Insulin resistance is accompanied by increased von Willebrand factor levels in nondiabetic women: a study of offspring of type 2 diabetic subjects compared to offspring of nondiabetic subjects.

Abstract. Foss CH, Vestbo E, froland A, Ingerslev J, Gjessing HJ, Mogensen CE, Damsgaard EM (Aarhus University Hospital, Aarhus, Denmark; Fredericia Hospital Fredericia, Denmark). Insulin resistance is accompanied by increased von Willebrand factor levels in nondiabetic women: a study of offspring of type 2 diabetic subjects compared to offspring of nondiabetic subjects. J Intern Med 2002; 252: 155–163. Objectives.  To examine whether levels of von Willebrand factor (vWF), fibrinogen and fibronectin are related to a parental history of type 2 diabetes and to determine possible explanatory factors for high versus low vWF and fibrinogen. Design.  Cross-sectional study. Subjects, main outcome measures.  We compared vWF, fibrinogen and fibronectin in 88 nondiabetic offspring of type 2 diabetic subjects (relatives) and 103 offspring of nondiabetic subjects (controls). Other measurements included urinary albumin excretion rate, blood pressure, lipid profile and insulin resistance using homostatis model assessment (HOMAIR). Results.  There were no significant differences in vWF (1.12 vs. 1.06 IU mL−1, P = 0.296), fibrinogen (3.2 vs. 3.1 g L−1; P = 0.263) or fibronectin (0.39 vs. 0.40 g L−1, P = 0.448) between relatives and controls. With multiple logistic regression we determined explanatory factors for high versus lowvWF and fibrinogen. Age (P < 0.01), urinary albumin excretion rate (P < 0.05), ischaemic heart disease (IHD) (P < 0.05) were found to be significant explanatory factors for vWF above the median (1.10 IU mL−1). Interaction between insulin resistance and sex was found. Odds ratio for high versus low insulin resistance was 18.39 (P < 0.001) for women and 1.92 (P = 0.32) for men. Body mass index (BMI) (P < 0.05), sex (P < 0.01), smoking status (P < 0.05) and IHD (P < 0.01) were significant explanatory factors for fibrinogen above the median (3.1 g L−1). Conclusions.  Levels of vWF, fibrinogen and fibronectin were not influenced by a parental history of type 2 diabetes. Insulin resistance was found to be a significant risk indicator for high vWF only in women. This may indicate that insulin resistance is a higher risk factor for women than for men, when the outcome is endothelial dysfunction possibly resulting in overt cardiovascular disease.