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J Lab Physicians. 2016 Jul-Dec;8(2):101-5. doi: 10.4103/0974-2727.180790.

Is There a Tendency for Thrombosis in Gestational Diabetes Mellitus?

Author information

1
Department of Endocrinology and Metabolism, Antalya Training and Research Hospital, Antalya, Turkey.
2
Department of Pediatric Hematology, Director of Hematology Laboratories, Ankara Training and Research Hospital, Ankara, Turkey.
3
Department of Endocrinology and Metabolism, Ankara Training and Research Hospital, Ankara, Turkey.
4
Department of Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
5
Department of Pediatric Hematology, Hematology Laboratories, Ankara Training and Research Hospital, Ankara, Turkey.

Abstract

CONTEXT:

Impact of gestational diabetes mellitus (GDM) on the coagulation system, dynamics involved at a pathophysiological level and the exact mechanism remain unclear.

AIMS:

To evaluate the association between diabetes-related parameters and hemostatic factors to search for a tendency of thrombosis in GDM.

SETTINGS AND DESIGN:

Nineteen pregnant women who had GDM, 16 healthy pregnant and 13 healthy nonpregnant controls admitted to the Endocrinology outpatient clinics were enrolled in the study.

SUBJECTS AND METHODS:

Fasting and postprandial glucose, hemoglobin A1c and insulin levels, and insulin resistance; fructosamine, thrombin activatable fibrinolysis inhibitor (TAFI), tissue factor pathway inhibitor (TFPI), plasminogen activator inhibitor Type-1 (PAI-1), tissue-type plasminogen activator (t-PA), fibrinogen, plasminogen and hemoglobin levels, platelet counts, prothrombin time (PT), and activated partial thromboplastin time (aPTT) were studied.

STATISTICAL ANALYSIS USED:

One-way analysis of variance, Kruskal-Wallis, and post hoc Tukey honestly significant difference or Conover's nonparametric multiple comparison tests for comparison of the study groups.

RESULTS:

PT and aPTT were significantly lower in GDM patients compared to controls (P < 0.05), whereas fibrinogen and plasminogen levels were significantly higher in this group compared to both nonpregnant and healthy pregnant controls (P < 0.05 for each). TAFI, TFPI, PAI-1, and tissue t-PA levels were not significantly different among groups.

CONCLUSIONS:

Our findings indicate tendency to develop thrombosis in GDM similar to diabetes mellitus; but more comprehensive studies with larger sample size are needed to determine the relationship between GDM and hemostasis.

KEYWORDS:

Gestational diabetes mellitus; hemostatic factors; thrombosis

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