ELEVATED SERUM AND URINARY THROMBOMODULIN LEVELS IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Increased plasma levels of soluble thrombomodulin have been reported i n several disorders as a marker for vascular endothelial damage. Serum and urinary thrombomodulin levels were measured in 79 patients with n on-insulin-dependent diabetes mellitus. Both levels were significantly higher (23.5 +/- 6.1 ng/ml and 146.6 +/- 64.9 ng/ml, respectively) th an those of normal healthy controls (18.8 +/- 3.1 ng/ml, P < 0.001, an d 96.8 +/- 60.3 ng/ml, P < 0.01). Serum thrombomodulin levels increase d in keeping with urinary albumin levels. In urine, thrombomodulin was lower in the macroalbuminuria group than in the microalbuminuria grou p, suggesting two mechanisms intravascular overproduction and impaired renal clearance. Both serum and urinary thrombomodulin levels in diab etic patients might be predictors for very early nephropathy.