scholarly journals Increased serum concentration of von Willebrand factor in non-insulin dependent diabetic patients with and without diabetic nephropathy

BMJ ◽  
1995 ◽  
Vol 311 (7017) ◽  
pp. 1405-1406 ◽  
Author(s):  
J-W Chen ◽  
M-A Gall ◽  
M Deckert ◽  
J S Jensen ◽  
H-H Parving
Keyword(s):  
Diabetic Nephropathy ◽  
Serum Concentration ◽  
Von Willebrand Factor ◽  
Diabetic Patients ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Von Willebrand ◽  
Willebrand Factor

Hormonal Control of Haemostasis During Hypoglycaemia in Diabetes Mellitus

1987 ◽  
Vol 57 (03) ◽  
pp. 341-344 ◽  
Author(s):  
P J Grant ◽  
M H Stickland ◽  
P G Wiles ◽  
J A Davies ◽  
J K Wales ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Plasma Insulin ◽  
Vascular Complications ◽  
Hormonal Control ◽  
Diabetic Patients ◽  
Coagulant Activity ◽  
Insulin Dependent ◽  
Insulin Dependent Diabetic ◽  
Von Willebrand ◽  
Willebrand Factor

SummaryFactor VIII (FVIII) and plasminogen activator activity (PAA) rise during hypoglycaemia, and this might contribute to the vascular complications of diabetes. Similar changes in haemostasis accompany raised plasma levels of vasopressin (aVP) and adrenaline. To investigate the effects of these hormones on haemostasis during hypoglycaemia and the role of plasma insulin concentrations, eight insulin-dependent diabetic patients underwent controlled hypoglycaemia for 20 min and 13 diabetic patients were investigated during hyperinsulinaemia with blood glucose maintained at 8.0 mmol/1. During hypoglycaemia, insulin levels increased to median values of 114 mU/1, aVP rose from 0.5 to 4.4 (p <0.005) pg/ml and adrenaline from 0.4 to 4.4 nmol/l (p <0.005). FVIII coagulant activity (FVIII :C) rose from 0.75 to 1.09 iU/ml (p <0.01) and the ristocetin co-factor (FVIIIR:Co) and von Willebrand factor antigen (vWF:Ag) showed similar responses. PAA increased from 156 to 745 units (p <0.005). During hyperinsulinaemia, insulin rose following infusion from 24 to 52 and 118 mU/l, maintained for an hour at each level. Despite this, plasma aVP, FVIII :C, FVIIIR:Co, vWF:Ag and PAA remained unchanged. This study indicates that the marked changes in FVIII, vWF and PAA concentrations which accompany hypoglycaemia depend on low blood glucose and not raised plasma insulin. The response in probably mediated by increases in adrenaline and aVP, which are part of the physiological response to hypoglycaemia.

Effects of acute insulin-induced hypoglycaemia on haemostasis, fibrinolysis and haemorheology in insulin-dependent diabetic patients and control subjects

1991 ◽  
Vol 80 (5) ◽  
pp. 525-531 ◽  
Author(s):  
B. M. Fisher ◽  
J. D. Quin ◽  
A. Rumley ◽  
S. E. Lennie ◽  
M. Small ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Von Willebrand Factor ◽  
Erythrocyte Aggregation ◽  
Control Group ◽  
Diabetic Patients ◽  
Tissue Plasminogen ◽  
Insulin Dependent ◽  
Von Willebrand ◽  
Willebrand Factor

1. The effects of acute hypoglycaemia on haemostasis, fibrinolysis, blood viscosity and erythrocyte aggregation were examined after acute insulin-induced hypoglycaemia in six normal male subjects and in six male patients with poorly controlled insulin-dependent diabetes. In the control subjects hypoglycaemia caused a significant increase in the concentration of von Willebrand factor, with no change in the concentrations of fibrinogen and cross-linked fibrin degradation products. Fibrinolysis was enhanced, as indicated by significant increases in tissue plasminogen activator concentration and the fibrin plate lysis area, with a fall in plasminogen-activator inhibitor activity, suggesting complex formation. Whole-blood and plasma viscosity increased significantly after hypoglycaemia, but there was no significant change in erythrocyte aggregation tendency. 2. In diabetic patients the increase in the concentration of von Willebrand factor was significantly greater than in the control group (analysis of variance, P < 0.02). The basal concentration of tissue plasminogen activator was reduced at 3.7 ± 0.7 mg/l (mean ± sem) in the diabetic group compared with 8.5 ± 1.3 mg/l in the control group (Student's t-test, P < 0.01), but thereafter the increase in response to hypoglycaemia was similar. The changes in the other variables were not significantly different from the changes in the control group. 3. During acute hypoglycaemia in poorly controlled diabetic patients there is promotion of haemostasis with a greater increase in the concentration of von Willebrand factor, which, in association with the increase in viscosity, might reduce perfusion in diabetic microangiopathy, leading to aggravation of the microvascular complications of diabetes.

scholarly journals The role of diabetes mellitus on the thrombus composition in patients with acute ischemic stroke

2020 ◽  
Vol 26 (3) ◽  
pp. 329-336 ◽  
Author(s):  
Gengfan Ye ◽  
Qun Gao ◽  
Peng Qi ◽  
Junjie Wang ◽  
Shen Hu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Red Blood Cells ◽  
Acute Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Blood Cells ◽  
Smoking History ◽  
Diabetic Patients ◽  
Von Willebrand ◽  
Willebrand Factor

Purpose Diabetes mellitus indicated poor clinical prognosis for patients with acute ischemic stroke. Furthermore, diabetes mellitus could also impact the hemostatic system, while its influence on the histological composition of thrombus is unclear. Methods Consecutive patients with retrieved clots were included. Histologic staining for thrombus included hematoxylin and eosin, Martius Scarlet Blue, immunohistochemistry for von Willebrand factor. The differences in clot composition were compared according to diabetes mellitus history or hyperglycemia (≥7.8 mmol/L) on admission. Results A total of 52 patients were included; half of them were diagnosed as diabetes mellitus previously. Diabetic patients showed higher serum glucose on admission (8.90 vs. 7.40, p = 0.012). The baseline characteristics (expect smoking history and thrombus location), procedural, and clinical outcomes were similar between diabetic patients and nondiabetic patients. As for histologic composition, thrombus in patients with diagnosed diabetes mellitus had more fibrin (44.2% vs. 28.3%, p = 0.004) and fewer red blood cells (26.0% vs. 42.9%, p = 0.013) and equivalent content of platelets (24.0% vs. 21.5%, p = 0.694) and von Willebrand factor (0.041 vs. 0.031, p = 0.234) than patients without diabetes mellitus. However, there was no statistical difference in the content of red blood cells (41.6% vs. 27.3%, p = 0.105), fibrin (37.6% vs. 34.3%, p = 0.627), platelets (21.2% vs. 24.2%, p = 0.498), and von Willebrand factor (0.038 vs. 0.034, p = 0.284) between patients with or without hyperglycemia on admission. Conclusion Clots in diabetic patients had more fibrin and fewer erythrocyte components compared with patients without diabetes mellitus, while hyperglycemia on admission did not show association with clot composition. Further studies are needed to confirm these results.

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