Haemostatic profiles of type 2 Diabetes Mellitus patients at Ndola Central Hospital-Ndola, Zambia

Abstract

Background: Patients with diabetes mellitus have a high risk of atherothrombotic events. Eighty percent of patients with diabetes mellitus die due to thrombosis, and 75% of these deaths are due to cardiovascular complications. A cross-sectional analytical study was conducted at Ndola Central Hospital between November 2012 and April 2013 with the main objective of determining the hypercoagulability state of type 2 diabetes mellitus (T2DM) patients. Method: Prothrombin time (PT), Activated partial thromboplastin time (APTT),von Willebrands factor (vWF) and Fibrinogen concentrations were measured in 213 T2DM patients and 172 non-diabetic healthy participants. vWF and fibrinogen were used as proxy biomarkers for hypercoagulability in T2DM patients. A structured questionnaire was used to capture Age, sex, duration of diabetes mellitus and knowledge on T2DM of study participants. Body weight and body height were also measured and Body mass index (BMI) calculated. Results: The mean fibrinogen concentration for T2DM patients (4.3±2.5g/l) was significantly higher than control participants (2.3±1.6g/l). Mean vWF concentration was also significantly higher in T2DM patients (7.4±4.1 IU/ml) than in control participants (2.6±2.2 IU/ml) P=0.004. The mean APTT in T2DM patients was significantly shorter than in control study participants P=0.000. Prevalence of hypercoagulability among T2DM patients was significantly higher [126(59.2%)] than in the control participants [22(12.7%)]. Female type 2 diabetic participants had higher proportion of hypercoagulability than male participants 88(73.3%) and 38(40.9%) respectively P=0.000. Age ,Sex, glycaemic control, Obesity and duration of T2DM were found to be independent risk factors for hypercoagulability in T2DM participants with the AOR of 4.42(95% CI 2.77-10.63), 1.45(95% CI 1.19-3.16), 6.12(95% CI 2.27-8.36),5.28 (95% CI 3.01-8.21),4.54(95% CI 2.88-10.59) and 5.28(95% CI 3.01-8.21) respectively. APTT was found to be a probable marker of hypercoagulability in T2DM patients due to its high sensitivity (93.7%), Specificity (95.4%) PPV (96.7%), NPV (91.2%) and had a strong statistically significant correlation with vWF; R= -0.783 P=0.001. Conclusion: T2DM patients are more hypercoagulable than non-diabetic healthy individuals and female T2DM patients were more hypercoagulable than male patients. APTT may be introduced as a marker for hypercoagulability in T2DM after conducting a prospective study to follow-up T2DM patients and determine how many will develop thrombosis in future