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Objective: To investigate the level of 8-iso-PGF2a, Hcy in diabetes mellitus patients, and their relationship with the coagulation system, further to guide the clinical antioxidant and anticoagulant therapy.Methods: 55 diabetes mellitus patients who hospitalized in our hospital during the August 2009 to the August 2010 were chosen. According to the rate of urinary albumin to creatinine (ACR), these patients were divided into two groups: diabetes mellitus group (DM), ACR<30mg/g and diabetic nephropathy group (DN), ACR≥30mg/g. Another 28 healthy people were chosen as control group (NC). The ELISA was used to detect the level of 8-iso-PGF2a, Hcy and vWF in plasma; The Turbidimetry-immunoassay to urinary albumin and urine creatinine; And Stago coagulation analyzer to FIB, PC, PS and AT-Ⅲin plasma.Results: 1.The level of 8-iso-PGF2a in DN group was (554.49±134.28)pg/ml, which was higher than DM group (386.68±117.10)pg/ml and control group (287.55±108.95)pg/ml significantly. There was statistical difference among the three groups.2.The level of Hcy in DN group was (32.42±8.12)umol/l, and in DM group was( 25.57±8.03)umol/l, both higher than control group. Comparing the level both among these three groups and in one single group, differences were significant statistically.3.The level of HsCRP in DN group was (4.35±2.07)mg/L. Comparing with (3.19±1.66)mg/L in DM group and (1.42±0.71)mg/L in control group, differences were statistical significance. Comparing the later two groups, differences were statistical significance too (p<0.05). There was significant difference in TC level of groups DN and normal control (p<0.05); The level of TG in DM and DN were significantly higher than in the control group (p<0.01).4.Comparing the level of vWF and FIB in DN group with in DM group and control group, the difference was statistical significance, (p<0.05). Comparing the later two groups, differences were statistical significance too (p<0.05).5.The activities of PC, PS in group DM and DN were higher than that in normal control (p<0.05). But there was no significant difference comparing group DM with DN(p>0.05). The activities of plasma AT-Ⅲin normal control, DM and DN groups were (95.43±9.71)%, (88.63±10.03)% and (68.04±7.91)% respectively. Comparing the level both among these three groups and in one single group, differences were significant statistically (p<0.05).6.Single factor correlation analysis 8-iso-PGF2a level in plasma was positively correlated with Hcy (r=0.698), HsCRP (r=0.333), BMI (r=0.235), TG (r=0.437), ACR (r=0.661), vWF (r=0.660), FIB (r=0.378), PC (r=0.253), PS (r=0.260), and was negatively correlated with AT-Ⅲ(r=-0.556).Hcy level in plasma was positively correlated with HsCRP (r=0.564), TG (r=0.629), FPG (r=0.296), BMI (r=0.271), ACR (r=0.713), vWF (r=0.684), FIB (r=0.503), PS (r=0.376), and was negatively correlated with AT-Ⅲ(r=-0.598).Conclusions: 1.The level of 8-iso-PGF2a increased significantly in DM patients,and further increased as the diabetes mellitus progressed to diabetic nephropathy. Reveal that oxidative stress was with the occurrence and development of diabetes, and participated in the occurrence of diabetic nephropathy.2.Hyperhomocysteinemia was in almost all Diabetic patients. The levels of blood homocysteine further increased with the occurrence of diabetic nephropathy, and homocysteine associated with the 8-iso-PGF2a, HsCRP, vWF, FIB, PS, AT-Ⅲ. Suggested that the oxidative stress in diabetes interact with hyperhomocysteinemia , which might lead to vascular disease, hypercoagulable state, further to involved in the development of diabetic nephropathy. 3.High-sensitivity C-reactive protein increased significantly in patients with diabetic nephropathy, and positively correlated with 8-iso-PGF2a, indicating that inflammatory action participated the diabetic nephropathy development, furthermore, associated with oxidative stress in patients.4.VWF had increased in diabetes mellitus ,and increased further in the period of diabetic nephropathy. Which proved that vascular endothelial damage and dysfunction existed in early diabetic, and the vascular endothelial injury aggravated with microvascular disease; VWF and 8-iso-PGF2a were positively correlated. indicated that oxidative stress related to endothelial damage in diabetes patients, oxidative stress can promote the progress of diabetic microangiopathy.5.Diabetic patients were all with hyperfibrinogenemia. PC and PS in plasma increased, and AT-Ⅲlower. 8-iso-PGF2a were positively correlated with FIB, PC and PS, but negative correlated With AT-Ⅲ. Indicated that diabetic patients were in Hypercoagulable state; oxidative stress is closely related with coagulopathy; and early reasonable antioxidant, anticoagulant treatment was of far-reaching significance in diabetic patients.
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