HYPERCOAGULABILITY AND HIGH LIPOPROTEIN(A) LEVELS IN PATIENTS WITH TYPE-II DIABETES-MELLITUS

Diabetes mellitus is associated with disturbances in hemostasis that c ould contribute to the development of diabetic vascular disease. We in vestigated the changes in parameters of blood coagulation and the fibr inolytic system and in plasma levels of lipoprotein(a) (Lp(a) in 124 p atients with type II diabetes mellitus and 44 healthy control subjects matched for age and body mass index (BMI) to determine whether hemost atic disturbances map lead to increased cardiovascular mortality. Medi an levels of fibrinogen (P < 0.0001), thrombin-antithrombin III comple x (TAT) (P < 0.005), and plasminogen activator inhibitor-1 (PAI-I) act ivity (P < 0.05) in plasma were significantly elevated in diabetic pat ients compared with controls. The median concentration of Lp(a) was si gnificantly higher in diabetic patients than in normal controls (18.2 vs. 12.6 mg/dl, P < 0.0005). Lp(a) levels tended to be elevated in pat ients with a prolonged history of diabetes. There was no evidence that Lp(a) levels were affected by metabolic control or by type of treatme nt. Twenty-two diabetics with coronary heart disease (CHD) had signifi cantly higher levels of fibrinogen (P < 0.05), TAT (P < 0.05), and Lp( a) (24.7 vs. 13.7 mg/dl, P < 0.01) than the 51 patients without diabet ic angiopathy. Our data indicate that impaired hemostatic balance in d iabetes map cause hypercoagulability and may thus contribute to the in creased cardiovascular mortality in diabetes.