Fibrinolytic Activity in Chinese Patients with Diabetes or Hyperlipidemia in Comparison with Healthy Controls

Chao Hung Ho; Tjin Shing Jap

doi:10.1055/s-0038-1647443

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 1991; 65(01): 003-006
DOI: 10.1055/s-0038-1647443

Original Article

Schattauer GmbH Stuttgart

Fibrinolytic Activity in Chinese Patients with Diabetes or Hyperlipidemia in Comparison with Healthy Controls

Chao Hung Ho

¹The Division of Haematology, Department of lnternal Medicine, Veterans General Hospital, Taipei, Taiwan, R. O. C

,

Tjin Shing Jap

²The Division of Endocrinology, Department of lnternal Medicine, Veterans General Hospital, Taipei, Taiwan, R. O. C

› Author Affiliations

Abstract

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Summary

Plasma tissue-type plasminogen activator (tPA), plasminogen activator inhibitor (PAI) and euglobulin lysis time (ELT) were determined before and after the venous occlusion test (VOT) in 3 groups of patients with mean age about 60 years: 29 diabetic patients (D group), 8 hyperlipidemic patients (H group) and 19 healthy controls (C group). In the D and H groups, the mean of morning tPA was significantly higher than that of the C grogp, but the means of PAI were not significantly different among the 3 groups. ELI was significantly shortened and tPA was markedly increased after the VOT in all 3 groups whereas PAI had not significantly changed. In conclusion, high tPA activity and good fibrinolytic response without significant change of PAI .activity were found in the diabetic and hyperlipidemic patients, and no definite impairment of the fibrinolytic activity could be found in the Chinese patients with diabetes and hyperlipidemia. This might be one of the reasons why the Chinese has low incidence of thromboembolic diseases.

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References

References
1 Bick RL. Hypercoagulability and thrombosis. In: Basic Concepts of Hemostasis and Thrombosis Murano G, Bick RL. (eds). CRC Press; Boca Raton, FL: 1983: 31
2 Rabkin SW, Sackett D. Arterial thromboembolism — Epidemiology. In: Haemostasis and Thrombosis — Basic Principles and Clinical Practice 2nd ed. Colman RW, Hirsh J, Marder VJ, Salzman EW. (eds). J. B. Lippincott Company; Philadelphia, PA: 1987: 1273 1289
3 Epstein FH. The epidemiology of coronary heart disease: A review. J Chronic Dis 1965; 18: 735-774
4 Rabkin SW, Mathewson FA L, Tate RB. Predicting risk of ischemic heart disease and cerebrovascular disease form systolic and diastolic blood pressure. Ann Intern Med 1978; 88: 342-345
5 Kannel WB, Castelli WP, Gordon T, McNamara PF. Serum cholesterol, lipoproteins and the risk of coronary heart disease: The Framingham study. Ann Intern Med 1974; 74: 1-12
6 Doll R, Peto R. Mortality in relation to smoking: 20 years’ observation on male British doctors. Br Med J 1976; 11: 1525-1536
7 Friedman GD, Dales LG, Wry K. Mortality in middle-aged smokers and nonsmokers. N Engl J Med 1977; 300: 213-217
8 Pell S, D’Alonzo CA. A three-year study of myocardial infarction in a large employed population. JAMA 1961; 175: 463-470
9 Kannel WB, McGee DC. Diabetes and cardiovascular risk factors: The Framingham study. Circulation 1979; 59: 8-13
10 Samama M, Conard J, Horellou MH, Nguyen G, Soria J, VanDreden P. Hypofibrinolysis and thrombosis: state of the art. In: Thrombosis: Diagnosis, Prophylaxis, Therapy Diagnostica Stago Abstract Book; Paris: 1987: 5-9
11 Juhan-Vague I, Valadier J, Alessi MC, Aillaud MF, Ansaldi J, Philip-Joet C, Holvoet P, Serradimigni A, Collen D. Deficient tPA release and elevated PA inhibitor levels in patients with spontaneous or recurrent deep venous thrombosis. Thromb Haemostas 1987; 57: 67-72
12 Juhan-Vague I. Acquired hypofibrinolysis. In: Thrombosis: Diagnosis, Prophylaxis, Therapy Diagnostica Stago Abstract Book; Paris: 1987: 10-14
13 Hamsten A, Wiman B, Defair U, Blombäck M. Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 1985; 313: 1557-1563
14 Vague P, Juhan-Vague I, Aillaud MF, Badier C, Viard R, Alessi MC, Collen D. Correlation between blood fibrinolytic activity, plasminogen activator level, plasma insulin level and relative body weight in normal and obese subjects. Metabolism 1986; 2: 250-253
15 Juhan-Vague I, Vague P, Alessi MC, Badier C, Valadier J, Aillaud MF, Atlan C. Relationship between insulin, triglyceride, body mass index, and plasminogen activator inhibitor 1. Diab Metab 1987; 13: 331-336
16 Nilsson IM, Robertson B. Effect of venous occlusion on coagulation and fibrinolytic components in normal subjects. Thromb Diathes Haemorrhag 1968; 20: 397-408
17 Holvoet P, Cleemput H, Collen D. Assay of human tissue-type plasminogen activator (tPA) with an enzyme-linked immunosorbent assay (ELISA) based on three murine monoclonal antibodies to tPA. Thromb Haemostas 1985; 54: 684-687
18 Contant G, Angles-Cano E, Martinoli JL. A simple and rapid plasminogen activator inhibitor (PAI) assay in plasma, using a unique concentration of tissue plasminogen activator (tPA) and PAI-depleted plasma. Thromb Haemostas 1987; 58: 448 (Abstr 1653)
19 Chakrabarti M, Bielawiec JF, Evans JF, Fearnley GR. Methodological study and a recommeded technique for determining the euglobulin lysis time. J Clin Pathol 1968; 21: 698-701
20 Collen D, Juhan-Vague I. Fibrinolysis and atherosclerosis. Semin Thromb Hemostas 1988; 14: 180-183
21 Juhan-Vague I, Roul C, Alessi MC, Ardissone JP, Heim M, Vague P. Increased plasminogen activator inhibitor activity in non insulin dependent diabetic patients - relationship with plasma insulin. Thromb Haemostas 1989; 61: 370-373
22 Alessi MC, Juhan-Vague I, Kooistra T, Declerck PJ, Collen D. Insulin stimulates the synthesis of plasminogen activator inhibitor 1 by the human hepatocellular cell line Hep G2. Thromb Haemostas 1988; 60: 491-494
23 Ahmad M, Saku K, Glas-Greenwalt P, Kashyap ML. Inhibitor and activator of plasminogen in patients with hyperlipoproteinemias. Thromb Haemostas 1985; 54: 266 (Abstr 1578)
24 Mehta J, Mehta P, Lawson D, Saldeen T. Plasma tissue plasminogen activator inhibitor in coronary artery disease: correlation with age and serum triglyceride concentrations. J Am Coll Cardiol 1987; 9: 263-268
25 Hamsten A, Widam B, De Faire U, Blombäck M. Increased plasma levels of rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 1985; 313: 1557-1563
26 Wiman B, Ljungberg B, Chmielewska J, Urden G, Blombäck M, Johnsson H. The role of the fibrinolytic system in deep vein thrombosis. J Lab Clin Med 1985; 105: 265-270
27 Nilsson IM, Ljungner H, Tengbom L. Two different mechanisms in patients with venous thrombosis and defective fibrinolysis: Low concentration of plasminogen activator or increased concentration of plasminogen activator inhibitor. Br Med J 1985; 290: 1453-1456
28 Paramo JA, De Boer A, Colucci M, Jonker JJ C, Collen D. Plasminogen activator inhibitor (PA-inhibitor) activity in the blood of patients with deep vein thrombosis. Thromb Haemostas 1985; 54: 725
29 Garcia Frada LJ, de la Calle H, Alava I, Navarro JL, Creighton LJ, Gaffney PJ. Diabetes mellitus as a hypercoagulable state: its relationship with fibrin fragments and vascular damage. Thromb Res 1987; 47: 533-540
30 Fuller JH, Keen H, Jarrett RJ, Omer T, Meade TW, Chakrabarti R, North WR S, Stirling Y. Haemostatic variables associated with diabetes and its complications. Br Med J 1979; 2: 964-966
31 Hu HH, Chu FL, Wong WJ, Lo YK, Sheng WY. Trends in mortality from cerebrovascular disease in Taiwan. Stroke 1986; 17: 1121-1125
32 The Taiwan Health Administration. The prevention of cardiac diseases (in Chinese). Health Administ 1987; 7: 18-27
33 Shaper AG. Epidemiology of ischaemic heart disease. Med Int 1989; 3: 2808-2813
34 Chan CW, Hoaglund FT. Pulmonary thromboebolism and venous thrombosis in Chinese. Clin Orthop 1980; 150: 253-260
35 Kemble JV H. Incidence of deep vein thrombosis. Br J Hosp Med 1971; 6: 721-726
36 Heatley RV, Hughes LE, Morgan A, Okwonga W. Deep vein thrombosis in a Queensland hospital. Br Med J 1973; 1: 517-519
37 Nandi P, Wong KP, Wei WI, Ngan H, Ong GB. Incidence of postoperative deep venous thrombosis in Hong Kong Chinese. Br J Surg 1980; 67: 251-253
38 Cheng KK, Lai ST, Yu TJ, Kuo SM. Postoperative deep vein thrombosis in the Taiwanese Chinese population. Am J Surg 1987; 153: 302-305
39 Chiu ZH, Chong LL, Lin TC, Ho CH, Lee JY, Yung CH. Comparing the level of contact factors between Chinese and American (in Chinese). Transact Hematol Soc ROC 1987; 56: 68-70
40 Schonfeld G. Hypertriglyceridemia in noninsulin dependent diabetes mellitus. Semin Thromb Hemostas 1988; 14: 184-188
41 Pan XR, Walden CE, Wamick GR, Hu SX, Albers JJ, Cheung M, Bierman EL. Comparison of plasma lipoproteins and aporoteins in Chinese and American non-insulin-dependent diabetic subjects and controls. Diabetes Care 1986; 9: 395-400