Association of fibrinogen, factors VII and VIII activities with insulin resistance and diabetes mellitus in an adult black sample residing in a semi-rural area of Limpopo Province, South Africa

Diabetes mellitus (DM), either due to insulin deficiency or insulin resistance (IR), is a chronic metabolic disorder which affects more than 400 million people worldwide. Fibrinogen, FVII and FVIII are coagulation factors with hyperactivity reported in DM-induced cardiovascular disease, affecting the prognosis. It is not known whether their hyperactivity can be triggered in all types of DM or only where IR is involved or, merely co-occurs. Association studies to resolve this uncertainty are scarce, especially among black people. The purpose of the study was thus, to determine the association of fibrinogen, FVII and FVIII activities with DM and IR among black people residing in a semi-rural area. Fasting blood samples were collected from 201 participants aged 18-65 years (males: 41; 20%; females: 160; 80%) from Ga-Mothapo village located in Limpopo Province of South Africa. Glucose, cholesterol and triglycerides were analysed on an ILab 300 Plus Chemistry System; while insulin level was determined on the Access Immunoassay System. Fibrinogen, FVII and FVIII activities were assessed using the ACL 200 Coagulation Analyser. Blood pressure, body weight and height were measured using Omron M5-1, Omron BF 400 and stadiometer, respectively. Data was analysed using the Statistical Package for Social Sciences version 24.0. Binary logistic regression did not show any significant association between DM and the coagulation factors. Only FVII activity was significantly associated with IR, both in the binary (r = 5.202) and multivariate (r = 6.223) logistic regression analyses (p = 0.001), respectively. Insulin resistance is an independent risk factor for FVII hyperactivity