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Thromb Haemost 1998; 80(06): 1002-1007
DOI: 10.1055/s-0037-1615401
Letters to the Editor
Schattauer GmbH

von Willebrand Factor (vWf) as a Plasma Marker of Endothelial Activation in Diabetes: Improved Reliability with Parallel Determination of the vWf Propeptide (vWf:AgII)

Ulrich Vischer
1   Division de Biochimie Clinique, Department of Internal Medicine, HCU, Geneva, Switzerland
,
Jef J. Emeis
2   Division of Vascular and Connective Tissue Research, Gaubius Laboratory TNO-PG, Leiden, The Netherlands
,
Henk J. G. Bilo
3   Department of Internal Medicine, Weezenlanden Hospital, Zwolle, The Netherlands
,
Coen D. A. Stehouwer
4   Department of Internal Medicine, Aacademisch Ziekenhuis Vrije Universiteit, Amsterdam, The Netherlands
,
Claus Thomsen
5   Department of Endocrinology and Metabolism
,
Ole Rasmussen
5   Department of Endocrinology and Metabolism
,
Kjeld Hermansen
5   Department of Endocrinology and Metabolism
,
Claes B. Wollheim
1   Division de Biochimie Clinique, Department of Internal Medicine, HCU, Geneva, Switzerland
,
Jørgen Ingerslev
6   Center for Hemophilia and Thrombosis, Aarhus University Hospital, Aarhus, Denmark
› Author Affiliations
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Publication History

Received 14 April 1998

Accepted after resubmission 19 August 1998

Publication Date:
07 December 2017 (online)

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Summary

Elevated plasma von Willebrand factor (vWf) levels are found in diabetes and other vasculopathies, and predict cardiovascular mortality. vWf is stored and released from endothelial cell secretory granules, along with equimolar amounts of its propeptide (vWf:AgII). In the present study, we examined plasma propeptide levels as a marker of endothelial secretion in vivo, using an ELISA based on monoclonal antibodies. vWf but not propeptide levels are influenced by blood groups, explaining in part the smaller variation in plasma propeptide levels among normal individuals. In both controls and insulin-dependent diabetic patients, we found a close correlation between propeptide and immunoreactive vWf levels (r2 = 0.54, p <0.0001). vWf and propeptide were elevated in patient subgroups with microalbuminuria or overt diabetic nephropathy, whereas only the propeptide was significantly elevated in the normoalbuminuric subgroup. This observation suggests that in conjunction with vWf, propeptide measurements may improve the identification of endothelial activation, which occurs frequently even without increased urinary albumin excretion. In 12 NIDDM patients, a 3-week diet enriched in monounsaturated fat (MUFA) resulted in parallel decreases in vWf (-22%, p <0.05) and propeptide (-17%, p <0.05) levels, indicating that the experimental diet affected endothelial secretion rather than vWf catabolism. A carbohydrate-enriched control diet did not significantly influence either marker.

Our results suggest that concomittant determinations of plasma vWf and propeptide are useful tools to assess endothelial activation in vivo, and reinforce our previous conclusion that a diet rich in MUFA can improve endothelial function in NIDDM.

 

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