Effects of hyperglycemia and hyperinsulinemia on the tissue factor pathway of blood coagulation

被引：52
作者：
Boden G. [1 ]
Rao A.K. [1 ]
机构：
[1] Division of Endocrinology/Diabetes/Metabolism, Clinical Research Center, Temple University Hospital, Philadelphia, PA 19140
来源：
Current Diabetes Reports | 2007年 / 7卷 / 3期
基金：
美国国家卫生研究院;
关键词：
High Glucose; Tissue Factor; Cilostazol; High Insulin; Arterioscler Thromb Vasc Biol;
D O I：
10.1007/s11892-007-0035-1
中图分类号：
学科分类号：
摘要：
Tissue factor (TF) is the primary initiator of blood coagulation. Circulating TF procogulant 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. Somostatin abolished these changes. We conclude that hyperinsulinemia, but particularly the combination of and hyperglycemia and hyperglycemia, creates a prothrombotic state and may, in addition, be proinflammatory and proatherogenic by virtue of actions of CD40L and TF. Copyright © 2007 by Current Medicine Group LLC.
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页码：223 / 227
页数：4
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