インスリン非依存型糖尿病における凝固線溶系の研究
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In order to investigate the abnormalities of coagulation-fibrinolysis system in non-insulindependent diabetes mellitus (NIDDM) and their relationships with the diabetic retinopathy, we measured the fasting plasma concentrations of tissue plasminogen activator (t-PA), plasminogen activator inhibitor type 1 (PAI-1), and von Willebrand factor (VWF) in 112 patients and conducted 10 minutes venous occlusion test (VOT) in 34 patients. Although the concentrations of fasting plasma t-PA were not significantly different between NIDDM and controls, those of PAI-1 were lowered (control groupvs NIDDM group; 40.8 ± 5.6 ng/ml vs 28.9 ± 2.2 ng/ml, m + SE, p< 0.03), and those of vWF were elevated (control group vs NIDDM group; 121.5 ± 7.3% vs 149.6 ± 5.6%, p<0.02) in NIDDM. When the 3 stages of diabetic retinopathy (no retinopathy: DR_0, simple retinopathy: DR_1, proliferative retinopathy: DR_2) were taken into considerations, the concentrations of PAI-1 became lower as the stages of diabetic retinopathy progressed (DR_0 35.1 ± 3.4 ng/ml, DR_1 23.7 ± 4.0, DR_2 21.1 ± 3.3, p<0.01). Those of vWF were already elevated in the patients with no clinical diabetic retinopathy, and especially elevated in the patients with simple diabetic retinopathy (DR_0 148.8 ± 7.3%, DR_1 172.9 ± 14.6, DR_2 128.1 ± 7.5, p<0.02). In VOT, t-PA levels increased after venous occlusion in both NIDDM and controls. The degrees of the change were not significantly different between them. In conclusion, activities of coagulation and fibrinolysis systems were both chronically enhanced in NIDDM, which could be detected by the abnormalities of plasma PAI-1 and vWF levels.
- 東京女子医科大学の論文
- 1996-04-25
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- インスリン非依存型糖尿病における凝固線溶系の研究