Correlation Between Insulin Resistance And Plasma Fibrinogen In Patients With Type 2 Diabetes Mellitus

Background and purpose: Type 2 diabetes mellitus(T2DM)is a chronic,serious disease which impacts on the global residents health,its pathophysiology is characterized from priority of insulin resistance along with different grade of inadequate secretion of insulin to priority of inadequate secretion of insulin along with different levels of insulin resistance.The prevalence increased significantly in a period of 30 years in China.Macrovascular complications in patients with type 2 diabetes is the major cause of disability and death.Insulin resistance(IR)refers to a variety of reasons depresses the effect of insulin on glucose uptake.The compensatory secretion of insulin cause the hyperinsulinemia.It’s generally agreed that insulin resistance is the basis of blood lipid,blood glucose,uric acid,abnormal blood pressure,was considered as an important part of the onset of metabolic syndrome.Plasma fibrinogen is the center protein of the blood coagulation system,and plays an important role in maintaining homeostasis of blood coagulation and fibrinolysis in body,and directly participate in the development of atherosclerosis.The correlation between insulin resistance and FIB was reported in the group of obesity and polycystic ovary syndrome(PCOS),gestational diabetes,elderly patients with type 2 DM at present.The aim of this study is to study if insulin resistance is associated with level of plasma fibrinogen in patient with T2 DM.Methods: A total of 1006 patients with T2 DM were selected from patients hospitalized from July 2015 to July 2016 after excluding those of patients without diabetes,type 1 diabetes,critical states,and those conditions might influencing the metabolism of fibrinogen.Clinical data and laboratory test results of fasting blood glucose(FBG),fasting insulin(Fins),fasting C peptide(FCP),Hb A1 c,plasma cholesterol(Chol),triglycerides(Tg),HDL-C,LDL-C,uric acid,plasma fibrinogen(FIB)were retrieved within 24 hours of admission.Patients were divided into four groups according toquartiles of plasma fibrinogen.SPSS software(Ver 19.0,IBM,USA)was use for statistics analysis.Results: Sixty point three percent were men,aged 14 to 90 years old,mean age was 55.7±12.7 years with duration of 0-37 years,the average duration was 7.7±7 years,BMI was from 14.5 to 40.0 kg/m2 with average of 25.3±3.3 kg/m2,28.9% of patients did not receive treatment,39.7% received oral hypoglycemic therapy,14.1% receive individual insulin,17.3% receiving oral and insulin therapy.ANOVA found age,duration of diabetes(DD),FCP,Hb A1 c,LDL-C,Chol increased with the increase of quartiles of FIB.FIB levels in women was higher than in men.Linear stepwised regression found age,DD,gender,FCP,Hb A1 c,LDL-C,Uric acid(UA)were independent variable for level of FIB among the varibles of age,DD,gender,HOMA-IR,FCP,Hb A1 c,BMI,TG,Chol,HDL-C,LDL-C,UA.Conclusion: Insulin resistance expressed as FCP in overt diabetes state might be a risk factor for increased plasma level of FIB.