Thromb Haemost 1973; 30(01): 123-132
DOI: 10.1055/s-0038-1649108
Original Article
Schattauer GmbH

Fibrinocoagulopathy in Maturity Onset Diabetes Mellitus and Atherosclerosis[*]

R.N Banerjee
1   Department of Haematology & Nuclear Medicine, Safdarjang Hospital, New Delhi-16; India.
,
A.L Sahni
1   Department of Haematology & Nuclear Medicine, Safdarjang Hospital, New Delhi-16; India.
,
Vijay Kumar
1   Department of Haematology & Nuclear Medicine, Safdarjang Hospital, New Delhi-16; India.
› Author Affiliations
Further Information

Publication History

Received for publication 16 November 1972

Accepted for publication 25 June 1973

Publication Date:
30 June 2018 (online)

Summary

Immunofluorescent demonstrations of platelet-free fibrin deposit in the micro and macro-vascular lesions of maturity onset diabetes mellitus and atherosclerosis by earlier workers called for investigations of fibrino-coagulopathy in the two disorders. The present investigation included the determinations of plasma thrombin time (PTCT), fibrinogen concentration (FC), plasma fibrinogen half life (PFT ½) and plasma fibrinogen degradation product (FDP) in (i) the subjects of the two age-onset disorders and their consanguinous family members, and (ii) juvenile diabetes.

The assays were carried out by standard methods. 125Iodine labelled human fibrinogen was used for half life studies.

In a study of 525 subjects, very highly significant (p <0.001) reduction in PTCT, FC and PFT ½ with a very highly significant (p < 0.001) elevation of FDP were observed in the patients of the two age onset disorders. The results were normal in juvenile diabetes.

The study provides convincing evidence of a ‘state of slow consumptive fibrino-coagulopathy’ in the subjects and their siblings with the observed haemostatic defect likely being due to genetically determined Anti-thrombin III deficiency. This observation stimulates a unitary concept of a primary fibrinopathic vascular aetio-pathogenesis, with selective localisation in the macro and microvascular compartment being responsible for the clinical syndromes of ischaemic and metabolic alterations in athersclerosis and maturity onset diabetes mellitus respectively.

* This study was presented in part at the III Congress of International Society of Thrombosis and Haemostasis, Washington DC, USA, August, 1972.


 
  • References

  • 1 Allington M. J. 1970; The Latex Flocculation inhibition test for the detection of Fibrinogen Degradation Products. Scandinavian Journal of Haematology Suppl 13: 389.
  • 2 Antonini F. M. 1959; Plasmatic Fibrinogen in Diabetic Vasculopathy. Journal of Gerontology 7: 900.
  • 3 Banerjee R. N, Vijayakumar and Sahni A. L. 1972; Plasma Thrombin Clotting Time and Plasma Fibrinogen in Diabetes Mellitus and Atherosclerosis. Indian Journal of Medical Research 60: 1432.
  • 4 Basu H. N, Hussain Q, Mittal M. M, and Sharma M. L. 1971; Study of Plasma Fibrinogen and Fibrinolytic Activity in Acute Myocardial infarction. Journal of Indian Medical Association 57: 135.
  • 5 Bloodworth Jr. J. M. B, and Hamwi G. J. 1955; Histopathology of Experimental Glomerulosclerosis Simulating Diabetic Glomerulosclerosis. American Journal of Pathology 31: 167.
  • 6 Chakravarthy R, Fearnley G. R, Elizabeth D, Hocking A, Delithes A, and Clarke G. M. 1966; Fibrinolytic Activity related to age in Survivors of Myocardial Infarction. Lancet I: 573.
  • 7 Cotton R.C, Shaikh M. S, and Dutt R. V. 1968; Heparin Resistance and Plasma Fibrinogen in Elderly Subjects with and without Occlusive Vascular Disease. Journal of Atherosclerosis Research 8: 959.
  • 8 Crawford T, and Woolf N. 1960; Hyaline Arteriosclerosis in the Spleen. An Immunohisto-chemical Study. Journal of Pathology and Bacteriology 79: 221.
  • 9 Dacie J. V, and Lewis S. M. 1968 Practical Haematology. 4th edition 274.
  • 10 Davies M. J, Woolf N, and Carstairs G. 1966; Immunohistochemical Studies in Diabetic Glomerulosclerosis. Journal of Pathology and Bacteriology 92: 441.
  • 11 Dtjguid J. B. 1946; Thrombosis as a factor in the Pathogenesis of Coronary Atherosclerosis. Journal of Pathology and Bacteriology 78: 207.
  • 12 Eastham R. D, and Morgan E.H. 1963; Plasma Fibrinogen Levels in Coronary Artery disease. Lancet 2: 1196.
  • 13 Eisenberg S. 1966; Blood Viscosity and Fibrinogen Concentration following Cerebral Infarction. Circulation 33 (02) nd supplement. 10.
  • 14 Farquahr A, Mac Donald Mary K, and Ireland J. T. 1972; The role of Fibrindeposition in Diabetic Glomerulosclerosis: a light electron and immuno fluorescence microscopy study. Journal of Clinical Pathology 25: 657.
  • 15 Fearnley G. R, Chakaravarthi R, and Avis P. R. D. 1963; Blood Fibrinolytic Activity in Diabetes Mellitus and its Bearing on Ischaemic Heart Disease and Obesity. British Medical Journal I: 921.
  • 16 Fearnley G. R, and Chakaravarthi R. 1964; The Pharmacological Enhancement of Blood Fibrinolytic Activity with Special Reference to Phenformin. Acta Condiologica (Brux) 19: 1.
  • 17 Fearnley G. R, and Charavarthi R. 1971; Mode of Action of Phenformin plus Ethyloestrenol on Fibrinolysis. Lancet I: 723.
  • 18 Hajjar G. C, Willington J. C, and Moser K. M. 1956; Diurnal Variation in Plasma Euglo-bulin Activity and Fibrinogen. Angiology 7: 454.
  • 19 Hansen V. F. Coagulability in Diabetes. Acta Medica Scandinavica Supplementary 467: 147.
  • 20 Haust M, Daria Wyllie J. C, and More R. M. 1965; Atherogenesis and Plasma Constituents. I. Demonstration of Fibrin in the white Plaque by the Fluorescent Antibody Technique. American Journal of Pathology 44: 255.
  • 21 Katz A, Mac Donald L, Davies B, and Edgill M. 1963; Fibrinolysis and Blood Coagulation in Ischamic Heart Disease. Lancet 1: 801.
  • 22 Lendrum A. C. 1963; The hypertensive diabetic kidney as a model of the socalled collagen diseases. Canadian Medical Association Journal 88: 442.
  • 23 Lonser S, and Volk B. W. 1956; Plasma Fibrinogen and Myocardial Infarction. Angiology 7: 454.
  • 24 MacDonald L, and Edgil M. 1957; Coagulability of the Blood in Ichaemic Heart Disease. Lancet 2: 457.
  • 25 Merskey C, Cordon H, Lackner H, Schrie V, Kaplan B. J, Songin Mibashan R, Nossel H. C, and Moodie A. 1960; Blood Coagulation and Fibrinolysis in relation to Coronary Heart Disease and Normal Bantu men. British Medical Journal 1: 219.
  • 26 Meyers L.D. 1948; Blood Fibrinogen in Myocardial Infarction. Archives of Internal Medicine 82: 419.
  • 27 Ogston G. M, and Ogston D. 1966; Plasma Fibrinogen and Plasminogen levels in Health and in Ischaemic Heart Disease. Journal of Clinical Pathology 19: 352.
  • 28 Petrova T.R, and Kiseleva E.N. 1964; The Diagnostic Importance of Blood Fibrinogen determination in Myocardial Infarction and Arterial Thrombosis. Soviet Medicine 27: 10.
  • 29 Pilgeram L. O. 1961; Relationship of Plasma Fibrinogen Concentration Changes to Human Atherosclerosis. Journal of Applied Physiology 16: 600.
  • 30 Prentice C. R, Ratnoff O. D, and Breckenridge R. T. 1967; Experiments on the Nature of Pro-thrombin Concerting Principle: Alteration of Proacceler in by Thrombin. British Journal of Haematology 13: 898.
  • 31 Ratnoff O. D, and Menzie C. 1951; New Method of the Determination of Fibrinogen in small samples of Plasma. Journal of Laboratory and Clinical Medicine 37: 316.
  • 32 Sandberg H, Tsiours G, Debon A. C, and Bellet S. 1960; Studies of inhibition of the Plasma Plasminogen, Fibrinogen Enzyme Systems in patients with Myocrdial Infarction. American Journal of Cardiology 5: 660.
  • 33 Takeda Y. 1966; Studies of the Metabolism and Distribution of Fibrinogen in Healthy men with Autologons I125 labelled Fibrinogen. Journal of Clinical Investigation 45: 103.
  • 34 Von Kaijlla E, and Van Kaulla K.N. 1967; Anti-thrombin III and Disease. American Journal of Clinical Pathology 48: 69.
  • 35 Woolf X, and Craford T. 1960; Fatty Streaks in the Gortu Initma Studied by an Immunohistochemical Technique. Journal of Pathology Bacteriology 80: 405.
  • 36 Woolf N, and Pilkington T. R. E. 1956; The Immunohis to chemical Demonstration of Lipoprotein in Vessel walls. Journal of Pathology Bacteriology 90: 459.
  • 37 Yin E. T, and Wessler S. 1968; Bovine thrombin and activated factor X. Separation and purification. Journal of Biological Chemistry 243: 112.