Inflammatory cytokines in type 2 diabetes mellitus as facilitators of hypercoagulation and abnormal clot formation - PubMed (original) (raw)

Inflammatory cytokines in type 2 diabetes mellitus as facilitators of hypercoagulation and abnormal clot formation

Shehan N Randeria et al. Cardiovasc Diabetol. 2019.

Abstract

Background: The global burden of type 2 diabetes mellitus (T2DM), together with the presence of cardiovascular risk in this population, is reaching pandemic levels. A prominent feature of T2DM is chronic and systemic inflammation, with the accompanying presence of circulating and dysregulated inflammatory biomarkers; which in turn is associated with abnormal clot formation.

Methods: Here, we investigate the correlation between abnormal blood clotting, using thromboelastography (TEG), clot ultrastructure using scanning electron microscopy (SEM) and the presence of a dysregulated inflammatory cytokine profile, by examining various circulating biomarkers.

Results: Our results show that many biomarkers, across TEG, cytokine and lipid groups, were greatly dysregulated in the T2DM sample. Furthermore, our T2DM sample's coagulation profiles were significantly more hypercoagulable when compared to our heathy sample, and ultrastructural analysis confirmed a matted and denser clot structure in the T2DM sample.

Conclusions: We suggest that dysregulated circulating molecules may in part be responsible for a hypercoagulable state and vascular dysfunction in the T2DM sample. We propose further that a personalized approach could be of great value when planning treatment and tracking the patient health status after embarking on a treatment regimes, and that looking to novel inflammatory and vascular biomarkers might be crucial.

Keywords: Biomarkers; Systemic inflammation; Type 2 diabetes mellitus; Vascular dysfunction.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1

Fig. 1

Representative fibrin clot structure of a control (A) versus a T2DM individual (B–D)

Fig. 2

Fig. 2

Box and whisker plots for highlighted parameters for healthy (left box) and T2DM populations (right box). Notice the presence of strong outliers, such as the IL-6 healthy group outlier

Fig. 3

Fig. 3

Lattice of cross-plots and correlation values across statistically significant TEG, cytokine and lipid measurements (with groups separated by blue lines). Red represents the T2DM population

Fig. 4

Fig. 4

Lattice of cross-plots and correlation values for the vascular injury measurements for the expanded population. Red represents the T2DM population

Fig. 5

Fig. 5

Summary of the circulating biomarkers and hypercoagulation markers of T2DM. Diagram created using BioRender (

https://biorender.com/

)

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