PROTHROMBIN FRAGMENT 1-III THROMBIN COMPLEX IN MICROALBUMINURIC TYPE-2 DIABETIC-PATIENTS(2 AND ANTITHROMBIN)

In microalbuminuria there is an increased cardiovascular risk not full y explained by the excess of conventional risk factors. To investigate whether or not microalbuminuria is associated with haemostatic abnorm alities in Type 2 diabetic patients, we measured the prothrombin fragm ent 1 + 2, a marker of thrombin generation, and the thrombin-antithrom bin complex, a marker of thrombin neutralization. Plasma levels of pro thrombin fragment 1 + 2 and thrombin-antithrombin complex were assayed in 17 microalbuminuric patients (albumin excretion rate, AER 20-200 m ug min-1) and in 17 comparable normoalbuminuric (AER < 20 mug min-1) T ype 2 diabetic patients. Plasma prothrombin fragment 1 + 2 was signifi cantly higher in microalbuminuric than in normoalbuminuric patients (1 .09 +/- 0.06 vs 0.86 +/- 0.04 nM, p = 0.003). Individual values of F1 + 2 were above the upper limit of the normal range in 8/17 microalbumi nuric and in none of the normoalbuminuric Type 2 diabetic patients. Pl asma thrombin-antithrombin complex values were not significantly diffe rent in the two groups and were not correlated with AER. These results suggest that microalbuminuria is associated with a prethrombotic stat e and a relatively defective thrombin neutralization. Coagulation abno rmalities might be part of the cardiovascular risk in microalbuminuric patients.