Laboratory Parameters of Hemostasis, Adhesion Molecules, and Inflammation in Type 2 Diabetes Mellitus: Correlation with Glycemic Control

• Main Authors: Eleonora Palella, Rossella Cimino, Salvatore A. Pullano, Antonino S. Fiorillo, Elio Gulletta, Antonio Brunetti, Daniela P. Foti, Marta Greco
• Format: Article
• Language: English
• Published: MDPI AG 2020-01-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: type 2 diabetes mellitus; prothrombotic risk; hemostasis; inflammation; adhesion molecules
• Online Access: https://www.mdpi.com/1660-4601/17/1/300

Background: Type 2 diabetes mellitus (T2DM) is characterized by a prothrombotic state, predisposing to vascular complications. Some related markers, linking thrombophilia to hemostasis and inflammation, however, have been poorly explored in relation to patients&#8217; glycemia. We therefore investigated the association of laboratory hemostatic parameters, circulating adhesion molecules (ADMs), white blood cell (WBC) count, and neutrophil/lymphocyte ratio (NLR) with T2DM and glycemic control. Research design: In this study, 82 subjects, grouped into T2DM patients (<i>n</i> = 41) and healthy individuals (<i>n</i> = 41) were enrolled. To evaluate glycemic control, the T2DM cohort was expanded to 133 patients and sub-classified according to glycated hemoglobin (HbA1c) &lt;7% and &#8805; 7% (<i>n</i> = 58 and <i>n</i> = 75, respectively). We assessed glycemia, HbA1c, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, plasminogen activator inhibitor-1 (PAI-1), platelet and leukocyte parameters, vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), and selectins (E-, P-, L-). Results: PT % activity, PAI-1, VCAM-1, WBC, and neutrophil counts were significantly higher in T2DM patients than in healthy subjects. Poor glycemic control (HbA1c &#8805; 7%) was correlated with increased PT activity (<i>p</i> = 0.015), and higher levels of E-selectin (<i>p</i> = 0.009), P-selectin (<i>p</i> = 0.012), and NLR (<i>p</i> = 0.019). Conclusions: Both T2DM and poor glycemic control affect some parameters of hemostasis, inflammation, and adhesion molecules. Further studies are needed to establish their clinical utility as adjuvant markers for cardio-vascular risk in T2DM patients.