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Impaired fibrinolytic activity in type II diabetes: Correlation with urinary albumin excretion and progression of renal disease
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Impaired fibrinolytic activity in type II diabetes: Correlation with urinary albumin excretion and progression of renal disease
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Journal Article
Impaired fibrinolytic activity in type II diabetes: Correlation with urinary albumin excretion and progression of renal disease
2006
Overview
Progression of renal disease and cardiovascular complications in type II diabetes mellitus have been shown to correlate with control of blood glucose, lipids, blood pressure, and smoking. These factors, however, do not appear to totally explain these diabetic complications. Renal disease and cardiovascular complications in type II diabetes are associated with vascular abnormalities and fibrosis, both of which may occur with impaired fibrinolysis. A cross-sectional study was therefore performed in 107 type II diabetic patients recruited from the Denver Metropolitan Area to examine the effect of impaired fibrinolysis, as assessed by the ratio of plasminogen activator inhibitor (PAI-1) to tissue-type plasminogen activator (t-PA). With urinary albumin excretion (UAE) as a risk factor for both renal disease progression and cardiovascular complications, the patients were analyzed with respect to UAE less than and greater than 1 gm/day. The age, blood glucose, hemoglobin A1C, duration of diabetes, lipids, body mass index, and smoking were no different between the groups. As expected, the group with greater UAE had worse renal function, the serum creatinine (1.98±0.24 vs 1.21±0.05 mg/dl, P<0.001) and creatinine clearance (55.5±6.0 vs 76.8±2.7 ml/min, P<0.001) were significantly different. The type II diabetic patients with greater UAE exhibited significantly higher PAI-1/t-PA (2.43±0.26 vs 1.85±0.07, P<0.03). The past history of cardiac complications was also higher (87.5 vs 72.3%, P<0.07) in the diabetic patients with more impaired fibrinolysis and greater UAE. Thus a prospective, randomized clinical trial in type II diabetes with PAI-1 inhibitors is needed.
Publisher
Elsevier Inc,Nature Publishing,Elsevier Limited
Subject
/ Albuminuria - physiopathology
/ Antihypertensive Agents - therapeutic use
/ Biological and medical sciences
/ Cardiovascular Diseases - complications
/ Diabetes Mellitus, Type 2 - diagnosis
/ Diabetes Mellitus, Type 2 - physiopathology
/ Diabetes. Impaired glucose tolerance
/ Diabetic Nephropathies - physiopathology
/ Endocrine pancreas. Apud cells (diseases)
/ Etiopathogenesis. Screening. Investigations. Target tissue resistance
/ Humans
/ Hydrochlorothiazide - therapeutic use
/ Hypertension - complications
/ Nephrology. Urinary tract diseases
/ Plasminogen Activator Inhibitor 1 - blood
/ Tissue Plasminogen Activator - blood
/ Urinary system involvement in other diseases. Miscellaneous
