Endocrinologie et syndrome métabolique
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Prothrombotic and Endothelial Inflammatory Markers in Greek Patients with Type 2 Diabetes Compared to Non-Diabetics

Siomos K, Papadakis E, Tsamardinos I, Kerkentzes K, Koygioylis M and Trakatelli CM

Objective: To evaluate specific factors of coagulation and endothelial inflammatory markers namely, thrombomodulin, soluble receptor of the protein C (sEPCR), factor VIII, plasminogen activator inhibitor 1, Von Willebrandt factor, fibrinogen, fibrinogen dimers (d-dimers), high sensitivity C-reactive protein and homocysteine in a subset of Greek subjects with and without Type 2 (T2) Diabetes. Design: 84 subjects, of which 44 patients with T2 diabetes, were included in the randomized comparative prospective cross sectional study. The subjects were split into a Τ2 diabetics group and a group of healthy controls of similar age, anthropometric profiles and similar gender distribution.

Results: A total of 47 variables and biomarkers together with indicators for metabolic profiles, clinical history, as well as detailed anthropometric profiles and traditional risk factors, were evaluated. Dipeptidyl peptidase-4 (DPP4), Insulin, use of Sulfonylurea, high HBA1c and glucose levels, were clearly statistically differentiated in the two groups, while no other biomarkers including the new potential indicators were found to be different. High values of thrombomodulin and homocysteine were correlated with a rise in creatinine and thus seem to affect renal function in the diabetic patients group while in the non-diabetics group the correlations are different with sEPCR having a relative strong negative correlation in renal function as measured with The Modification of Diet in Renal Disease, in agreement with the latest international findings.

Conclusions: The presence of T2 diabetes in conjunction with age clearly correlates with problems in renal function, thrombomodulin and homocysteine could serve as indicators for renal damage in diabetics but not in healthy individuals. sEPCR on the other hand could be a potential generic indicator for renal damage. Thrombomodulin and sEPCR as prothombotic agents, did not show any indication that they can be utilised as markers for the prevention and/or treatment of thrombotic complications in diabetic patients.