The Buffering Role of HDL in Balancing the Effects of Hypercoagulable State in Type 2 Diabetes

Abstract

Diabetes mellitus as a heterogeneous disease along with hyperglycemia causes quite many acute and chronic complications including cardiovascular complication. Cardiovascular complications are caused because of numerous factors such as increased Fasting Blood Sugar (FBS), Triglyceride (TG), hypercholesterolemia, hypercoagulable state and a change in balancing lipoproteins including Low Density Lipoproteins (LDL) and High Density Lipoproteins (HDL). Because of probable role of HDL in prevention of cardiovascular complications and its antithrombotic role in diabetics, we have studied lipoproteins and HDL in particular, effect on coagulation parameters which may potentially lead to cardiovascular complications in type 2 diabetics. In this study, 60 type 2 diabetics in early stage of diabetes were compared statistically with 50 healthy subjects in terms of biochemical factors of: FBS, TG, VLDL, LDL, coagulation parameters of: Partial thromboplastin time (PT), Activated Partial Thromboplastin Time (APTT), specific activity of coagulation factors and then the correlation between the biochemical and coagulation parameters was measured using Pearson’s correlation coefficient. Our findings showed that FBS, TG, VLDL and coagulation factors of: II, IX, X, XI in diabetics had increased significantly compared with healthy subjects. They also indicated that APTT and therefore, the intrinsic coagulation pathway in diabetics prolonged in comparison with the healthy individuals. There were no other significant differences in the measured parameters between two groups. On the other hand, by studying biochemical and coagulation factors, it was shown that there was a positive significant correlation among FBS, cholesterol and HDL with the coagulation factors of II, V, IX, X, XI. There was, interestingly, a negative significant correlation between HDL and APTT. The observed correlation between coagulation factors and HDL, regardless of the no significant difference of HDL in the two groups, shows that probably the hypercoagulable state as a result of hyperglycemia led to plasma increase of HDL. In other words, HDL, probably, because of hypercoagulable state, intended to remove their destructive effects of hypercoagulable state and then correlated with them.