Detection And Clinical Significance Of Thrombus Premise Protein And Antithrombin-Ⅲ In Patients Diabetic Microangiopathy

Objective:1). To detect the serum TpP levels and AT-III activity inpatients with diabetic microangiopathy;2.To analyze the relationshipbetween the changes of TpP concentrations/AT-III activity and the diabeticthrombotic complications (or comorbid disease);3).To evaluate therelationship between TpP concentrations/AT-III activity and the duration/glycosylated hemoglobin of diabetes.Materials and Methods:101hosaipitalized patients with diabeticmicroangiopathy and31healthy people in endocrinology/Geriatrics ofSichuan Academy of Medical Sciences＆Sichuan Provincial People’sHospital from April2012to November2012were cross-sectional studied.The serum TpP concentrations were measured by using a specific TpP ELISAkit, and AT-III activity was determined by using an automatic bloodcoagulation analyzer (sysmexCA-7000). Using mean+/-standard deviationfor measurement data,using SPSS17.0software for statistical processing.Thedifferences of TpP concentrations and AT-III activity, as well as other indexessuch as Fib, D-dimer, PT, APTT, HCY, whole blood viscosity and plasmaviscosity between patients and healthy controls were compared. Therelationship between the indexes and cerebral infarction was also statisticallyanalyzed.Results:1). Serum TpP concentrations in the diabetic microangiopathygroup was significantly higher than that the control group (P <0.01, Wilcoxon rank and inspection). AT-III activity in the diabeticmicroangiopathy group was significantly lower than that in the healthycontrols (P <0.01, Wilcoxon rank and inspection)2). No statistical differences in Fib, D-dimer, PT, APTT, HCY, plasmaviscosity and whole blood viscosity were found between the two groups.3). According to whether or not mergerd cerebral infarction, the patientswere divided into two subgroups: diabetic cerebral infarction group anddiabetic not merged cerebral infarction group. Serum TpP concentrationswere the highest in the diabetic cerebral infarction subgroup when comparedto the diabetic not merged cerebral infarction subgroup and the healthycontrol group (P <0.01, Kruskal Wallis H rank and inspection). However,AT-III activity was the lowest in the diabetic cerebral infarction subgroupwhen compared to the diabetic not merged cerebral infarction subgroup andthe healthy control group (P <0.01, Kruskal Wallis H rank and inspection).4). Correlation analysis showed that cerebral infarction was significantlyassociated with TpP, AT-III, age and D-dimer (P <0.05, Multivariate Logisticregression analysis), but not with PT, APTT, HCY, Fib, plasma viscosity andwhole blood viscosity.5). According to the duration of the disease, the patients were dividedinto two subgroups: disease course<10years group and course≧10yearsgroup. No significant differences in serum TpP concentrations and AT-IIIactivity were found between the two subgroups.6). According to different HbA1c, the patients were divided into twosubgroups: HbA1c≤7%group and HbA1c>7%group. No significantdifferences in serum TpP concentrations and AT-III activity were foundbetween the two subgroups. 7). Serum TpP concentrations was negatively correlated with AT-IIIactivity although it did not reach statistically significant (Pearson correlationtest: r=-0.17，P=0.051).Conclusions: In patients of diabetes mellitus, the serum TpP levels areincreased while AT-III activity is declined. The increased TpP concentrationsand the declined AT-III activity suggest that there may be a pre-thromboticstatus in patients with diabetic microangiopathy, which is risk for thrombosis.Combined detections of TpP and AT-III may contribute to early diagnosis andearly treatment of thrombotic diseases for these patients.