https://doi.org/10.4081/acbr.2021.121
Assessment of coagulation and fibrinolytic factors among patients with type 2 diabetes mellitus in University of Ilorin Teaching Hospital, Ilorin, Nigeria
Submitted: 24 November 2020
Accepted: 22 February 2021
Published: 3 March 2021
Accepted: 22 February 2021
Abstract Views: 2171
PDF: 225
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Diabetes mellitus is characterized by major changes in the coagulation and fibrinolytic system. The study was aimed at assessing the degree of changes in the coagulation and fibrinolytic system in patients with type 2 diabetes mellitus in North-central Nigeria. This was a hospital based comparative Cross-sectional study involving 78 type 2 diabetics and 78 healthy controls. Full blood count was performed using Sysmex XP 300 according to manufacturer’s instructions. Prothrombin time was determined using one stage test of Owren. Activated partial thromboplastin time was determined by method of Proctor and Rapaport. Fibrinogen assay was determined using AssayMax Human Fibrinogen ELISA. Plasminogen Activator Inhibitor type-1 was determined using the AssayMax Human PAI-1 ELISA kit. The mean age of the subjects and controls were 60.73 ± 10.8 and 59.65 ± 12.7 years respectively. The mean diastolic blood pressure of subjects with Diabetes was significantly higher than that of the controls (91.84 ± 11.02 vs 87.58 ± 11.3: p-value =0.002). The mean Prothrombin time, Fibrinogen concentration and PAI- 1 level were significantly higher in the subjects than the controls (p = 0.047, 0.031 & 0.020). No significant differences were observed in Platelet count, APTT and INR (P=0.938, 0.664 & 0.059 respectively). This study confirms that diabetes mellitus is a cause of hypercoagulable state as evidenced by the significant alteration in the coagulation and fibrinolytic system. There is need for proper glycaemic control in patients with diabetes.
Roglic G, Varghese C, Riley L, et al. Global Report on Diabetes. Geneva. World Health Organization, 2016. Report No: ISBN 978 92 4 156525 7 (NLM classification: WK 810).
Wild S, Roglic G, Green A, et al. Global Prevalence of diabetes: Estimates for the year 2000 and Projections for 2030. Diabetes care 2004:27:1047-53.
DOI: https://doi.org/10.2337/diacare.27.5.1047
International Diabetes Federation. IDF Diabetes Atlas 9th ed. Brussels, Belgium. 2019. Available from: http://www.idf.org/diabetesatlas
World Health Organization. Global Action Plan for the Prevention and Control of Non-Communicable Diseases 2013-2020. Geneva. World Health Organization, 2013. Report No: ISBN 978 92 4 150623 6 (NLM classification: WT 500).
Type 2 Diabetes Mellitus. In: Kroneberg H, Melmed S, Polonsky K, Reed Larsen P, Editors: Williams Textbook of Endocrinology (12th Ed) Philadelphia, Elsevier/Saunders. PP 1371-1435. ISBN 978-1-4377-0324-5.
Australian Indigenous HealthInfoNet. 2020. Diabetes - Health Topics - Australian Indigenous Healthinfonet. Accessed 28 June 2020. Available from: https://healthinfonet.ecu.edu.au/learn/health-topics/diabetes/
Ogbera AO, Ekpebegh C. Diabetes mellitus in Nigeria : The past, present and future. World J Diabetes 2014;5:905–11.
DOI: https://doi.org/10.4239/wjd.v5.i6.905
Okafor CI, Ofoegbu EN. Indications and Outcome of Admission of Diabetic Patients into the medical wards in a Nigerian Tertiary Hospital. Niger Med J 2011;52:86–9.
Ngwogu KO, Mba IEK, Ngwogu AC. Morbidity patterns of community research at the Abia state university teaching hospital, Aba, Nigeria. IJCR 2001;1:49–53.
Chijioke A, Adamu A, Makusidi A. Mortality patterns among type 2 diabetes mellitus patients in Ilorin, Nigeria. JEMDSA 2010;15:79-82.
DOI: https://doi.org/10.1080/22201009.2010.10872231
Edem M, Emeribe A, Akpotuzor J. Haemorrheologic and fibrinolytic activities in diabetics resident in Calabar, Cross-River State, Nigeria. Afr J Biotechnol 2008;7:1400–3.
Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature 2001;414:782-7.
DOI: https://doi.org/10.1038/414782a
Yamada T, Sato A, Nishimori T, Mitsuhashi T, Terao A, Sagai H et al. Importance of hypercoagulability over hyperglycemia for vascular complication in type 2 diabetes. Diabetes Res Clin Pract 2000;49:23-31.
DOI: https://doi.org/10.1016/S0168-8227(00)00134-0
Nazimek-Siewniak B, Moczulski D, Grzeszczak W. Risk of macrovascular and microvascular complications in Type 2 diabetes: results of longitudinal study design. J Diabetes Complications 2002;16:271-6.
DOI: https://doi.org/10.1016/S1056-8727(01)00184-2
Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001;414:813-20.
DOI: https://doi.org/10.1038/414813a
Fuller JH, Stevens LK, Wang SL. Risk factors for cardiovascular mortality and morbidity: the WHO Mutinational Study of Vascular Disease in Diabetes. Diabetologia 2001;44:S54-64.
DOI: https://doi.org/10.1007/PL00002940
Bennett PH, Lee ET, Lu M, et al. Increased urinary albumin excretion and its associations in the WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 2001;44:S37-45.
DOI: https://doi.org/10.1007/PL00002938
Carr ME. Diabetes melito: a hypercoagulable state. J Diabetes Complications 2001;15:44-54.
DOI: https://doi.org/10.1016/S1056-8727(00)00132-X
Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease: an update. Hypertension. 2001;37:1053-9. Erratum in: Hypertension 2001;37:1350. Comment in: Hypertension 2001;38:E11.
DOI: https://doi.org/10.1161/01.HYP.37.4.1053
Soares A, Sousa M, Fernandes A, Carvalho M. Hemostatic changes in patients with type 2 diabetes mellitus. Rev Bras Hematol Hemoter 2010;32:482-8.
DOI: https://doi.org/10.1590/S1516-84842010000600013
Subject selection. In: Araoye MO, (ed.) Research Methodology With Statistics For Health and Social Sciences. Ilorin Nathadex 2003:118-9.
Owren PA, Aas K. The control of dicumarol therapy and the quantitative determination of prothrombin and proconvertin. Scand J Clin Lab Invest 1951:3:201–8.
DOI: https://doi.org/10.3109/00365515109060600
Proctor RR, Rappaport SI. The partial thromboplastin time with kaolin. A simple screening test for first stage plasma clotting factor deficiencies. Am J Clin Pathol
;36:212–9.
Adediran I. Fibrinolytic activity in Nigerian diabetics. Postgrad Med J 2004;80:610-2.
DOI: https://doi.org/10.1136/pgmj.2003.017996
Alao O, Damulak D, Joseph D, Puepet F. Haemostatic Profile of Patients with Type 2 Diabetes Mellitus in Northern Nigeria. Int J Endocrinol 2010;6:122-32.
Iloh G, Amadi A, Ebirim C. Type 2 Diabetes Mellitus in Ambulatory Adult Nigerians: Prevalence and Associated Family Biosocial Factors in a Primary Care Clinic in Eastern Nigeria: A Cross-sectional Study. Br J Med Med Res 2015;9:1–12.
DOI: https://doi.org/10.9734/BJMMR/2015/18783
Aguiree F, Brown A, Cho NH, et al. IDF Diabetes Atlas: 6th edition. Basel, Switzerland: International Diabetes Federation. 2013.
Erem C, Hacıhasanoğlu A, Çelik Ş, et al. Coagulation and Fibrinolysis Parameters in Type 2 Diabetic Patients with and without Diabetic Vascular Complications. Med Princ Pract 2005;14:22–30.
DOI: https://doi.org/10.1159/000081919
Nordström A, Hadrévi J, Olsson T, et al. Higher Prevalence of Type 2 Diabetes in Men Than in Women Is Associated With Differences in Visceral Fat Mass. J Endocrinol Metab 2016;101:3740–6.
DOI: https://doi.org/10.1210/jc.2016-1915
Lipscombe LL, Hux JE. Trends in diabetes prevalence, incidence, and mortality in Ontario, Canada 1995-2005: a population-based study. Lancet 2007;369:750–6.
DOI: https://doi.org/10.1016/S0140-6736(07)60361-4
Fadupin G, Joseph E, Keshinro O. Prevalence of obesity among type 2 diabetics in
Nigeria a case study of patients in Ibadan, Oyo State, Nigeria. Afr J Med Med Sci 2004;33:381–4.
Mugharbel KM, Al-Mansouri MA. Prevalence of obesity among type 2 diabetic patients in Al-khobar primary health care centers. J Family Community Med 2003;10:49-53.
Karim F, Akter Q, Jahan S, et al. Coagulation impairment in Type 2 Diabetes Mellitus. J Bangladesh Soc Physiol 2015;10:26-9.
DOI: https://doi.org/10.3329/jbsp.v10i1.24614
Zhao Y, Zhang J, Zhang J, Wu J. Diabetes Mellitus is associated with shortened activated partial thromboplastin time and increased fibrinogen values. PLoS ONE 2011;6:1-4.
DOI: https://doi.org/10.1371/journal.pone.0016470
Adonu C, Ugwu PC, Bawa A, et al. Intrinsic Blood Coagulation Studies in Patients Suffering from both Diabetes and Hypertension. Int J Pharm Med Bio Sci 2013;2:36-45.
Bae SH, Lee J, Roh KH, Kim J. Platelet activation in patients with diabetic retinopathy. Korean J Opthalmol 2003;17:140-4.
DOI: https://doi.org/10.3341/kjo.2003.17.2.140
Acang N, Jalil FD. Hypercoagulation in diabetes mellitus. Southeast Asian J Trop Med Public Health 1993;24:263-6.
Odusan O, Olayemi O, Raimi H, et al. A study of hemorrhological parameters as risk factors for cardiovascular diseases in Nigerian type 2 diabetes mellitus patients. Nig J Cardiol 2013;10:72.
DOI: https://doi.org/10.4103/0189-7969.127004
Kannel W, D'Agostino R, Wilson P, et al. Diabetes, fibrinogen, and risk of cardiovascular disease: The Framingham experience. Am Heart J 1990;120:672-6.
DOI: https://doi.org/10.1016/0002-8703(90)90026-T
Festa A, D'Agostino R, Tracy R, Haffner S. Elevated Levels of Acute-Phase Proteins and Plasminogen Activator Inhibitor-1 Predict the Development of Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study. Diabetes 2002;51:1131-7.
DOI: https://doi.org/10.2337/diabetes.51.4.1131
Soares A, Sousa M, Fernandes A, Carvalho M. Hemostatic changes in patients with type 2 diabetes mellitus. Rev Bras Hematol Hemoter 2010;32:482-8.
DOI: https://doi.org/10.1590/S1516-84842010000600013
Grant PJ. Diabetes mellitus as a prothrombotic condition. J Inter Med 2007;262:157-72.
DOI: https://doi.org/10.1111/j.1365-2796.2007.01824.x
Yarmolinsky J, Barbieri NB, Weinmann T, et al. Plasminogen activator inhibitor-1 and type 2 diabetes : a systematic review and metaanalysisof observational studies. Nat Publ Gr 2016;8:1–13.
DOI: https://doi.org/10.1038/srep17714
How to Cite
Toyosi, A. A., Oluwayemisi, O. H. ., Adenike, D. I., Kola, O. J., & Joyce, O.-A. K. (2021). Assessment of coagulation and fibrinolytic factors among patients with type 2 diabetes mellitus in University of Ilorin Teaching Hospital, Ilorin, Nigeria. Annals of Clinical and Biomedical Research, 2(1). https://doi.org/10.4081/acbr.2021.121
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.