Is There a Tendency for Thrombosis in Gestational Diabetes Mellitus?
Is There a Tendency for Thrombosis in Gestational Diabetes Mellitus?
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DOI：
10.4103/0974-2727.180790
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发表时间：
2016-07
影响因子：
1.1
通讯作者：
Aral Y
中科院分区：
文献类型：
--
作者：
Gorar S;Alioglu B;Ademoglu E;Uyar S;Bekdemir H;Candan Z;Saglam B;Koc G;Culha C;Aral Y
妊娠期糖尿病（GDM）对凝血系统的影响，在病理生理水平上的动力学和确切机制尚不清楚。探讨妊娠期糖尿病相关指标与止血因子的关系，寻找妊娠期糖尿病血栓形成的趋势。19名患有GDM的孕妇、16名健康孕妇和13名健康非妊娠对照者入组本研究，这些孕妇在内分泌门诊就诊。空腹和餐后血糖、血红蛋白A1 c和胰岛素水平以及胰岛素抵抗;果糖胺、凝血酶激活的纤维蛋白溶解抑制剂（TAFI）、组织因子途径抑制剂（TFPI）、1型纤溶酶原激活物抑制剂（派-1）、组织型纤溶酶原激活物（t-PA）、纤维蛋白原、纤溶酶原和血红蛋白水平、血小板计数、凝血酶原时间（PT）、和活化部分凝血活酶时间（aPTT）。单因素方差分析、Kruskal-Wallis和事后Tukey诚实显著性差异或科诺菲尔非参数多重比较检验用于研究组的比较。GDM患者的PT和aPTT显著低于对照组（P < 0.05），而纤维蛋白原和纤溶酶原水平显著高于非妊娠对照组和健康妊娠对照组（均P < 0.05）。TAFI、TFPI、派-1和组织t-PA水平在组间无显著差异。我们的研究结果表明，GDM与糖尿病相似，有发生血栓形成的趋势，但需要更全面的研究，更大的样本量，以确定GDM和止血之间的关系。
Impact of gestational diabetes mellitus (GDM) on the coagulation system, dynamics involved at a pathophysiological level and the exact mechanism remain unclear. To evaluate the association between diabetes-related parameters and hemostatic factors to search for a tendency of thrombosis in GDM. Nineteen pregnant women who had GDM, 16 healthy pregnant and 13 healthy nonpregnant controls admitted to the Endocrinology outpatient clinics were enrolled in the study. Fasting and postprandial glucose, hemoglobin A1c and insulin levels, and insulin resistance; fructosamine, thrombin activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor Type-1 (PAI-1), tissue-type plasminogen activator (t-PA), fibrinogen, plasminogen and hemoglobin levels, platelet counts, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were studied. One-way analysis of variance, Kruskal–Wallis, and post hoc Tukey honestly significant difference or Conover's nonparametric multiple comparison tests for comparison of the study groups. PT and aPTT were significantly lower in GDM patients compared to controls (P < 0.05), whereas fibrinogen and plasminogen levels were significantly higher in this group compared to both nonpregnant and healthy pregnant controls (P < 0.05 for each). TAFI, TFPI, PAI-1, and tissue t-PA levels were not significantly different among groups. Our findings indicate tendency to develop thrombosis in GDM similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between GDM and hemostasis.