ADVERTISEMENT

ADVERTISEMENT

MOLÉCULAS PROTROMBÓTICAS EN NIÑOS CON DIABETES MELLITUS TIPO 1

Adela Victoria Abregú, Elba Irma Díaz, María Cristina Bazán, Mariano Nicolás Áleman, María Constanza Luciardi, Ana Carolina Mariani

Resumen


Introducción: la hiperglucemia contribuye a cambios moleculares que alteran la hemostasia.
Objetivos: determinar moléculas circulantes que indiquen la presencia de un estado protrombótico en una población infanto juvenil con diabetes mellitus tipo 1 (DM1), sin manifestación clínica de enfermedad vascular, y compararla con una población control.
Pacientes y métodos: se estudiaron 35 pacientes con DM1, de 11,0±2,5 años de edad y 3,7±2,0 años de evolución de la enfermedad, sin complicaciones vasculares y 20 controles sanos de edad, sexo e IMC semejantes. Se determinaron: fibrinógeno (Fg), inhibidor del activador del plasminógeno 1 (PAI-1), antígeno del factor von Willebrand (FvW:Ag), ligando CD40 soluble (sCD40L) y pruebas globales de coagulación como recuento de plaquetas, tiempo de protrombina (TP) y tiempo de tromboplastina parcial activado (APTT). El control glucémico se evaluó mediante glucemia en ayunas y A1c, y se descartó la presencia de retinopatía y nefropatía.


Palabras clave


diabetes; estado protrombótico; PAI-1; factor von Willebrand; sCD40L

Texto completo:

PDF

Referencias


Vehik K, Dabelea D. The changing epidemiology of type 1 diabetes: why is it going through the roof? Diabetes Metab Res Rev 2011; 27(1):3-13.

Targher G, Chonchol M, Zoppini G, et al. Hemostatic disorders in type 1 diabetes mellitus. Semin Thromb Hemost 2011; 37(1):58-65.

Rodrigues TC, Snell-Bergeon JK, Maahs DM, et al. Higher fibrinogen levels predict progression of coronary artery calcification in adults with type 1 diabetes. Atherosclerosis 2010; 210(2):671-673.

Alessi MC, Poggi M, Juhan-Vague I. Plasminogen activator inhibitor-1, adipose tissue and insulin resistance. Curr Opin Lipidol 2007; 18(3):240-245.

Cesari M, Pahor M, Incalzi RA. Plasminogen activator inhibitor-1 (PAI-1): a key factor linking fibrinolysis and age-related subclinical and clinical conditions. Cardiovasc Ther 2010; 28(5):72-91.

Gragnano F, Sperlongano S, Golia E, et al. The role of von Willebrand factor in vascular inflammation: from pathogenesis to targeted therapy. Mediators Inflamm 2017; 2017:5620314. Doi: 10.1155/2017/5620314.

Frankel DS, Meigs JB, Massaro JM, et al. Von Willebrand factor, type 2 diabetes mellitus, and risk of cardiovascular disease: the Framingham Offspring Study. Circulation 2008; 118(24): 2533-2539.

Madan R, Gupt B, Saluja S, et al. Coagulation profile in diabetes and its association with diabetic microvascular complications. J Assoc Physicians India 2010; 58:481-484.

Adly AA, Elbarbary NS, Ismail EA, et al. Plasminogen activator inhibitor-1 (PAI-1) in children and adolescents with type 1 diabetes mellitus: relation to diabetic micro-vascular complications and carotid intima media thickness. J Diabetes Complications 2014; 28(3):340-347.

Antoniades C, Bakogiannis C, Tousoulis D, et al. The CD40/CD40 ligand system: linking inflammation with atherothrombosis. J Am Coll Cardiol 2009; 54(8):669-677.

Rizvi M, Pathak D, Freedman JE, et al. CD40-CD40 ligand interactions in oxidative stress, inflammation and vascular disease. Trends Mol Med 2008; 14(12):530-538.

Carrizo T del R, Prado MM, Velarde MS, et al. Soluble E-selectin in children and adolescents with type 1 diabetes. Medicina 2008; 68(3):193-197.

Rabago-Rodríguez R, Gómez-Díaz RA, Tanus-Haj J, et al. Carotid intima-media thickness in pediatric type 1 diabetic patients. Diabetes Care 2007; 30(10):2599-2602.

Babar GS, Zidan H, Widlansky ME, et al. Impaired endothelial function in preadolescent children with type 1 diabetes. Diabetes Care 2011; 34(3):681-685.

Romano M, Pomilio M, Vigneri S, et al. Endothelial perturbation in children and adolescents with type 1 diabetes: association with markers of the inflammatory reaction. Diabetes Care 2001; 24(9):1674-1678.

Carmassi F, Morale M, Puccetti R, et al. Coagulation and fibrinolytic system impairment in insulin dependent diabetes mellitus. Thromb Res 1992; 67(6):643-654.

Blann AD, Lip GY. Endothelial integrity, soluble adhesion molecules and platelet markers in type 1 diabetes mellitus. Diabet Med 1998; 15(8):634-642.

el Khawand C, Jamart J, Donckier J, et al. Hemostasis variables in type I diabetic patients without demonstrable vascular complications. Diabetes Care 1993; 16(8):1137-1145.

Sapkota B, Shrestha SK, Poudel S. Association of activated partial thromboplastin time and fibrinogen level in patients with type II diabetes mellitus. BMC Res Notes 2013; 6:485.

Targher G, Bertolini L, Zoppini G, et al. Increased plasma markers of inflammation and endothelial dysfunction and their association with microvascular complications in type 1 diabetic patients without clinically manifest macroangiopathy. Diabet Med 2005; 22(8):999-1004.

Binay C, Bozkurt Turhan A, Simsek E, et al. Evaluation of coagulation profile in children with type 1 diabetes mellitus using rotational thromboelastometry. Indian J Hematol Blood Transfus 2017; 33(4):574-580.

Behl T, Velpandian T, Kotwani A. Role of altered coagulation-fibrinolytic system in the pathophysiology of diabetic retinopathy. Vascul Pharmacol 2017; 92:1-5.

Lemkes BA, Hermanides J, Devries JH, et al. Hyperglycemia: a prothrombotic factor? J Thromb Haemost 2010; 8(8):1663-1669.

Milne R, Brownstein S. Advanced glycation end products and diabetic retinopathy. Amino Acids 2013; 44(6): 1397-1407.

Geraldes P, King GL. Activation of protein kinase C isoforms and its impact on diabetic complications. Circ Res 2010; 106(8):1319-1331.

El-Asrar MA, Adly AA, Ismail EA. Soluble CD40L in children and adolescents with type 1 diabetes: relation to microvascular complications and glycemic control. Pediatr Diabetes 2012; 13(8):616-624.

Metwalley KA, Farghaly HS, El-Saied AR. Assessment of serum levels of soluble CD40L in Egyptian children and adolescents with type 1diabetes mellitus: relationship to microalbuminuria and glycemic control. Indian J Endocrinol Metab 2013; 17(6):1024-1029.

Targher G, Zoppini G. Soluble CD40L in young type 1 diabetic individuals without clinical microvascular and macrovascular complications. Diabetes Care 2004; 27(5): 1236-1237.




Copyright (c) 2019 Sociedad Argentina de Diabetes Asociación Civil

ADVERTISEMENT

ADVERTISEMENT