ISSN:1424-8832    

DOI:10.1159/000215314

出版商:S. Karger AG    

年代:1986

数据来源: Karger

ISSN:1424-8832    

DOI:10.1159/000215315

出版商:S. Karger AG    

年代:1986

数据来源: Karger

ISSN:1424-8832    

DOI:10.1159/000215316

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Diabetes mellitus is associated with a variety of vascular complications like diabetic retinopathy, myocardial infarction, stroke and peripheral vessel disease. These complications are of utmost importance because they lead to disability and premature death of the patients. The pathogenesis of these lesions has been thought to depend at least partly on defects in the hemostatic system. Many alterations of the coagulation and the fibrinolytic system as well as of the reaction of platelets have been found in diabetics. In general these tend to suggest a state of slightly activated coagulation, of increased platelet reactivity and of decreased fibrinolysis. However, no conclusive picture of the role of hemostasis in the development of vascular lesions in diabetics has emerged yet, as contradictive results have been found by many investigators. The aim of this review article is to sum up the knowledge that has accumulated in the last years in controlled clinical trials concerning the state of the diabetic hemostatic system.

ISSN:1424-8832    

DOI:10.1159/000215317

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Twenty type II (non-insulin-dependent) poorly controlled diabetics had tests of coagulation and platelet function performed while receiving high-dose sulphonylurea therapy and at 1 and 3 months following their conversion to insulin. Although no overall change in glycaemic control (assessed by glycosylated haemoglobin) was noted, a reduction in thrombin generation was observed, as judged by a significant fall in fibrinopeptide A concentrations. No changes in factor VIII coagulant activity (VIII:C), factor VIII-related antigen or antithrombin III were found. Glycosylated haemoglobin concentrations showed significant correlations with antithrombin III and factor VIII:C, suggesting that improved glycaemic control might lead to an improvement of antithrombin III function and lower factor VIIl·C concentrations. No changes in platelet function were detected. The introduction of an insulin regimen that improves glycaemic control might lead to a reversal of the ‘hypercoagulable state’ found in type II diab

ISSN:1424-8832    

DOI:10.1159/000215318

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Serum levels of apolipoprotein B were measured, and investigations of the platelet function were carried out in 32 patients with insulin-dependent dabetes and in 34 healthy controls similar in age. Mean serum levels of apolipoprotein B were 1.51 g/l in the diabetic patients and 1.18 g/l in the control group, and this difference was significant. In the diabetic patients a secondary wave of aggregation was more easily induced by low concentrations of adenosine diphosphate or adrenaline. It was also possible to induce 50% of maximal aggregation by lower concentrations of adenosine diphosphate or arachidonic acid in these patients, and their number of circulating platelet aggregates increased. Plasma levels of β-thromboglobulin and platelet factor 4 were raised and, in the presence of N-ethyl maleimide, platelets from diabetic patients produced significantly more malondialdehyde than those from normal controls. The relationship between increased serum levels of apolipoprotein B and platelet hyperreactivity may be more than accidental and should be studied further to elucidate its possible implication with platelet function and atherogenesis

ISSN:1424-8832    

DOI:10.1159/000215319

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Serum concentrations of two basement membrane components (7S collagen and laminin P1) were detected by specific radioimmunoassays in 70 patients suffering from diabetes mellitus type I and II with and without clinical signs of microangiopathy. Serum levels of both antigens were increased compared to controls. 7S collagen concentrations were significantly different between the diabetics with signs of microvascular damage and those without small-vessel disease (p < 0.05). Laminin P1 concentrations were also elevated, but the difference between the two groups of diabetics was not significant (p < 0.2). Raised levels of circulating basement membrane proteins may indicate connective tissue activity and development of diabetic microangiopathy. In vitro 7S collagen is a moderate platelet activator inducing platelet spreading, aggregation, and malondialdehyde production. Laminin activates platelet spreading. As a part of the altered hemostatic system the activation of basement membrane components may contribute to the development of microvascular damage.

ISSN:1424-8832    

DOI:10.1159/000215320

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

This paper review some of the issues faced by the investigators involved in a VA Cooperative Study on Antiplatelet Agents in Diabetic Patients after Amputation for Gangrene. The study was a negative one, and some of the reasons for this are considered. In addition, suggestive results in two subgroups, cerebrovascular disease and unexpected, sudden, or unobserved deaths, were found. The implications and interpretation of these findings are discussed.

ISSN:1424-8832    

DOI:10.1159/000215321

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Kinetics of activation of plasminogen purified from the plasma of 3 uncontrolled diabetic patients by tissue type plasminogen activator revealed substrate inhibition in the fibrin-stimulated system. After improvement of metabolic parameters activation of plasminogen was found to be normal in 1 of these patients and partially improved in another patient. Studies performed to investigate a possible nonenzymatic glucosylation of plasminogen showed that purified control plasminogen incorporates 14C-glucose in a dose- and time-dependent manner and that in vitro glucosylation of control plasminogen results in functional abnormalities of plasminogen, which resemble those observed with plasminogen from diabetic patients as far as substrate inhibition in the fibrin-stimulated system is concerned.

ISSN:1424-8832    

DOI:10.1159/000215322

出版商:S. Karger AG    

年代:1986

数据来源: Karger

摘要:

Reduced prostacyclin (PGI2) production by the vascular wall has been proposed as a possible cause of macro- or microangiopathy in diabetes mellitus. In the present study, we confirmed the stimulatory activity on PGI2 (PSA) production in plasma-derived serum (PDS) by cultured aortic endothelial cells. Furthermore, the abnormality of PSA was examined in diabetic PDS. PSA in PDS from non-insulin-dependent diabetics significantly decreased as compared with that in PDS from age-matched control subjects. There was no difference in PSA in PDS between diabetic patients with and without vascular complications such as retinopathy and nephropathy. In addition, after treatment with dialysis, PSA in diabetic PDS was still not restored to that in normal PDS. These findings suggest that relatively heat-stable (56 °C, 30 min) and nondialyzable PGI2 stimulatory substance(s) may decrease in diabetic PDS. It is concluded that a reduction in PDS-stimulated PGI2 production by the vascular wall can play an important role in the pathogenesis of vascular lesions in diabetes mellitus

ISSN:1424-8832    

DOI:10.1159/000215323

出版商:S. Karger AG    

年代:1986

数据来源: Karger