Impaired fibrinolytic activity in type II diabetes: correlation with urinary albumin excretion and progression of renal disease.
Impaired fibrinolytic activity in type II diabetes: correlation with urinary albumin excretion and progression of renal disease.
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II 型糖尿病中纤溶活性受损：与尿白蛋白排泄和肾脏疾病进展的相关性。
DOI：
10.1038/sj.ki.5000355
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发表时间：
2006
影响因子：
19.6
通讯作者：
Robert W. Schrier
中科院分区：
文献类型：
--
作者：
M. Kamgar;N. Nobakhthaghighi;A. Shamshirsaz;R. Estacio;Kimberly K. McFann;Robert W. Schrier
已证明II型糖尿病肾病和心血管并发症的进展与血糖、血脂、血压和吸烟的控制相关。然而，这些因素似乎并不能完全解释这些糖尿病并发症。II型糖尿病的肾脏疾病和心血管并发症与血管异常和纤维化相关，这两者都可能发生在纤维蛋白溶解受损的情况下。因此，对从丹佛大都会区招募的107名II型糖尿病患者进行了一项横断面研究，以检查纤维蛋白溶解受损的影响，通过纤溶酶原激活物抑制剂（派-1）与组织型纤溶酶原激活物（t-PA）的比率进行评估。将尿白蛋白排泄（UAE）作为肾脏疾病进展和心血管并发症的风险因素，分析UAE小于和大于1 gm/d的患者。年龄、血糖、血红蛋白A1 C、糖尿病病程、血脂、体重指数和吸烟在两组之间没有差异。正如预期的那样，UAE较大的组肾功能较差，血清肌酐（1.98 ± 0.24 vs 1.21 ± 0.05 mg/dl，P < 0.001）和肌酐清除率（55.5 ± 6.0 vs 76.8 ± 2.7 ml/min，P < 0.001）有显著差异。2型糖尿病合并UAE组派-1/t-PA明显高于对照组（2.43 ± 0.26 vs 1.85 ± 0.07，P < 0.03）。纤溶受损程度越高、UAE越大的糖尿病患者既往心脏并发症发生率也越高（87.5%比72.3%，P < 0.07）。因此，一个前瞻性的，随机的临床试验在II型糖尿病与派-1抑制剂是必要的。
Progression of renal disease and cardiovascular complications in type II diabetes mellitus have been shown to correlate with control of blood glucose, lipids, blood pressure, and smoking. These factors, however, do not appear to totally explain these diabetic complications. Renal disease and cardiovascular complications in type II diabetes are associated with vascular abnormalities and fibrosis, both of which may occur with impaired fibrinolysis. A cross-sectional study was therefore performed in 107 type II diabetic patients recruited from the Denver Metropolitan Area to examine the effect of impaired fibrinolysis, as assessed by the ratio of plasminogen activator inhibitor (PAI-1) to tissue-type plasminogen activator (t-PA). With urinary albumin excretion (UAE) as a risk factor for both renal disease progression and cardiovascular complications, the patients were analyzed with respect to UAE less than and greater than 1 gm/day. The age, blood glucose, hemoglobin A1C, duration of diabetes, lipids, body mass index, and smoking were no different between the groups. As expected, the group with greater UAE had worse renal function, the serum creatinine (1.98 +/- 0.24 vs 1.21 +/- 0.05 mg/dl, P < 0.001) and creatinine clearance (55.5 +/- 6.0 vs 76.8 +/- 2.7 ml/min, P < 0.001) were significantly different. The type II diabetic patients with greater UAE exhibited significantly higher PAI-1/t-PA (2.43 +/- 0.26 vs 1.85 +/- 0.07, P < 0.03). The past history of cardiac complications was also higher (87.5 vs 72.3%, P < 0.07) in the diabetic patients with more impaired fibrinolysis and greater UAE. Thus a prospective, randomized clinical trial in type II diabetes with PAI-1 inhibitors is needed.
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影响因子：
158.5
作者：
Estacio, RO;Jeffers, BW;Schrier, RW
通讯作者：
Schrier, RW
影响因子：
13.6
作者：
Ma, LJ;Nakamura, S;Fogo, AB
通讯作者：
Fogo, AB
影响因子：
19.6
作者：
Schrier, RW;Estacio, RO;Mehler, P
通讯作者：
Mehler, P
影响因子：
19.6
作者：
Nicholas, SB;Aguiniga, E;Hsueh, WA
通讯作者：
Hsueh, WA