Effects of hyperglycemia and hyperinsulinemia on the tissue factor pathway of blood coagulation.
Effects of hyperglycemia and hyperinsulinemia on the tissue factor pathway of blood coagulation.
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DOI：
10.1007/s11892-007-0035-1
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发表时间：
2007-06-01
影响因子：
4.2
通讯作者：
Rao, A Koneti
中科院分区：
文献类型：
--
作者：
Boden, Guenther;Rao, A Koneti
组织因子（TF）是血液凝固的主要起始因子。循环TF促凝血活性（TF-PCA）与血细胞和微粒有关，在2型糖尿病患者中升高。在健康志愿者中，高胰岛素血症和高血糖症的组合以及在较小程度上选择性高胰岛素血症持续24小时增加循环TF-PCA、单核细胞TF表面表达和mRNA、血浆凝血酶生成以及凝血因子VII和VIII活性，表明凝血系统已被激活。此外，血小板CD 40 L和血小板-单核细胞聚集体增加，表明血小板活化。生长抑素消除了这些变化。我们的结论是，高胰岛素血症，但特别是高胰岛素血症和高血糖症的组合，创建一个血栓形成前的状态，并可能，此外，通过CD 40 L和TF的作用，是促炎症和促动脉粥样硬化。
Tissue factor (TF) is the primary initiator of blood coagulation. Circulating TF procoagulant activity (TF-PCA) is associated with blood cells and microparticles and is elevated in patients with type 2 diabetes mellitus. Combined hyperinsulinemia and hyperglycemia and to a lesser degree selective hyperinsulinemia for 24 hours in healthy volunteers increased circulating TF-PCA, monocyte TF surface expression and mRNA, plasma thrombin generation, and coagulation factors VII and VIII activities, suggesting that the coagulation system had been activated. In addition, platelet CD40L and platelet-monocyte aggregates increased, indicating platelet activation. Somatostatin abolished these changes. We conclude that hyperinsulinemia, but particularly the combination of hyperinsulinemia and hyperglycemia, creates a prothrombotic state and may, in addition, be proinflammatory and proatherogenic by virtue of the actions of CD40L and TF.