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. 1984 Jun;37(6):659–664. doi: 10.1136/jcp.37.6.659

Platelet and coagulation factors in proliferative diabetic retinopathy.

D Q Borsey, C V Prowse, R S Gray, J Dawes, K James, R A Elton, B F Clarke
PMCID: PMC498841  PMID: 6202721

Abstract

Plasma beta-thromboglobulin, platelet factor 4, fibrinogen, fibrinopeptide A, antithrombin III, factor VIII related antigen, alpha 2-macroglobulin, platelet count, and total glycosylated haemoglobin were measured in three well matched groups of subjects: non-diabetic controls, diabetics without retinopathy, and diabetics with proliferative retinopathy. beta-thromboglobulin and platelet factor 4 concentrations were significantly higher in the diabetics with retinopathy than in the controls and platelet factor 4 was also increased in the diabetics without retinopathy compared with controls. Fibrinogen concentration was raised in diabetics without retinopathy compared with controls, diabetics with retinopathy compared with controls, and diabetics with retinopathy compared with those without. Fibrinopeptide A concentration did not differ significantly between groups. Antithrombin III levels were increased in diabetics with retinopathy compared with controls, and in diabetics with retinopathy compared with those without. Factor VIII related antigen values were higher in both the diabetic groups when compared with the controls. Fibrinopeptide A concentration correlated with both beta-thromboglobulin and platelet factor 4 in each of the three groups. Haemostatic abnormalities in diabetes have been shown, although a hypercoagulable state has not been confirmed. These changes in platelet and coagulation function may be secondary to the development of microvascular disease and their role in the pathogenesis of retinopathy remains uncertain.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Almér L. A., Pandolfi M. Fibrinolysis and diabetic retinopathy. Diabetes. 1976;25(2 Suppl):807–810. [PubMed] [Google Scholar]
  2. Banerjee R. N., Sahni A. L., Kumar V., Arya M. Antithrombin 3 deficiency in maturity onset diabetes mellitus and atherosclerosis. Thromb Diath Haemorrh. 1974 May 15;31(2):339–345. [PubMed] [Google Scholar]
  3. Betteridge D. J., Zahavi J., Jones N. A., Shine B., Kakkar V. V., Galton D. J. Platelet function in diabetes mellitus in relationship to complications, glycosylated haemoglobin and serum lipoproteins. Eur J Clin Invest. 1981 Aug;11(4):273–277. doi: 10.1111/j.1365-2362.1981.tb02116.x. [DOI] [PubMed] [Google Scholar]
  4. Bolton A. E., Ludlam C. A., Moore S., Pepper D. S., Cash J. D. Three approaches to the radioimmunoassay of human beta-thromboglobulin. Br J Haematol. 1976 Jun;33(2):233–238. doi: 10.1111/j.1365-2141.1976.tb03534.x. [DOI] [PubMed] [Google Scholar]
  5. Bolton A. E., Ludlam C. A., Pepper D. S., Moore S., Cash J. D. A radioimmunoassay for platelet factor 4. Thromb Res. 1976 Jan;8(1):51–58. doi: 10.1016/0049-3848(76)90122-5. [DOI] [PubMed] [Google Scholar]
  6. Boneu B., Abbal M., Plante J., Bierme R. Letter: Factor-VIII complex and endothelial damage. Lancet. 1975 Jun 28;1(7922):1430–1430. doi: 10.1016/s0140-6736(75)92650-1. [DOI] [PubMed] [Google Scholar]
  7. Borsey D. Q., Dawes J., Fraser D. M., Prowse C. V., Elton R. A., Clarke B. F. Plasma beta-thromboglobulin in diabetes mellitus. Diabetologia. 1980 May;18(5):353–357. doi: 10.1007/BF00276813. [DOI] [PubMed] [Google Scholar]
  8. Borsey D. Q., Fraser D. M., Gray R. S., Elton R. A., Smith A. F., Clarke B. F. Glycosylated hemoglobin and its temporal relationship to plasma glucose in non-insulin dependent (type 2) diabetes mellitus. Metabolism. 1982 Apr;31(4):362–365. doi: 10.1016/0026-0495(82)90111-1. [DOI] [PubMed] [Google Scholar]
  9. Burrows A. W., Chavin S. I., Hockaday T. D. Plama-thromboglobulin concentrations in diabetes mellitus. Lancet. 1978 Feb 4;1(8058):235–237. doi: 10.1016/s0140-6736(78)90482-8. [DOI] [PubMed] [Google Scholar]
  10. Campbell I. W., Dawes J., Fraser D. M., Pepper D. S., Clarke B. F., Duncan L. J., Cash J. D. Plasma beta-thromboglobulin in diabetes mellitus. Diabetes. 1977 Dec;26(12):1175–1177. doi: 10.2337/diab.26.12.1175. [DOI] [PubMed] [Google Scholar]
  11. Carvalho A., Ellman L. Activation of the coagulation system in polycythemia vera. Blood. 1976 Apr;47(4):669–678. [PubMed] [Google Scholar]
  12. Cederholm-Williams S. A., Dornan T. L., Turner R. C. The metabolism of fibrinogen and plasminogen related to diabetic retinopathy in man. Eur J Clin Invest. 1981 Apr;11(2 Suppl 1):133–138. doi: 10.1111/j.1365-2362.1981.tb02050.x. [DOI] [PubMed] [Google Scholar]
  13. Chmielewski J., Farbiszewski R. Platelet factor 4(PF4) release during human platelet aggregation in diabetic patients. Thromb Diath Haemorrh. 1970 Oct 31;24(1):203–205. [PubMed] [Google Scholar]
  14. Coller B. S., Frank R. N., Milton R. C., Gralnick H. R. Plasma cofactors of platelet function: correlation with diabetic retinopathy and hemoglobins Ala-c. Ann Intern Med. 1978 Mar;88(3):311–316. doi: 10.7326/0003-4819-88-3-311. [DOI] [PubMed] [Google Scholar]
  15. Corbella E., Miragliotta G., Masperi R., Villa S., Bini A., de Gaetano G., Chiumello G. Platelet aggregation and antithrombin III levels in diabetic children. Haemostasis. 1979;8(1):30–37. doi: 10.1159/000214288. [DOI] [PubMed] [Google Scholar]
  16. Dawes J., Smith R. C., Pepper D. S. The release, distribution, and clearance of human beta-thromboglobulin and platelet factor 4. Thromb Res. 1978 May;12(5):851–861. doi: 10.1016/0049-3848(78)90279-7. [DOI] [PubMed] [Google Scholar]
  17. ELLIS B. C., STRANSKY A. A quick and accurate method for the determination of fibronogen in plasma. J Lab Clin Med. 1961 Sep;58:477–488. [PubMed] [Google Scholar]
  18. Elder G. E., Mayne E. E., Daly J. G., Kennedy A. L., Hadden D. R., Montgomery D. A., Weaver J. A. Antithrombin III activity and other coagulation changes in proliferative diabetic retinopathy. Haemostasis. 1980;9(5):288–296. doi: 10.1159/000214367. [DOI] [PubMed] [Google Scholar]
  19. Fuller J. H., Keen H., Jarrett R. J., Omer T., Meade T. W., Chakrabarti R., North W. R., Stirling Y. Haemostatic variables associated with diabetes and its complications. Br Med J. 1979 Oct 20;2(6196):964–966. doi: 10.1136/bmj.2.6196.964. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Gandolfo G. M., De Angelis A., Torresi M. V. Determination of antithrombin III activities by different methods in diabetic patients. Haemostasis. 1980;9(1):15–19. doi: 10.1159/000214336. [DOI] [PubMed] [Google Scholar]
  21. Ganrot P. O., Gydell K., Ekelund H. Serum concentration of alpha-2-macroglobulin, haptoglobin and alpha-1-antitrypsin in diabetes mellitus. Acta Endocrinol (Copenh) 1967 Jul;55(3):537–544. doi: 10.1530/acta.0.0550537. [DOI] [PubMed] [Google Scholar]
  22. Gensini G. F., Abbate R., Favilla S., Neri Serneri G. G. Changes of platelet function and blood clotting in diabetes mellitus. Thromb Haemost. 1979 Oct 31;42(3):983–993. [PubMed] [Google Scholar]
  23. Giustolisi R., Musso R., Russo M., Catania N., Lombardo T., Cacciola E. Possible evidence for an increased factor VIII antigen synthesis in vascular endothelium of diabetic subjects. Thromb Haemost. 1982 Jun 28;47(3):293–293. [PubMed] [Google Scholar]
  24. Gray R. S., James K., Merriman J., Starkey I. R., Elton R. A., Clarke B. F., Duncan L. J. Alpha 2-macroglobulin and proliferative retinopathy in type 1 diabetes. Horm Metab Res. 1982 Aug;14(8):389–392. doi: 10.1055/s-2007-1019026. [DOI] [PubMed] [Google Scholar]
  25. Hoare E. M., Barnes A. J., Dormandy J. A. Abnormal blood viscosity in diabetes mellitus and retinopathy. Biorheology. 1976 Feb;13(1):21–25. doi: 10.3233/bir-1976-13103. [DOI] [PubMed] [Google Scholar]
  26. Jaffe E. A. Endothelial cells and the biology of factor VIII. N Engl J Med. 1977 Feb 17;296(7):377–383. doi: 10.1056/NEJM197702172960707. [DOI] [PubMed] [Google Scholar]
  27. James K., Merriman J., Gray R. S., Duncan L. J., Herd R. Serum alpha 2-macroglobulin levels in diabetes. J Clin Pathol. 1980 Feb;33(2):163–166. doi: 10.1136/jcp.33.2.163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Jones R. L., Peterson C. M. Hematologic alterations in diabetes mellitus. Am J Med. 1981 Feb;70(2):339–352. doi: 10.1016/0002-9343(81)90771-3. [DOI] [PubMed] [Google Scholar]
  29. Jonsson A., Wales J. K. Blood glycoprotein levels in diabetes mellitus. Diabetologia. 1976 Jul;12(3):245–250. doi: 10.1007/BF00422091. [DOI] [PubMed] [Google Scholar]
  30. Kazmier F. J., Bowie E. J., O'Fallon W. M., Zimmerman B. R., Osmundson P. J., Palumbo P. J. A prospective study of peripheral occlusive arterial disease in diabetes. IV. Platelet and plasma functions. Mayo Clin Proc. 1981 Apr;56(4):243–253. [PubMed] [Google Scholar]
  31. Kockum C. Radioimmunoassay of fibrinopeptide A-clinical applications. Thromb Res. 1976 Feb;8(2):225–236. doi: 10.1016/0049-3848(76)90265-6. [DOI] [PubMed] [Google Scholar]
  32. Kurihara Y., Nakayama H., Nakagawa S. Plasma beta-thromboglobulin and platelet factor 4 in renal insufficiency. Thromb Res. 1980 May 1;18(3-4):557–560. doi: 10.1016/0049-3848(80)90353-9. [DOI] [PubMed] [Google Scholar]
  33. Laurell C. B. Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies. Anal Biochem. 1966 Apr;15(1):45–52. doi: 10.1016/0003-2697(66)90246-6. [DOI] [PubMed] [Google Scholar]
  34. Lufkin E. G., Fass D. N., O'Fallon W. M., Bowie E. J. Increased von Willebrand factor in diabetes mellitus. Metabolism. 1979 Jan;28(1):63–66. doi: 10.1016/0026-0495(79)90169-0. [DOI] [PubMed] [Google Scholar]
  35. Marciniak E., Farley C. H., DeSimone P. A. Familial thrombosis due to antithrombin 3 deficiency. Blood. 1974 Feb;43(2):219–231. [PubMed] [Google Scholar]
  36. Mayne E. E., Bridges J. M., Weaver J. A. Platelet adhesiveness, plasma fibrinogen and factor 8 levels in diabetes mellitus. Diabetologia. 1970 Aug;6(4):436–440. doi: 10.1007/BF01212078. [DOI] [PubMed] [Google Scholar]
  37. Monnier L., Follea G., Mirouze J. Antithrombin III deficiency in diabetes mellitus: influence on vascular degenerative complications. Horm Metab Res. 1978 Nov;10(6):470–473. doi: 10.1055/s-0028-1093373. [DOI] [PubMed] [Google Scholar]
  38. Niewiarowski S., Lipiński B., Farbiszewski R., Poplawski A. The release of platelet factor 4 during platelet aggregation and the possible significance of this reaction in hemostasis. Experientia. 1968 Apr 15;24(4):343–344. doi: 10.1007/BF02140810. [DOI] [PubMed] [Google Scholar]
  39. Nossel H. L., Ti M., Kaplan K. L., Spanondis K., Soland T., Butler V. P., Jr The generation of fibrinopeptide A in clinical blood samples: evidence for thrombin activity. J Clin Invest. 1976 Nov;58(5):1136–1144. doi: 10.1172/JCI108566. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Pandolfi M., Almér L. O., Holmberg L. Increased von Willebrand-antihaemophilic factor a in diabetic retinopathy. Acta Ophthalmol (Copenh) 1974;52(6):823–828. doi: 10.1111/j.1755-3768.1974.tb01119.x. [DOI] [PubMed] [Google Scholar]
  41. Preston F. E., Ward J. D., Marcola B. H., Porter N. R., Timperley W. R., O'Malley B. C. Elevated beta-thromboglobulin levels and circulating platelet aggregates in diabetic microangiopathy. Lancet. 1978 Feb 4;1(8058):238–240. doi: 10.1016/s0140-6736(78)90483-x. [DOI] [PubMed] [Google Scholar]
  42. Prowse C. V., Vigano S., Borsey D. Q., Dawes J. The release of beta-thromboglobulin from platelets during the clotting of whole blood. Thromb Res. 1980 Feb 1;17(3-4):433–442. doi: 10.1016/0049-3848(80)90078-x. [DOI] [PubMed] [Google Scholar]
  43. Rasi V., Ikkala E., Hekali R., Myllylä G. Factors affecting plasma beta-thromboglobulin in diabetes mellitus. Med Biol. 1980 Oct;58(5):269–272. [PubMed] [Google Scholar]
  44. Solum N. O., Stormorken H. Influence of fibrinogen on the aggregation of washed human blood platelets induced by adenosine diphosphate, thrombin, collagen, and adrenaline. Scand J Clin Lab Invest. 1965;17(Suppl):170+–170+. [PubMed] [Google Scholar]
  45. Sowers J. R., Tuck M. L., Sowers D. K. Plasma antithrombin III and thrombin generation time: correlation with hemoglobin A1 and fasting serum glucose in young diabetic women. Diabetes Care. 1980 Nov-Dec;3(6):655–658. doi: 10.2337/diacare.3.6.655. [DOI] [PubMed] [Google Scholar]
  46. Zucker M. L., Gomperts E. D., Russel D., Joffe B., Feesey M., Kuschke R., Seftel H. Antithrombin functional activity after saturated and unsaturated fatty meals and fasting in normal subjects and some disease states. Thromb Res. 1979;15(1-2):37–48. doi: 10.1016/0049-3848(79)90050-1. [DOI] [PubMed] [Google Scholar]
  47. van CREVOLD S., PAULSSEN M. M. P. Significance of clotting factors in blood-platelets, in normal and pathological conditions. Lancet. 1951 Aug 11;2(6676):242–244. [PubMed] [Google Scholar]

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