Hemostatic state of children with type 1 diabetes

Purpose: Hyperglycemia is one of the factors responsible for the molecular alterations that modify hemostasis. The aim of this study was to determine the levels of circulating molecules that have a prothrombotic impact on the child and adolescent population with type 1 diabetes mellitus. Methods: There were 35 patients with type 1 diabetes mellitus (11.0 +/- 2.5 years of age and a median 3.7 +/- 2.0 years of the disease) with no vascular complications and 20 healthy controls with similar age, sex, and body mass index included in the study. The evaluated parameters were fibrinogen, plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor antigen, and standard coagulation tests (platelet count, prothrombin time, and activated partial thromboplastin time). Glycemic control was evaluated by hemoglobin A1c and fasting blood glucose tests, and the presence of retinopathy and nephropathy was ruled out. The data obtained were analyzed by IBM SPSS Statistics ver. 20.0 and expressed as mean +/- standard deviation. The Pearson correlation coefficient was applied to investigate correlations between variables. Results: Diabetic patients showed significantly higher levels of fibrinogen (308 +/- 66 mg/dL vs. 246 +/- 18 mg/dL, P= 0.0001), PAI-1 (41.6 +/- 12 ng/ mL vs. 11.7 +/- 1.0 ng/ mL, P=0.0001), and von Willebrand factor antigen (284%+/- 55% vs. 121%+/- 19%, P=0.0001). However, standard coagulation tests did not show differences between the 2 groups. PAI-1 was correlated with glycemia, hemoglobin A1c, fibrinogen, and von Willebrand factor antigen. Conclusion: Elevated levels of fibrinogen, PAI-1, and von Willebrand factor antigen were found in the pediatric and adolescent population with type 1 diabetes mellitus, which suggests a prothrombotic state.