Evaluación de inhibidores fisiológicos de la coagulación en pacientes diabéticos tipo 2

La diabetes mellitus esta asociada a disturbios en la hemostasis que pueden contribuir al desarrollo de enfermedad vascular diabetica. El objetivo de este trabajo fue estudiar la coagulacion en una poblacion diabetica de Uruguay y compararla con una poblacion de referencia normal. Se trabajo con 100 pacientes diabeticos tipo 2, de ambos sexos (49 mujeres y 51 hombres), con edades comprendidas entre 42 y 79 anos, y una poblacion control representada por 130 individuos aparentemente sanos (73 mujeres y 57 hombres) cuyas edades oscilaron entre 37 y 78 anos, los que fueron tomados como referencia. Se realizaron las determinaciones de tiempo de protrombina (TP), fibrinogeno (Fib), proteina C (PC), proteina S (PS), antitrombina III (ATIII) e inhibidor del activador de plasminogeno (PAI) en plasma citratado. El TP y el Fib se realizaron por nefelometria, la PC, ATIII y PAI se midieron cromogenicamente y la PS se determino por coagulometria. Se encontro que los inhibidores fisiologicos de la coagulacion PS y ATIII son significativamente menores en la poblacion diabetica, en tanto que los factores procoagulantes Fib y PAI son significativamente mayores, comparados con la poblacion de referencia. De los hallazgos precedentes se confirma una tendencia a un disbalance hemostatico que contribuiria al estado protrombotico que acompana a un alto porcentaje de la poblacion diabetica. Diabetes mellitus is associated with disturbances in hemostasis, which may contribute to the development of diabetic vascular disease. Coagulation tests were performed both in diabetic patients and healthy individuals in Uruguay. The results obtained were compared. Diabetic patients were 100, with ages between 42 and 79 years, 49 females and 51 males. Reference population were 130 healthy individuals between 37 and 78 years, 73 females and 57 males. Prothrombin time (PT), fibrinogen( Fib), protein C (PC), protein S (PS), antithrombin III (ATIII) and plasminogen activator inhibitor (PAI) were measured on citrated plasma. PT and Fib were determined nephelometrically, PC, ATIII y PAI were measured cromogenically and PS was determined by coagulometry. Coagulation physiological inhibitors outcomes such as PS and ATIII showed significantly lower levels in the diabetic patient than in the healthy person, and at the same time, Fib and PAI, which are procoagulant factors, have significantly higher concentrations in the diabetic patient than in the healthy person. These findings permit to assess that an impaired haemostatic balance is present in the diabetic population, which may contribute to the hypercoagulability that accompanies a high percentage of these patients.