ASPECTS OF HEMOSTATIC FUNCTION IN HEALTHY-SUBJECTS WITH MICROALBUMINURIA - A POTENTIAL ATHEROSCLEROTIC RISK FACTOR

Microalbuminuria, i.e., slightly elevated urinary albumin excretion ra te (UAER), notifies increased risk for atherosclerotic disease and may reflect an early generalized vascular abnormality in healthy subjects . This study was designed in order to examine whether such abnormality is associated with a shift of the haemostatic balance in prothromboti c direction. The following haemostatic factors were measured in two re presentative groups of clinically healthy subjects, 28 with microalbum inuria (UAER of 6.6-150 mu g/min) and 60 age- and sex-matched controls with normoalbuminuria (UAER < 6.6 mu g/min): Coagulation factors: blo od platelet count and mean volume, plasma Factor VII antigen concentra tion and coagulant activity, and plasma concentrations of prothrombin fragment 1+2, thrombin-antithrombin III complexes, fibrinogen, and fib rinopeptide A; fibrinolytic and endothelial factors: plasma concentrat ions of tissue plasminogen activator antigen and plasminogen activator inhibitor type 1 antigen; and endothelial factor: plasma von Willebra nd factor antigen concentration. The fibrinolytic and endothelial fact ors were measured both before and after 10 minutes of venous occlusion of the atm. None of the haemostatic factors were significantly altere d in the microalbuminuric group. Plasma fibrinogen concentration tende d to be elevated but not statistically significant ((mean (95% C.I.) 7 .8 (7.2-8.3) vs. 7.2 (6.9-7.5) mu mol/l; p<0.1). Neither did any of th e haemostatic factors correlate with UAER in regression analyses. It i s concluded that the haemostatic balance is unaltered in healthy subje cts with microalbuminuria. It is unlikely that a prothrombotic state i s present as an intermedial factor early in a causal chain between mic roalbuminuria and atherosclerotic vascular disease.