ABSTRACT
BACKGROUND AND AIM: Previous data indicate that even mild postprandial hyperglycaemia in diabetic subjects, who are concerned to be in good control, activates haemostasis. The aim of this study was to investigate the effect of the oral administration of 5 mg glibenclamide on postprandial activation of coagulation in type 2 diabetics. METHODS AND RESULTS: We designed a placebo controlled, randomised study. After an overnight fast, each subject (n = 16, age 50-68 yr.) underwent a standard test meal (600 Kcal: carbohydrates 40%, lipids 50%, proteins 10%) preceded by one tablet of glibenclamide (5 mg) or placebo. The two tests were performed randomly, with an interval of 7 days. Blood samples were collected at baseline and 2 and 4 hours after the meal to measure the concentrations of glucose, insulin, c-peptide, triglycerides as well as of d-dimers, fibrinogen, F1.2 and TAT. The postprandial levels of TAT, fibrinogen, F1.2, d-dimers, insulin, glucose and triglycerides were significantly higher compared to baseline values. CONCLUSIONS: The postprandial levels of glucose, triglycerides, fibrinogen, F1.2, TAT and d-dimers were lower after glibenclamide administration as compared to placebo, while the concentrations of insulin and c-peptide were higher. Thus, acute administration of glibenclamide reduces the postprandial activation of coagulation.
Subject(s)
Blood Coagulation/drug effects , Diabetes Mellitus, Type 2/blood , Glyburide/pharmacology , Hypoglycemic Agents/pharmacology , Administration, Oral , Aged , Analysis of Variance , Area Under Curve , Cross-Over Studies , Female , Glyburide/administration & dosage , Hemostasis/drug effects , Humans , Hypoglycemic Agents/administration & dosage , Male , Middle Aged , Postprandial PeriodABSTRACT
Demographic data of the Greek haemophilia A and B population for the period 1972-1993 were analyzed. Prevalence at birth including known not-registered patients was calculated at 23.1 per 100,000 male births. However, the observed prevalence in 1993 was only 61% of the expected. Since 1975 the proportion of mild cases had significantly increased. Adjusted by age, severity and HIV status reproductive fitness of haemophiliacs was 0.62. Overall mortality was 2.6 times higher than in the general population, but 7.9 times among patients with severe haemophilia and 16.4 among HIV(+) haemophiliacs. Fifty out of 78 deaths occurred among HIV(+) patients and 28 of these were caused by AIDS. Inhibitor patients did not show excess mortality due to bleeding. Cancer mortality was equal to normal, but the number of deaths from ischaemic heart disease was 0.25 of the expected. Risk of death due to cerebral haemorrhage was 3.8 times higher in HIV(+) haemophiliacs than in HIV(-).
Subject(s)
Hemophilia A/epidemiology , Hemophilia B/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Cause of Death , Child , Child, Preschool , Greece/epidemiology , Hemophilia A/mortality , Hemophilia A/therapy , Hemophilia B/mortality , Hemophilia B/therapy , Humans , Infant , Male , Middle Aged , PrevalenceABSTRACT
Blood coagulation, fibrinolysis, platelet count-aggregation and cortisol were assessed in 35 Finnish amateur runners aged 27 to 56 years (mean 40) and three aged 65, 67, and 82 who had run a non-competitive Marathon in 1975, 1976 and 1977 over the classical itinerary. After the run, in all 3 years, APTT showed shortening (p < 0.001); prothrombin time and plasma fibrinogen were not significantly altered; euglobulin lysis time was shorter (p < 0.001) and FDP increased (p < 0.001); PSPT became positive in all subjects, whereas the ehtanol gelation test remained negative; no cryofibrinogen was detected. Platelet count and aggregation showed increase (p < 0.001) in 1975 (extreme heat, 25 degrees C) but remained unaltered in 1976, 1977 (15-18 degrees C). Cortisol levels were always significantly increased -- more markedly in 1975. Women's responses were similar to those of men. A possible correlation between physical fitness and the responses of haemostatic balance is suggested and the influence of weather is discussed.
Subject(s)
Blood Coagulation , Fibrinolysis , Hydrocortisone/blood , Platelet Aggregation , Running , Adult , Female , Humans , Male , Middle Aged , Platelet CountABSTRACT
Blood coagulation and fibrinolysis were assessed in 13 Finnish amateur runners aged 31 to 48, and one 65-year old taking part in a non-competitive marathon (42.2 km). After the run the mean values of partial thromboplastin time showed a very significant shortening, whereas the mean values of the prothrombin time and of plasma fibrinogen were not significantly altered. The mean values of euglobulin lysis time were significantly shorter and the mean values of fibrin degradation products increased highly significantly. After the run, protamine sulphate was positive or strongly positive in all subjects, whereas the ethanol gelation test was negative in all runners; no cryofibrinogen was detected in any participant. Thus, running a marathon race affects the haemostatic balance and activates the fibrinolytic mechanism. The effects of training and physical fitness on the above parameters are discussed.
Subject(s)
Blood Coagulation , Fibrinolysis , Running , Adult , Aged , Blood Coagulation Tests , Humans , Middle Aged , Physical Fitness , Prothrombin Time , Time FactorsABSTRACT
Serum samples from 134 Greek haemophiliacs multitransfused with fresh frozen plasma and factor--VIII or factor--IX concentrates were investigated for the presence of blood group antibodies. All samples were tested against a panel of selected cells of known but differing genotype. The incidence of blood group antibodies was 12.7%. Anti-D was found in 6 out of the 17 immunized patients, i.e., 35.3% of D-negative haemophiliacs were sensitized. It is concluded that the high incidence of immunization is a serious complication of repeated plasma transfusions.
