Study of fibrinogen in children with insulin-dependent diabetes mellitus

Abstract EN

A growing number of studies has focused attention on fibrinogen in diabetes suggesting its role as a marker of cardiovascular risk in this disease.

Our knowledge on the impact of fibrinogen as a cardiovascular risk factor in diabetes is incomplete and moreover, another important question is whether fibrinogen promotes atherosclerosis and cardiovascular disease in diabetes, or does it increase in plasma due to the presence of atherosclerotic lesions .As fibrinogen level is increased in insulin-dependent diabetes mellitus (IDDM) and related to glycemic control, we conducted this study to evaluate hyperfibrinogenemia in IDDM patients with variable degrees of metabolic control and its relation to other cardiovascular risks.

Forty IDDM children and adolescents with disease duration of > 5 years were enrolled in this study.

Their glycohemoglobin (HbAlc%), total cholesterol, low- and high-density lipoproteins, triglycerides , urinary albumin excretion and fibrinogen were markedly elevated than their matched healthy controls.

Fibrinogen level correlated with the other variables (p< 0.001 in all) and with age (p < 0.02) in IDDM patients but not in controls in univariate analysis.

IIbAlc% and triglycerides were the only variables which had significant impact ( p < 0.02 and < 0.05 respectively ) on fibrinogen level of the patients .

Triglycerides level of >150 mg/dl had 2-fold increase in risk for hyperfibrinogenemia in uncontrolled IDDM patients (IIR= 2.09, 95% Cl = 0.78 - 5.59, p - 0.001) and the underlying mechanisms should be further studied.

Our findings support the recommendation that tight glycemic control will substantially reduce complications of diabetes and intensive insulin therapy for IDD, that can normalize IibAlc%, will eventually protects patients from cardiovascular complications by attenuating the cascade that stimulate excess fibrinogen production.