Global coagulation assays in patients with diabetes mellitus

Abstract Background There is significant heterogeneity in the incidence and severity of diabetes‐associated vascular complications and there is no routine biomarker that accurately predicts these outcomes. This pilot study investigates the role of global coagulation assays in patients with diabetes...

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Autores principales:	Hui Yin Lim, Brandon Lui, Mark Tacey, Anna Kwok, Suresh Varadarajan, Geoffrey Donnan, Harshal Nandurkar, Prahlad Ho
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	diabetes mellitus fibrin fibrinolysis thrombin thromboelastography Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/2e7f05368ce845b79d5f884aa6003c95
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spelling	oai:doaj.org-article:2e7f05368ce845b79d5f884aa6003c952021-11-29T09:35:28ZGlobal coagulation assays in patients with diabetes mellitus2475-037910.1002/rth2.12611https://doaj.org/article/2e7f05368ce845b79d5f884aa6003c952021-10-01T00:00:00Zhttps://doi.org/10.1002/rth2.12611https://doaj.org/toc/2475-0379Abstract Background There is significant heterogeneity in the incidence and severity of diabetes‐associated vascular complications and there is no routine biomarker that accurately predicts these outcomes. This pilot study investigates the role of global coagulation assays in patients with diabetes mellitus. Methods In this cross‐sectional study, patients with diabetes not on anticoagulation or dialysis and without active malignancy were recruited from endocrinology clinics. Blood samples were collected for global coagulation assays including thromboelastography (TEG), thrombin generation using calibrated automated thrombogram (CAT), and fibrin generation and fibrinolysis using the overall hemostatic potential (OHP) assay. The results were compared with healthy controls. Results A total of 147 adult patients including 19 with type 1 diabetes (T1DM), 120 with type 2 diabetes (T2DM), and eight with latent autoimmune diabetes were recruited. Compared with 153 healthy controls, patients with diabetes demonstrated higher maximum amplitude (68.6 vs 60.2 mm, p < 0.001) on TEG, and higher OHP (9.3 vs 6.4, p < 0.001) with comparable CAT parameters. Patients with T2DM were more hypercoagulable than those with T1DM on most biomarkers. Higher maximum amplitude, velocity index, and OHP were associated with increased risk of complications (C‐stat 0.82). Patients with history of microvascular complications appear to have more hypercoagulable thrombin and fibrin generation than those without. Conclusion Patients with diabetes have more hypercoagulable profiles on global coagulation assays, particularly patients with T2DM and those with microvascular complications. Further studies with longitudinal follow‐up are ongoing to evaluate the utility of global coagulation assays in predicting long‐term patient outcomes.Hui Yin LimBrandon LuiMark TaceyAnna KwokSuresh VaradarajanGeoffrey DonnanHarshal NandurkarPrahlad HoWileyarticlediabetes mellitusfibrinfibrinolysisthrombinthromboelastographyDiseases of the blood and blood-forming organsRC633-647.5ENResearch and Practice in Thrombosis and Haemostasis, Vol 5, Iss 7, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes mellitus fibrin fibrinolysis thrombin thromboelastography Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	diabetes mellitus fibrin fibrinolysis thrombin thromboelastography Diseases of the blood and blood-forming organs RC633-647.5 Hui Yin Lim Brandon Lui Mark Tacey Anna Kwok Suresh Varadarajan Geoffrey Donnan Harshal Nandurkar Prahlad Ho Global coagulation assays in patients with diabetes mellitus
description	Abstract Background There is significant heterogeneity in the incidence and severity of diabetes‐associated vascular complications and there is no routine biomarker that accurately predicts these outcomes. This pilot study investigates the role of global coagulation assays in patients with diabetes mellitus. Methods In this cross‐sectional study, patients with diabetes not on anticoagulation or dialysis and without active malignancy were recruited from endocrinology clinics. Blood samples were collected for global coagulation assays including thromboelastography (TEG), thrombin generation using calibrated automated thrombogram (CAT), and fibrin generation and fibrinolysis using the overall hemostatic potential (OHP) assay. The results were compared with healthy controls. Results A total of 147 adult patients including 19 with type 1 diabetes (T1DM), 120 with type 2 diabetes (T2DM), and eight with latent autoimmune diabetes were recruited. Compared with 153 healthy controls, patients with diabetes demonstrated higher maximum amplitude (68.6 vs 60.2 mm, p < 0.001) on TEG, and higher OHP (9.3 vs 6.4, p < 0.001) with comparable CAT parameters. Patients with T2DM were more hypercoagulable than those with T1DM on most biomarkers. Higher maximum amplitude, velocity index, and OHP were associated with increased risk of complications (C‐stat 0.82). Patients with history of microvascular complications appear to have more hypercoagulable thrombin and fibrin generation than those without. Conclusion Patients with diabetes have more hypercoagulable profiles on global coagulation assays, particularly patients with T2DM and those with microvascular complications. Further studies with longitudinal follow‐up are ongoing to evaluate the utility of global coagulation assays in predicting long‐term patient outcomes.
format	article
author	Hui Yin Lim Brandon Lui Mark Tacey Anna Kwok Suresh Varadarajan Geoffrey Donnan Harshal Nandurkar Prahlad Ho
author_facet	Hui Yin Lim Brandon Lui Mark Tacey Anna Kwok Suresh Varadarajan Geoffrey Donnan Harshal Nandurkar Prahlad Ho
author_sort	Hui Yin Lim
title	Global coagulation assays in patients with diabetes mellitus
title_short	Global coagulation assays in patients with diabetes mellitus
title_full	Global coagulation assays in patients with diabetes mellitus
title_fullStr	Global coagulation assays in patients with diabetes mellitus
title_full_unstemmed	Global coagulation assays in patients with diabetes mellitus
title_sort	global coagulation assays in patients with diabetes mellitus
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/2e7f05368ce845b79d5f884aa6003c95
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Global coagulation assays in patients with diabetes mellitus

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