What question did this study set out to answer?

To determine whether acute elevations in blood glucose and insulin levels, either alone or combined, increase circulating tissue factor and promote blood clotting.

January 1, 2006Diabetes

Effects of Hyperglycemia and Hyperinsulinemia on Circulating Tissue Factor Procoagulant Activity and Platelet CD40 Ligand

Q: What is the clinical evidence from this study?

Study design: Other. Population: Healthy volunteers. Intervention: Combined hyperinsulinemia and hyperglycemia vs. Selective hyperinsulinemia or selective hyperglycemia. Primary outcome: Tissue factor procoagulant activity (PCA) (ninefold increase).

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Key result

Combined 24-hour insulin and glucose elevation produces a ~9-fold increase in tissue factor procoagulant activity.

ninefold increase

Why the study?

Does hyperinsulinemia and/or hyperglycemia increase circulating tissue factor procoagulant activity in healthy volunteers?

Population

healthy volunteers

Design

Other

Follow-up

24 h

Authors

VVVijender R. VaidyulaBridgewater College

Discussion

Member takes

Implication

May promote thrombosis in combined hyperinsulinemia and hyperglycemia; hypothesis-generating for cardiovascular risk in diabetes.

Key Points

To determine whether acute elevations in blood glucose and insulin levels, either alone or combined, increase circulating tissue factor and promote blood clotting.
Healthy volunteers were exposed for 24 hours to selective hyperinsulinemia, selective hyperglycemia, or combined hyperinsulinemia and hyperglycemia.
Assessed circulating tissue factor procoagulant activity, monocyte tissue factor expression via flow cytometry and RT-PCR, platelet CD40 ligand, and plasma coagulation markers.
Combined 24-hour hyperglycemia and hyperinsulinemia produced a ninefold increase in tissue factor procoagulant activity, alongside increased monocyte tissue factor mRNA and protein.
Combined elevations raised platelet CD40 ligand, thrombin-antithrombin complexes, prothrombin fragment 1.2, and factor VIII activity, while decreasing factor VII antigen and coagulant activity.
Selective hyperglycemia and hyperinsulinemia alone produced less pronounced increases in procoagulant factors, demonstrating an additive relationship when combined.

Structured PICO

Does hyperinsulinemia and/or hyperglycemia increase circulating tissue factor procoagulant activity in healthy volunteers?

Population

Healthy volunteers exposed to 24 hours of selective hyperinsulinemia, selective hyperglycemia, or combined hyperinsulinemia and hyperglycemia.

Intervention

24 h of selective hyperinsulinemia, selective hyperglycemia, or combined hyperinsulinemia and hyperglycemia

Outcome

changes in circulating tissue factor procoagulant activity (PCA) and other procoagulation proteinssurrogate

Main Result

Effect estimate: ninefold increase

Combined hyperinsulinemia and hyperglycemia create a prothrombotic state by significantly increasing tissue factor procoagulant activity.

Cite This Study

Vijender R. Vaidyula (2006) studied Healthy volunteers. Combined hyperinsulinemia and hyperglycemia vs. Selective hyperinsulinemia or selective hyperglycemia was evaluated on Tissue factor procoagulant activity (PCA) (ninefold increase). Combined elevations of plasma insulin and glucose levels for 24 hours produced a ninefold increase in tissue factor procoagulant activity in healthy volunteers.

synapsesocial.com/papers/6aa232d401abe00586efa43c https://doi.org/10.2337/diabetes.55.1.202

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Effects of Hyperglycemia and Hyperinsulinemia on Circulating Tissue Factor Procoagulant Activity and Platelet CD40 Ligand

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Cite This Study

Effects of Hyperglycemia and Hyperinsulinemia on Circulating Tissue Factor Procoagulant Activity and Platelet CD40 Ligand

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider