Diabetes mellitus (DM) is considered a prothrombotic, proatherogenic state, characterized by chronic activation of platelets, exaggerated activation of coagulation factors and decreased fibrinolytic mechanisms. Haemostasis is additionally altered by increased plasmatic lipids and obesity. DM therefore represents a major risk factor for the onset and development of coronary disease or ischemic stroke.
Purpose: The purpose of our study is to assess the correlations between the breakage resistance of the fibrin clot (BRFC) and anthropometric parameter, in type 2 DM, as well as the association with past thrombotic events, such as acute myocardial infarction and ischemic stroke in type 2 DM patients.
Methods: The 83 patients with type 2 DM, 41 men and 42 women, with a mean age of 63.5 +/- 9.03, have been divided into two study groups: obese and non-obese. The following parameters were assessed: the breakage resistance of the fibrin clot, anthropometric parameters, plasma fibrinogen, plasma lipids, fasting blood glucose, platelet count and other haemostasis parameters--APTT and PT. Descriptive statistics, Pearson correlation, t-Student and OR have been applied.
Results: Both study groups had a high mean of BRCF, but the greatest increase was found for patients with waist circumference WC >100 cm (345.5 +/- 17.3 FU). A strong correlation was found for BRFC and WC (r = 0.621, p = 0.003), and a weaker correlation for FBR and BMI (r = 0.453, p = 0.025). Plasma lipids were increased in both groups. Significant correlations were found for TG and BRFC in both obese (r = 0.551; p = 0.004) and non-obese lot (r = 0.498; p = 0.003). HDL and BRFC were negatively correlated (r = -0.562; p = 0.002 for the obese lot; r = -0.521; p = 0.003 for the non-obese lot). The subgroup with vascular pathology registered a significantly greater mean value (361.7 +/- 11.8 vs. 319.3 +/- 5.1, p = 0.021) than the subgroup without vascular complications. BRFC can be an independent predictor of vascular accidents in obese diabetics (OR = 6.88; 95% CI, 3.90-20.63; p = 0.021).
Conclusion: Our study evaluates the state of hypercoagulability in diabetic patients, expressed by increased values of the breakage resistance of the fibrin clot. BRFC is positively correlated with a history of diabetes of more than 10 years, increased WC, alteration of lipid metabolism and increased incidence of cardiovascular disease and ischemic stroke. We believe that the breakage resistance of the fibrin clot can be an independent predictor of vascular accidents, coronary or cerebral, in diabetic patients, both obese or non-obese.