Activators and inhibitors of the fibrinolytic system in maturity-onset diabetes mellitus without thromboembolic manifestations

In patients with maturity-onset diabetes mellitus without thromboembolic manifestations, significant increases in both fibrinolytic and antifibrinolytic activity were demonstrated. The increased fibrinolytic activity observed under basal conditions could be due to the continuous release of plasminogen activators from damaged endothelial cells. This hypothesis is supported by the fact that the higher fibrinolytic activity observed in diabetics is followed by a lesser increase in fibrinolytic activity than in controls after the venous occlusion test. The main antiplasmins, except α₂-antiplasmin, were significantly higher in diabetics, and their levels were not affected by sex, metabolic regulation, retinopathy, duration of the disease or cholesterolemia. On the contrary, weight, therapy and triglyceridemia significantly influenced the levels of some anti-plasmins. Furthermore, hypertriglyceridemia and hypercholesterolemia were associated with a reduction of fibrinolysis. Thus, these conditions may further increase the risk of thromboembolic complications of diabetes mellitus.