Studies on the Coagulation-Fibrinolysis System in Non-Insulin-Dependent Diabetes Mellitus(NIDDM)

In order to investigate the abnormalities of coagulation-fibrinolysis system in non-insulindependent diabetes mellitus (NIDDM) and their relationships with the diabetic retinopathy, we measured the fasting plasma concentrations of tissue plasminogen activator (t-PA), plasminogen activator inhibitor type 1 (PAI-1), and von Willebrand factor (VWF) in 112 patients and conducted 10 minutes venous occlusion test (VOT) in 34 patients. Although the concentrations of fasting plasma t-PA were not significantly different between NIDDM and controls, those of PAI-1 were lowered (control groupvs NIDDM group; 40.8 ± 5.6 ng/ml vs 28.9 ± 2.2 ng/ml, m + SE, p< 0.03), and those of vWF were elevated (control group vs NIDDM group; 121.5 ± 7.3% vs 149.6 ± 5.6%, p<0.02) in NIDDM. When the 3 stages of diabetic retinopathy (no retinopathy: DR_0, simple retinopathy: DR_1, proliferative retinopathy: DR_2) were taken into considerations, the concentrations of PAI-1 became lower as the stages of diabetic retinopathy progressed (DR_0 35.1 ± 3.4 ng/ml, DR_1 23.7 ± 4.0, DR_2 21.1 ± 3.3, p<0.01). Those of vWF were already elevated in the patients with no clinical diabetic retinopathy, and especially elevated in the patients with simple diabetic retinopathy (DR_0 148.8 ± 7.3%, DR_1 172.9 ± 14.6, DR_2 128.1 ± 7.5, p