Do elevated plasma prothrombin levels correspond to genetic variation in the 3'-untranslated region of the prothrombin gene in type 2 diabetic patients? - preliminary report
Marcin Różalski, Magdalena Boncler, Tadeusz Pietrucha, Cezary Watała
Med Sci Monit 1999; 5(6): BR1065-1069
Background:Numerous coagulation abnormalities resulting in a state of acquired thrombophilia have been demonstrated in the patients suffering from diabetes mellitus. Diabetes itself, however, is known to constitute an additional independent risk factor in the development of vascular complications. Recently, occasional reports pointed to the possible correlation between the genetic polymorphism 20210G/A in 3'-untranslated region in prothrombin gene and the elevated prothrombin level in blood plasma, particularly in the cases of familial thrombophilia. Our aim was to verify the hypothesis whether the elevated plasma prothrombin levels in some patients might correspond to the genetic variation in the 3'-untranslated region of the prothrombin gene in patients with type 2 diabetes mellitus.
Results: We revealed that the averaged plasma level of prothrombin fragment F1&plus;2 in an overall group of 128 type 2 diabetic patients was not significantly different compared to controls (2.93&plusm;2.40 nmol/l vs. 2.21&plusm;1.83 nmol/l); in selected patients (16&percnt;), however, the level of F1&plus;2 was vastly increased (7.70&plusm;1.83 nmol/l), although these patients showed no evident clinical symptoms of vascular disease. The frequency of the genetic polymorphism 20210G/A in 3'-untranslated region in prothrombin gene in the examined group of diabetic subjects (1.3&percnt;) was not significantly higher compared to the group of control individuals and did not correspond to the increased F1&plus;2 plasma levels: all the diabetic patients with the markedly increased levels of F1&plus;2, were wild type homozygotes 20210G/G.
Conclusions: Overall, we conclude that the genetic polymorphism 20210G/A in 3'-untranslated region in prothrombin gene is not evidently associated with the increased plasma thrombin generation in the examined group of diabetic patients. Other, yet undefined, compounding factors might underlie the accelerated thrombogenesis occurring in some patients with diabetes mellitus.
Keywords: Prothrombin, A20210G prothrombin gene polymorphism, prothrombin fragment F 1+2, Type 2 diabetes mellitus, thrombinogenesis