Effects of heparin treatment on hemostatic abnormalities in obese non—insulin-dependent diabetic patients
G Avellone, V Di Garbo, R Cordova, G Rotolo, G Raneli… - Metabolism, 1997 - Elsevier
G Avellone, V Di Garbo, R Cordova, G Rotolo, G Raneli, R De Simone, GD Bompiani
Metabolism, 1997•ElsevierThis study was conducted to identify the mechanisms responsible for coagulative and
fibrinolytic alterations and to study the effects of a short-term treatment with low-dose heparin
on hemostatic abnormalities in obese non—insulin-dependent d! abetes mellitus (NIDDM)
patients. Four groups of age-and sex-matched patients were studied:(1) lean nondiabetic
subjects (n= 30) with a body mass index (BMI) less than 25 kg/m2 (lean control subjects),(2)
obese nondiabetic subjects (n= 30) with a BMI greater than 30 kg/m2 (obese control …
fibrinolytic alterations and to study the effects of a short-term treatment with low-dose heparin
on hemostatic abnormalities in obese non—insulin-dependent d! abetes mellitus (NIDDM)
patients. Four groups of age-and sex-matched patients were studied:(1) lean nondiabetic
subjects (n= 30) with a body mass index (BMI) less than 25 kg/m2 (lean control subjects),(2)
obese nondiabetic subjects (n= 30) with a BMI greater than 30 kg/m2 (obese control …
This study was conducted to identify the mechanisms responsible for coagulative and fibrinolytic alterations and to study the effects of a short-term treatment with low-dose heparin on hemostatic abnormalities in obese non—insulin-dependent d!abetes mellitus (NIDDM) patients. Four groups of age- and sex-matched patients were studied: (1) lean nondiabetic subjects (n = 30) with a body mass index (BMI) less than 25 kg/m2 (lean control subjects), (2) obese nondiabetic subjects (n = 30) with a BMI greater than 30 kg/m2 (obese control subjects), (3) lean NIDDM patients (n = 30), and (4) obese NIDDM patients (n = 30). All subjects were tested on the following parameters: fibrinogen, factor VII, prothrombin fragment 1 + 2 (F1 + 2), thrombin—antithrombin III complexes (TAT), tissue plasminogen activator (t-PA) antigen (Ag) before and after venous occlusion (VO), and plasminogen activator inhibitor Wpe,1 (PAl-1) activity pre, and post-VO. In addition, all these parameters were evaluated in obese NIDDM patients after 10 days of treatment with a single dose of 12,5,00-U/d subcutaneous calcium heparin and after a 10-day washout period. At baseline, obese nondiabetic subjects, lean NIDDM patients, and especially obese NIDDM patients displayed significantly (P < .01) higher levels of fibrinogen, factor VII, F1 + 2, TAT, t-PA(Ag) pre-VO, and PAl-1 pre- and post-VO and significantly (P < .01) lower levels of t-PA(Ag) post-VO. In obese NIDDM patients treated with heparin fibrinogen, factor VII, F1 + 2, TAT, t-PA(Ag) pre-VO, and PAl-1 pre- and post-VO levels significantly (P < .01) decreased and t-PA(Ag) post-VO levels significantly (P < .01) increased at the end of treatment. Our findings demonstrate in obese nondiabetic subjects, lean NIDDM patients, and especially obese NIDDM patients the hemostatic abnormalities contributing to, an enhanced risk of thrombotic complications. We conclude that in obese NIDDM patients, short-term treatment with heparin may reduce this thrombophilic state and have a potential benefit in the progression of diabetic microvascular and macrovascular disease and needs further investigation.
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