Tissue Factor Levels Used as Coagulation Biomarkers in Diabetic and Hypertensive Patients
Waleed Haji Saeed 1*, Zikri Mahmood Mirza 1, Mohammed Rashid Ameen 1, Sarkaft Ghareeb Omer 2
Journal of Angiotherapy 8(7) 1-6 https://doi.org/10.25163/angiotherapy.879801
Submitted: 03 June 2024 Revised: 19 July 2024 Published: 22 July 2024
Abstract
Background: Tissue factor is a key initiator of the clotting process, and elevated levels are associated with abnormal thrombogenesis. Patients with chronic conditions like diabetes and hypertension may exhibit increased tissue factor concentrations, which can lead to serious complications. This study aims to determine tissue factor levels among diabetic patients, diabetics with uncontrolled hypertension, and healthy volunteers, to explore the potential of tissue factor as a diagnostic biomarker. Methods: Tissue factor concentrations were measured using enzyme-linked immunosorbent assay (ELISA), and glycated hemoglobin type 1A (HbA1c) levels were estimated with the Cobas instrument. The study population included diabetic patients, diabetics with uncontrolled hypertension, and healthy volunteers. Statistical analysis was performed using SPSS version 26, with comparisons made between the groups. Results: The results showed significantly higher tissue factor concentrations in patients compared to healthy volunteers. The mean tissue factor level in patients was 100.12 (±26.92) pg/mL, while in healthy volunteers, it was 59.17 (±19.24) pg/mL (p < 0.001). Diabetic patients with elevated HbA1c levels had higher tissue factor concentrations compared to healthy volunteers (mean HbA1c: 6.95 (±1.853)% vs. 4.28 (±0.327)%). Moreover, patients with both diabetes and hypertension had the highest tissue factor levels, with a mean of 130.89 (±14.33) pg/mL (p < 0.001). No significant differences in tissue factor levels were observed based on gender or age (p > 0.05). Conclusion: Elevated tissue factor levels were observed in patients with diabetes and hypertension, particularly in those with poorly controlled conditions. This elevation suggests an increased risk of coagulation disorders, potentially affecting vital organs such as the heart, brain, and kidneys. Tissue factor could serve as a valuable diagnostic biomarker, allowing for early intervention in patients at risk of developing serious complications.
Keywords: Tissue Factor (TF), Diabetes Mellitus (DM), Hypertension (HT), Coagulation Cascade, Cardiovascular Disease (CVD)
References
Abed, B. A., Farhan, L. O., & Dawood, A. S. (2024). Relationship between serum Nesfatin-1, Adiponectin, Resistin Concentration, and obesity with type 2 diabetes mellitus. Baghdad Science Journal, 21(1), 117-123. https://doi.org/10.21123/bsj.2023.8119
Ahmed, A. O., Abbas Ali, A., & Mardan, H. J. (2023). Hematological change in type II diabetic mellitus (TIIDM) patient infected with intestinal parasites in Kirkuk/Iraq. NTU Journal of Pure Sciences, 2(1), 1–4. https://doi.org/10.56286/ntujps.v2i1
Ahmed, M., Younis, N. M., Hussein, A. A., Ahmed, M. M., Younis, M., & Ibrahim, M. (2021). Apply Pender’s health promotion towards hypertension of employees in Mosul City/Iraq. Current Medical Research and Opinion, 7(5), 2529–2535. https://doi.org/10.52845/CMRO/2024/7-5-19
Bryk-Wiazania, A. H., & Undas, A. (2021). Hypofibrinolysis in type 2 diabetes and its clinical implications: From mechanisms to pharmacological modulation. Cardiovascular Diabetology, 20, 191. https://doi.org/10.1186/s12933-021-01372-w
Chrysanthopoulou, A., Gkaliagkousi, E., Lazaridis, A., Arelaki, S., Pateinakis, P., Ntinopoulou, M., Mitsios, A., Antoniadou, C., Argyriou, C., & Georgiadis, G. S. (2021). Angiotensin II triggers the release of neutrophil extracellular traps, linking thromboinflammation with essential hypertension. JCI Insight, 6(18), e148668. https://doi.org/10.1172/jci
Grassi, G. (2024). New guidelines for hypertension diagnosis and treatment: A European perspective. Reviews in Cardiovascular Medicine, 25(2), 55. https://doi.org/10.31083/j.rcm2502055
Grover, S. P., & Mackman, N. (2020). Tissue factor in atherosclerosis and atherothrombosis. Atherosclerosis, 307, 80–86. https://doi.org/10.1016/j.atherosclerosis.2020.06.003
Li, S., Wang, J., Zhang, B., Li, X., & Liu, Y. (2019). Diabetes mellitus and cause-specific mortality: A population-based study. Diabetes & Metabolism Journal, 43(3), 319-322. https://doi.org/10.4093/dmj.2018.0060
Li, X., Weber, N. C., Cohn, D. M., Hollmann, M. W., DeVries, J. H., Hermanides, J., & Preckel, B. (2021). Effects of hyperglycemia and diabetes mellitus on coagulation and hemostasis. Journal of Clinical Medicine, 10(11), 2419. https://doi.org/10.3390/jcm10112419
Moreno, P. R., & Fuster, V. (2004). New aspects in the pathogenesis of diabetic atherothrombosis. Journal of the American College of Cardiology, 44(11), 2293–2300. https://doi.org/10.1016/j.jacc.2004.07.060
Mousa, N. A. W., Khaleefah, M. A., & Al-Badri, H. J. (2022). Hypertension control among adult Iraqis. Journal of the Faculty of Medicine Baghdad, 64(3), 145–152. https://doi.org/10.32007/jfacmedbagdad.6431935
Osman, E. A., & Al-Badri, H. J. (2021). Frequency of hypertension and associated risk factors in Mosul City, Iraq. Kirkuk University Journal-Scientific Studies (KUJSS), 15(1), 221-227. https://doi.org/10.30651/kujss.v15i1.9937
Savoia, C., D’Agostino, M., Lauri, F., & Volpe, M. (2011). Angiotensin type 2 receptor in hypertensive cardiovascular disease. Current Opinion in Nephrology and Hypertension, 20(2), 125–132. https://doi.org/10.1097/MNH.0b013e328343f303
Schneider, D. J. (2023). Diabetes and thrombosis. In Diabetes and cardiovascular disease (pp. 99–127). Springer. https://doi.org/10.1007/978-3-031-13177-6_5
Sobczak, A. I. S., & Stewart, A. J. (2019). Coagulatory defects in type-1 and type-2 diabetes. International Journal of Molecular Sciences, 20(24), 6345. https://doi.org/10.3390/ijms20246345
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., & Commodore-Mensah, Y. (2022). Heart disease and stroke statistics—2022 update: A report from the American Heart Association. Circulation, 145(5), e153–e639. https://doi.org/10.1161/CIR.0000000000001052
Verdoia, M., Pergolini, P., Rolla, R., Ceccon, C., Caputo, M., Amaretti, G., Suryapranata, H., & De Luca, G. (2021). Use of metformin and platelet reactivity in diabetic patients treated with dual antiplatelet therapy. Experimental and Clinical Endocrinology & Diabetes, 129(1), 43–49. https://doi.org/10.1055/a-0787-1382
Vrigkou, E., Tsantes, A. E., Kopterides, P., Orfanos, S. E., Armaganidis, A., Maratou, E., Rapti, E., Pappas, A., Tsantes, A. G., & Tsangaris, I. (2020). Coagulation profiles of pulmonary arterial hypertension patients, assessed by non-conventional hemostatic tests and markers of platelet activation and endothelial dysfunction. Diagnostics, 10(10), 758-765. https://doi.org/10.3390/diagnostics10100758
Wang, Y., & Liang, X. (2020). Correlation analysis of four blood coagulation items with blood lipids and blood glucose in stroke patients with type 2 diabetes. OAlib, 07(4), 1–5. https://doi.org/10.4236/oalib.1107042
Witkowski, M., Friebel, J., Tabaraie, T., Grabitz, S., Dörner, A., Taghipour, L., Jakobs, K., Stratmann, B., Tschoepe, D., & Landmesser, U. (2021). Metformin is associated with reduced tissue factor procoagulant activity in patients with poorly controlled diabetes. Cardiovascular Drugs and Therapy, 35(5), 809–813. https://doi.org/10.1007/s10557-020-07040-7
Witkowski, M., Saffarzadeh, M., Friebel, J., Tabaraie, T., Ta Bao, L., Chakraborty, A., Dörner, A., Stratmann, B., & Tschoepe, D. (2020). Vascular miR-181b controls tissue factor-dependent thrombogenicity and inflammation in type 2 diabetes. Cardiovascular Diabetology, 19(1), 20-26. https://doi.org/10.1186/s12933-020-0993-z
Yi, M., Cruz Cisneros, L., Cho, E. J., Alexander, M., Kimelman, F. A., Swentek, L., Ferrey, A., Tantisattamo, E., & Ichii, H. (2024). Nrf2 pathway and oxidative stress as a common target for treatment of diabetes and its comorbidities. International Journal of Molecular Sciences, 25(2), 821. https://doi.org/10.3390/ijms25020821
Zhang, C., Ou, Q., Gu, Y., Cheng, G., Du, R., Yuan, L., Cordiner, R. L., Kang, D., Zhang, J., & Huang, Q. (2020). Circulating tissue factor-positive procoagulant microparticles in patients with type 1 diabetes. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 12, 2819–2828. https://doi.org/10.2147/DMSO.S225761
View Dimensions
View Altmetric
Save
Citation
View
Share