Study of blood coagulation and fibrinolysis in obese non-insulin dependent diabetes mellitus [NIDDM] patients

ABSTRACT

Four groups of age and sex matched patients were studied group 120 nondiabetic subjects with a body mass index [BMI] <25 kg/m[2] [lean control subjects]; group 1120 obese non diabetic subjects with a BMI>30 kg/m[2] group; 11120 lean NIDDM subjects; and group IV.-20 obese NIDDM subjects. We determined blood glucose, total cholesterol, triglycerides, HDL-Cholesterol, Apolipoprotein Al and B, insulin, Lipoprotein [a] [Lp[a]], fibrinogen, Factor VII, plasminogen, tissue plasminogen activator antigen[t-PA] [Ag] pre and post venous occlusion [VO] and plasminogen activator inhibitor [PAI] activity pre and post VO [VO test is a physiological stress test used to study the fibrinolytic activity]. In addition to metabolic abnormalities obese non diabetic subjects and lean and obese NIDDM patients displayed significantly higher levels of fibrinogen, Factor VII, plasminogen, PAI pre and post VO and t-PA [Ag] pre VO and significantly lower levels of t-PA [Ag] post VO. Our findings demonstrate an impairment of the haemostatic and fibrinolytic mechanisms which may be a key role in the pathogenesis of atherosclerotic vascular complications in obesity and in NIDDM. From this study we can recommend the following 1] Prophylaxis and early tretment of obesity 2] Early and proper treatment of NIDDM. 3] Early and proper treatment of any metabolic abnormalities as regards lipids or carbohydrate metabolism, and proper treatment of atherosclerosis