Enhanced Anticoagulant Response to Activated Protein C in Patients With IDDM

Anticoagulant response to activated protein C (APC) was studied in 40 healthy subjects and 67 patients with insulin-dependent diabetes mellitus (IDDM) using a modified activated thromboplastin time assay. Results are expressed in terms of the APC sensitivity ratio (APC SR). In addition, plasma levels of protein C, total and free protein S (PS), coagulation factors V and VIII, and prothrombin fragment 1+2 (F1+2) were measured. Patients with IDDM and a urinary albumin excretion rate (UAER) &amp;lt;30 mg/24 h showed a median APC SR of 2.5 (interquartile range 2.3–2.9). In patients with a UAER between 30 and 300 mg/24 h, the median APC SR was 2.7 (2.7–2.9). Both values were significantly greater than the median APC SR of 2.1 (2.0–2.5) observed in healthy control subjects (P &amp;lt; 0.001). Also, the percentage of subjects with an APC SR ≤2.0 was markedly smaller in both patient groups. Factor V and VIII levels were not significantly different between IDDM patients and healthy subjects. Grouping of IDDM patients according to the APC SR revealed significantly enhanced levels of total PS (P &amp;lt; 0.05) and factor VIII (P &amp;lt; 0.01) in patients with a poor anticoagulant response to APC (APC SR ≤2.0) compared with those with an APC SR &amp;gt;2.7. The negative correlation of the APC SR in diabetic patients with both coagulation and anticoagulation factors indicates a complex role of this parameter in regulating the coagulation system in IDDM.</jats:p

Trp64Arg Polymorphism of theβ 3-Adrenergic Receptor Gene in Pregnancy: Association with Mild Gestational Diabetes Mellitus

A missense mutation of the β3-adrenergic receptor gene (Trp64Arg) has been associated with obesity and increased capacity to gain weight in nonpregnant populations. Furthermore, the mutation is a potential modifying factor in the etiology of impaired glucose tolerance and type 2 diabetes. We studied the relation of theβ 3-adrenergic receptor genotype to glucose tolerance during pregnancy, a state of physiological insulin resistance. In 179 pregnant women (mean age, 28.5 ± 0.4 yr), a 2-h oral glucose tolerance test was performed between gestational weeks 20 and 31. Theβ 3-adrenergic receptor genotype was assessed using restriction fragment length polymorphism.The frequency of the Arg64 allele was 9.15%. In women with mild gestational diabetes (n = 70), as defined by 60 min postload glucose values, the Trp64Arg genotype was more frequent than in women with normal glucose tolerance (n = 109; 26% vs. 11%; P = 0.01). Furthermore, the Trp64Arg polymorphism was associated with increased weight gain during pregnancy (baseline to gestational weeks 20–31) and increased postload glucose, insulin, and C peptide values during the oral glucose tolerance test.The results of the present study extend current knowledge about the association of the Trp64Arg β3-adrenergic receptor polymorphism with glucose tolerance to a pregnant population. The association with mild gestational diabetes suggests that the impact of the polymorphism may be clinically important during pregnancy, a state of physiological insulin resistance.</jats:p

Epidemiology of haemoglobin disorders in Europe: An overview

SCOPUS: re.jinfo:eu-repo/semantics/publishe