DOI: http://dx.doi.org/10.18203/2349-3933.ijam20160194

Serum fibrinogen level in type 2 diabetes mellitus patients

Sanjay Dhawale, Satyam Jayant, Anil Kumar Gupta

Abstract


Background: Diabetes mellitus is the most common metabolic disorder characterized by metabolic abnormalities and long term complications. The chronic complications of diabetes mellitus affect many organ systems and are responsible for the majority of morbidity and mortality associated with the disease. The aim of the study is to estimate the serum fibrinogen level in patients of Type 2 diabetes and correlate it with parameters like glycemic control (HbA1C), duration of diabetes mellitus, complications and pharmacotherapy.

Methods: The study was conducted at the medicine department of J. A. Group of Hospital & G. R. Medical College, Gwalior, included patients of type-2 diabetes mellitus with or without microvascular complications between the ages of 25-85 years of either sex. Total 60 patients were selected randomly divided in two groups: Group A (n=34) was type-2 diabetes mellitus with microvascular complication, Group B (n=26) was type-2 diabetes mellitus without microvascular complication and Group C (n=28) was non diabetic healthy control. Patient’s history, clinical examination, routine blood tests, serum fibrinogen level and fundus examination were carried out. Serum fibrinogen was measured by Clauss method.

Results: Maximum number of patients in study was between 40-60 years’ age group. Microvascular complication in Group A were nephropathy (n=17), retinopathy (n=13) and neuropathy (n=4). Serum fibrinogen level in patient with microvascular complications, without microvascular complications and in non-diabetic controls were 515±138.7, 437±137 and 308±52.65 respectively. Serum fibrinogen level was higher in overweight patients as compared to normal weight patient in all groups. Serum fibrinogen level in different albuminuria groups (<30mg/l, 30-300mg/l, >300mg/l) were 439.7±135.15, 525.7±145.4, 545.7±112.2 respectively. Mean fibrinogen level was 541.1±121.7 in diabetics with total cholesterol >200. Serum fibrinogen level in patients with HbA1C >12% among both group A & B was 567.5±173.4 and 538.6±184.6 respectively. Most of type-2 diabetes mellitus patient have high fasting blood sugar >126 and high PPBS >200 in both group A & B. Mean fibrinogen level in patients taking insulin, oral hypoglycemic agents and in patients who were not taking any treatment was 640.8±126.4, 449.9±145.7, 419±72 respectively.

Conclusions: Further larger studies are required studying the serum fibrinogen level in diabetic patients with microvascular complications and effect of interventions done to reduce the fibrinogen levels.


Keywords


Type 2 diabetes mellitus, Microvascular complications, Serum fibrinogen, Nephropathy, Retinopathy, Neuropathy

Full Text:

PDF

References


American Diabetes association: Standard of medical care diabetes. Diabetes care. J Clin Appl Res Edu. 2008;31(1):S13-54.

Alvin CP, Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL, editors. Diabetes mellitus: Harrison’s principle of internal medicine, Vol 2. 17th ed. New York: McGraw Hill. 2008:338-2286.

Clavant SP, Osicka TM, Comper WD. Albuminuria: It’s Importance in Disease Detection. Lab Medicine. 2007;38(1):35-8.

Morrison G, Weston P. An overview of diabetic retinopathy for diabetes nurses. J Diabetes Nurs. 2014;18:126-36.

Meade TW, Mellows S, Brozovic M, Miller GJ, Chakrabarti RR, North WR, et al. Haemostatic function and ischemic heart disease: Principal results of the Northwick park heart study. Lancet. 1986;2(8506):533-7.

Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G. Fibrinogen as a risk factor for stroke and myocardiac infarction. N Engl J Med. 1984;311:501-5.

Christe M, Gattlen P, Fritschi J, lammle B, Berger W, Marbet A, et al. The contact phase of blood coagulation in diabetes mellitus and in patients with vasculopathy. Thromb Haemost. 1984;52(3):221-3.

Kannel WB, D’Agostino RB, Wilson PW, Belanger AJ, Gagnon DR. Diabetes, fibrinogen and risk of cardiovascular disease: the Framingham experience. Am Heart J. 1990;120:672-6.

Ganda OP, Arkin CH. Hyperfibrinogenemia, an important risk factor for vascular complications in diabetes. Diabetes care. 1992;15:1245-50.

De Maat MP. Effect of diet, drugs and genes on plasma fibrinogen levels. Ann NY Acad Sci. 2001;936:509-21.

Pierpaolo DP, Gan MG, Haymond MW. Differential effect of insulin deficiency on albumin and fibrinogen synthesis in humans. J Clin invest. 1991;88:833-40.

Mackie JI, Kitchen S, Maclin SJ, Lowe GD. Guidelines on Fibrinogen Assays. British J Hematol. 2003;121:396-404.

Demirci H, Eradamar H, karakoc A. Association between serum fibrinogen levels and diabetes microvascular complications in type-2 diabetes mellitus. The Endocrinologist. 2007;17:306-8.

Madan R, Gupta B, Saluja S, Kansra UC, Tripathy BK, Guliani BP. Coagulation profile in diabetes and its association with diabetic microvascular complications. JAPI. 2010;58:481-4.

Kuzhuppilly N., Pai VH. Plasma fibrinogen levels and its relation to diabetic retinopathy. Kerala J Ophthalmol. 2010;22(4):339-45.

Kafle DR, Shrestha P. Study of fibrinogen in patient with diabetes mellitus. NMCJ. 2010;12(1):34-7.

Bruno G, Cavallo-Perin P, Bargero G, Borra M, Errico ND, Pagano G. Association of fibrinogen with glycemic control and albumin excretion rate in patients with non-Insulin-dependent diabetes mellitus. Ann Intern Med. 1996;125:653-7.

Fujji C, Sakakibara H, Kondo T, Yatsuya H, Thomakoshi K, Toyoshima H. Plasma fibrinogen levels and cardiovascular risk factors in Japanese school children. J Epidemiol. 2006;16(2):64-70.

Emanuele N, Azad N, Abraira C, Henderson W, Colwell J, Levin S, et al. Effect of intensive glycemic control on fibrinogen, lipids and lipoprotein. Arch Intern Med. 1998;158:2485-90.