Tissue Factor, Tissue Factor Pathway Inhibitor and Factor VII activity in Cardiovascular Complicated Type 2 Diabetes Mellitus

R.S. El-Hagracy, G.M. Kamal, I.M. Sabry, A.A. Saad, N.F. Abou El Ezz, H.A.R. Nasr

Full Text | PDF File

Abstract:

Objective:

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). 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.

Methods:

Study was conducted on 60 T2DM patients divided into group I : 30 patients without history or clinically detected heart disease and group II : 30 patients with a history of myocardial infarction compared to 20 controls. Patients were recruited from Ain Shams University diabetes clinic from September 2007 to May 2009 after their informed consent. Peripheral blood samples were taken for measurement of plasma TF and TFPI levels using ELISA technique and quantitative FVIIa using FVII deficient plasma.

Results:

levels of TF, TFPI and FVIIa were significantly higher in T2DM compared to controls (p<0.001). TF and TFPI were significantly higher in group II (236.50 ± 79.23), (242.33 ± 85.84) compared to group I (150.33 ± 81.16), (152.8 ± 82.46) (p<0.001). 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 targeted therapy against TF may be beneficial for T2DM patients.

Keywords:

Tissue factor, Tissue factor pathway inhibitor, Diabetes.