The Relationship Between Fibrinolytic Capacity and Metabolic Control in Insulin-Dependent Diabetes Mellitus.

The purpose of this study was to investigate the relationship between fibrinolytic capacity and metabolic control in insulin-dependent diabetes mellitus. Testing protocol was explained and informed consent was obtained from 26 insulin-dependent diabetics and 20 healthy controls who agreed to serve as subjects. Fibrinolytic capacity (FC) was measured as the change in euglobulin lysis time produced by 10 min of venous occlusion with a sphygmomanometer cuff inflated around the upper arm at a pressure midway between systolic and diastolic blood pressure. Metabolic control was evaluated by measurement of hemoglobin A1 (HbA1) using a minicolumn chromatographic technique. Fasting glucose (GLU), cholesterol (CHO), and triglyceride (TRI) were measured on a Coulter Chemistry Analyzer. Significant differences were found to exist between diabetics and controls, respectively, for FC (46.6 (+OR-) 19.3% vs. 64.2 (+OR-) 12.1%), HbA1 (10.3 (+OR-) 2.1% vs. 6.5 (+OR-) .9%), GLU (209 (+OR-) 102 mg% vs. 95 (+OR-) 7 mg%), and CHO (215 (+OR-) 56 mg% vs. 186 (+OR-) 25 mg%). No differences were found for TRI. Bivariate correlations were calculated between FC and HbA1 for diabetics only, for controls only, and for all subjects combined. Significant relationships were found for both the combined sample (r = -.33) and for controls (r = .54), but not for diabetics (r = -.08). Stepwise linear regression revealed that FC could best be explained in insulin-dependent diabetes by TRI (p = .03), and no significance could be attached to HbA1 (p = .46). It is concluded that the positive relationship noted between FC and HbA1 for normal subjects is spurious and that the reduced capacity for fibrinolytic activity in insulin-dependent diabetes is not directly related to metabolic control