DECREASE IN UROKINASE-TYPE PLASMINOGEN-ACTIVATOR (U-PA) LEVELS IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

The objective of the study was to investigate the activity and antigen levels of u-PA in non-insulin dependent diabetes mellitus (NIDDM) pat ients, and their changes after venous stasis. A cross-sectional case-c ontrol study was carried out in the out-patient diabetology clinical u nit of the General Hospital in Pescara, Italy. Fifty-nine unselected N IDDM patients (23 females and 36 males; mean age 63 +/- 10, with diabe tes definition by WHO criteria) were studied. A group of 50 subjects, age matched (age 58 +/- 9, 42 males, 8 females), without a history of diabetes, were consecutively recruited among healthy relatives of pati ents admitted to the hospital for surgical interventions to serve as a control group. The levels of both u-PA activity (scu-PA) and antigen (u-PA Ag) were significantly lower in NIDDM patients compared to contr ols. In contrast, t-PA, PAI-1 antigen and PAI activity levels were inc reased in NIDDM patients. There was no change in u-PA levels (both act ivity and antigen) after venous stasis, while t-PA levels were signifi cantly increased. There was no difference in u-PA (both activity and a ntigen) and in t-PA levels between male and female patients. However, fibrinogen levels were lower and PAI-1, both antigen and activity, was higher in men than in women. No difference was found between patients with and without macrovascular complications in the parametres studie d. Besides changes in t-PA and PAI-1 levels, NIDDM is also characteriz ed by a decrease in u-PA activity and antigen levels. Such impairment of the fibrinolytic system, together with the increase in fibrinogen l evels, could contribute to the prothrombotic condition peculiar to the se patients.