Tissue factor, tissue factor pathway inhibitor and factor VII activity in cardiovascular complicated type 2 diabetes mellitus

الملخص EN

Background : Tissue factor (TF) is the main initiator of the extrinsic coagulation pathway through factor VII (FVII) activation, which is physiologically inhibited by tissue factor pathway inhibitor (TFPI).

Alteration in this pathway has been described in Type 2 diabetes mellitus (T2DM).

Objectives : The aim of the work was to assess TF and TFPI plasma levels and FVII coagulant activity (FVIIa) in T2DM in relation to cardiothrombotic disease and their correlation to metabolic and clinical behavior of the patients. Patients and Methods : The study was conducted on 60 T2DM patients divided to groupI:30 patients without history or clinically detected heart disease and groupII:30 patients with a history of myocardial infarction compared to 19 controls.

Patients were recruited from Ain Shams University diabetes clinic from May/2008 to June/2009.

Peripheral blood samples were taken for measurement of plasma TF and TFPI levels using ELISA technique and quantitative FVIIa using FVII deficient plasma.

Results : Plasma levels of TF, TFPI and FVIIa were significantly higher in T2DM compared to controls (p<0.001).

TF and TFPI were significantly higher in groupII (236.50±79.23), (242.33±85.84) compared to groupI (150.33±81.16), (152.8± 82.46)(p<0.001).

FVIIa tended to be higher in group II, but the difference was not statistically significant (P=0.65).

TF and TFPI were significantly correlated to body mass index and glycemic control.

They were significantly higher in hypertensives and dyslipidemics (P=0.001),(P=0.006) but not in smokers (p=0.64),( p=0.11). Conclusion : There was correlation between high TF, TFPI plasma levels, FVIIa activity and cardiothrombotic complications in T2DM especially in the presence of high risk factors as poor glycemic control, dyslipidemia and obesity.

Future target therapy against TF may be beneficial for T2DM patients.