FIBRINOGEN PLASMA-LEVELS AS A MARKER OF THROMBIN ACTIVATION IN DIABETES

This study attempted to verify the existence of a correlation between fibrinogen, a major cardiovascular risk factor in diabetes, and indexe s of thrombin generation and action, prothrombin fragment 1 + 2 (F1 2), and D-dimer (D-D), in a group of diabetic subjects compared with a matched control group. Forty insulin-dependent diabetes mellitus pati ents and 30 matched healthy control subjects participated in this stud y. The subjects were tested for the following parameters: fibrinogen, prothrombin F1 + 2, D-D, fasting glycemia, and HbA(1c). In addition, 5 diabetic subjects who maintained stable fibrinogen plasma levels >300 mg/dl for at least 6 months before the study were treated with 12,500 U/day subcutaneous heparin for 7 days. Diabetic subjects showed incre ased levels of fibrinogen, prothrombin F1 + 2, and D-D plasma levels. Simple linear regression analysis detected a positive correlation betw een fibrinogen and prothrombin F1 + 2, D-D, and glycosylated HbA(1c). In the five diabetic subjects treated with heparin fibrinogen, prothro mbin F1 + 2 and D-D levels decreased at the end of the treatment. All these parameters returned to baseline after 7 days of washout. These d ata indicate that fibrinogen plasma levels are correlated to parameter s of thrombin activation in plasma in diabetic patients and suggest th at high fibrinogen plasma levels might be a risk marker for cardiovasc ular disease in diabetes because it is an expression of an existing th rombophilia.