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Coagulation inhibitors and glycaemic control in non-insulin-dependent diabetes mellitus
Authors:Kay M. Reinhardt  Christine Burstein  Heinz-Rudolf Nagel  Beate Krammer  Olaf Anders  Andrew D. Blann  Bruno Ernst  Michael Steiner
Affiliation:(1) Present address: Institute of Clinical Chemistry & Pathobiochemistry, Faculty of Medicine, University of Rostock, Ernst-Heydemann-Strasse 6, PF 10 08 88, 18055 Rostock, Germany;(2) Department of Internal Medicine, Faculty of Medicine, University of Rostock, Ernst-Heydemann-Strasse 6, PF10 08 88, 18055 Rostock, Germany;(3) Department of Surgery, University Hospital of South Manchester, Manchester, UK
Abstract:The relationship between long-term glycaemic control and the activity of coagulation inhibitors was investigated in 60 non-insulin-dependent diabetes mellitus (NIDDM) patients not on insulin therapy. Overall, the activities of antithrombin III (AT III) (median 96%, range 65–133%), protein C (127%, 24–190%) and protein S (130%, 54–163%) were not reduced. Patients in poor long-term glycaemic control as verified by increased glycated haemoglobin (HbA1c) demonstrated significantly decreased median AT III activity in comparison with patients in good glycaemic control (92% vs 101%,P=0.016). However, individual values for AT III activity were not below the critical limit of 60%. An inverse correlation between AT III activity and long-term glycaemic control (HbA1c) was calculated (r=–0.378,P=0.0029). As AT III concentrations were found to be normal, we propose that non-enzymatic glycation leads to reduced activity of AT III without affecting its concentration.
Keywords:antithrombin III  glycaemic control  non-insulin-dependent diabetes mellitus  protein C  protein S
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