、血浆纤维蛋白凝块特性或纤维蛋白溶解变量没有关联。在多变量分析中，T2DM患者的HbA1c、ACR和总胆固醇仍与FVIIa-AT复合物独立相关：这是首次研究表明，在 T2DM 患者中，较高的 FVIIa-AT 复合物与血脂异常和血糖控制指标相关，这表明 TF 诱导的凝血活化可通过实现治疗目标而得到抑制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.