PMID- 17785358
OWN - NLM
STAT- MEDLINE
DCOM- 20080102
LR  - 20220410
IS  - 0021-972X (Print)
IS  - 0021-972X (Linking)
VI  - 92
IP  - 11
DP  - 2007 Nov
TI  - Circulating tissue factor procoagulant activity and thrombin generation in 
      patients with type 2 diabetes: effects of insulin and glucose.
PG  - 4352-8
AB  - CONTEXT: Type 2 diabetes mellitus (T2DM) is a hypercoagulable state. Tissue 
      factor (TF) is the principal initiator of blood coagulation. OBJECTIVE: Our 
      objective was to examine the effects of hyperglycemia and hyperinsulinemia on the 
      TF pathway of blood coagulation in T2DM. DESIGN: Three study protocols were used: 
      1) acute correction of hyperglycemia (with iv insulin) followed by 24 h of 
      euglycemia, 2) 24 h of selective hyperinsulinemia, and 3) 24 h of combined 
      hyperinsulinemia and hyperglycemia. SETTING: The study took place at a clinical 
      research center. STUDY PARTICIPANTS: Participants included 18 T2DM patients and 
      22 nondiabetic controls. RESULTS: Basal TF-procoagulant activity (TF-PCA), 
      monocyte TF mRNA, plasma coagulation factor VII (FVIIc), and 
      thrombin-anti-thrombin complexes were higher in T2DM than in nondiabetic 
      controls, indicating a chronic procoagulant state. Acutely normalizing 
      hyperglycemia over 2-4 h resulted in a small ( approximately 7%) but significant 
      decline in TF-PCA with no further decline over 24 h. Raising insulin levels alone 
      raised TF-PCA by 30%, whereas raising insulin and glucose levels together 
      increased TF-PCA (by 80%), thrombin-anti-thrombin complexes, and prothrombin 
      fragment 1.2. Plasma FVIIa and FVIIc declined with increases in TF-PCA. 
      CONCLUSION: We conclude that the combination of hyperglycemia and 
      hyperinsulinemia, common in poorly controlled patients with T2DM, contributes to 
      a procoagulant state that may predispose these patients to acute cardiovascular 
      events.
FAU - Boden, Guenther
AU  - Boden G
AD  - Division of Endocrinology/Diabetes/Metabolism and the Clinical Research Center, 
      Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA. 
      bodengh@tuhs.temple.edu
FAU - Vaidyula, Vijender R
AU  - Vaidyula VR
FAU - Homko, Carol
AU  - Homko C
FAU - Cheung, Peter
AU  - Cheung P
FAU - Rao, A Koneti
AU  - Rao AK
LA  - eng
GR  - HL-0733267/HL/NHLBI NIH HHS/United States
GR  - R01-DK58895/DK/NIDDK NIH HHS/United States
GR  - R01-DK66003/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20070904
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Antithrombins)
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 9001-25-6 (Factor VII)
RN  - 9001-26-7 (Prothrombin)
RN  - 9001-27-8 (Factor VIII)
RN  - 9035-58-9 (Thromboplastin)
RN  - EC 3.4.21.5 (Thrombin)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Antithrombins/metabolism
MH  - Blood Coagulation/*physiology
MH  - Blood Glucose/metabolism
MH  - Diabetes Mellitus, Type 2/blood/*metabolism
MH  - Factor VII/metabolism
MH  - Factor VIII/metabolism
MH  - Female
MH  - Glucose/*pharmacology
MH  - Glucose Clamp Technique
MH  - Humans
MH  - Hypoglycemic Agents/*pharmacology
MH  - Insulin/blood/*pharmacology
MH  - Male
MH  - Middle Aged
MH  - Monocytes/drug effects/metabolism
MH  - Prothrombin/metabolism
MH  - Thrombin/*biosynthesis/metabolism
MH  - Thromboplastin/*metabolism
EDAT- 2007/09/06 09:00
MHDA- 2008/01/03 09:00
CRDT- 2007/09/06 09:00
PHST- 2007/09/06 09:00 [pubmed]
PHST- 2008/01/03 09:00 [medline]
PHST- 2007/09/06 09:00 [entrez]
AID - jc.2007-0933 [pii]
AID - 10.1210/jc.2007-0933 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2007 Nov;92(11):4352-8. doi: 10.1210/jc.2007-0933. Epub 
      2007 Sep 4.