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Toorn, F.A. van der; Mutsert, R. de; Lijfering, W.M.; Rosendaal, F.R.; Vlieg, A.V. (2019)

Glucose metabolism affects coagulation factors: The NEO study

Article / Letter to editor
Background It is insufficiently understood if there is an association between diabetes and VT, and what the underlying mechanism would be. Objectives We aimed to study the association between glucose concentrations with several coagulation factors in the general population. Methods This is a cross-sectional analysis of baseline measurements within 5778 participants of the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study of individuals 45 to 65 years. Associations between fasting glucose and HbA1c concentrations, and postprandial glucose response and factor (F) VIII, FIX, FXI, and fibrinogen levels were examined using linear regression analyses and by calculating mean levels per category of glucose concentrations while adjusting for confounding factors. Results Per each mmol/L higher fasting glucose concentration we observed higher levels of fasting FVIII (5.33%, 95% CI: 4.00-6.65), FIX (6.19%, 95% CI: 5.15-7.23), and FXI (2.11%, 95% CI: 1.20-3.02)....Show moreBackground It is insufficiently understood if there is an association between diabetes and VT, and what the underlying mechanism would be. Objectives We aimed to study the association between glucose concentrations with several coagulation factors in the general population. Methods This is a cross-sectional analysis of baseline measurements within 5778 participants of the Netherlands Epidemiology of Obesity (NEO) study, a population-based cohort study of individuals 45 to 65 years. Associations between fasting glucose and HbA1c concentrations, and postprandial glucose response and factor (F) VIII, FIX, FXI, and fibrinogen levels were examined using linear regression analyses and by calculating mean levels per category of glucose concentrations while adjusting for confounding factors. Results Per each mmol/L higher fasting glucose concentration we observed higher levels of fasting FVIII (5.33%, 95% CI: 4.00-6.65), FIX (6.19%, 95% CI: 5.15-7.23), and FXI (2.11%, 95% CI: 1.20-3.02). Results for fasting HbA1c and postprandial glucose response were similar. Participants with an impaired fasting glucose, high fasting glucose, and diabetes mellitus had higher mean levels of FVIII, FIX, and FXI than those with a normal glucose metabolism, with the highest differences in the levels of FVIII, FIX, and FXI between a high fasting glucose and a normal glucose metabolism. All associations attenuated after adjustment for total body fat, yet all of the above associations remained after adjustment for the confounding factors, except for fibrinogen when contrasted to glucose. Conclusion Concentrations of fasting glucose and HbA1c and postprandial glucose response were positively associated with FVIII, FIX, and FXI, and to some extent also with fibrinogen.Show less
blood coagulation factors
diabetes mellitus
fibrinogen
glucose
hyperglycemia
All authors
Toorn, F.A. van der; Mutsert, R. de; Lijfering, W.M.; Rosendaal, F.R.; Vlieg, A.V.
Date
2019-08-09
Journal
Journal of Thrombosis and Haemostasis
Volume
17
Issue
11
Pages
1886 - 1897
DOI
doi:10.1111/jth.14573