EFFECT OF INTENSIVE GLYCEMIC CONTROL ON FIBRINOGEN PLASMA-CONCENTRATIONS IN PATIENTS WITH TYPE-II DIABETES-MELLITUS - RELATION WITH BETA-FIBRINOGEN GENOTYPE

Recent studies show that in diabetic subjects an increase of plasma fi brinogen concentration is associated with a high risk of cardiovascula r complications. Environmental and genetic factors contribute to the p lasma fibrinogen concentration. Several studies indicate a relation be tween the polymorphism in the 5' region of the beta-fibrinogen gene an d plasma protein concentrations and in diabetes the possible influence of hyperglycaemia on fibrinogen is still debated. In this study we in vestigated these relations. Hind III polymorphism was evaluated by a p olymerase chain reaction-technique, On the basis of the observed allel ic combination of fibrinogen beta-gene polymorphism and the existence of poor metabolic control (glycated haemoglobin greater than or equal to 7.5%), 50 Type IT diabetic patients were selected. They were divide d into three groups according to their beta-gene polymorphism (alpha 1 alpha 1: n = 20, alpha 1 alpha 2: n = 15, alpha 2 alpha 2: n = 15) an d then intensive insulin therapy was started. After 3 months of intens ive treatment, the improvement in glycaemic control was equivalent, in terms of glycated haemoglobin, in all the three groups, A fibrinogen reduction was observed in alpha 1 alpha 2 and alpha 2 alpha 2 but not in alpha 1 alpha 1 subjects. These results underline a possible relati on between fibrinogen genotypes and glycaemic control in determining p lasma fibrinogen concentrations in diabetic patients.