Clinical correlates of thrombodynamics in men with metabolic syndrome: the impact of insulin resistance
Background. Hypercoagulation is one of the cardiovascular risk factors in patients with metabolic syndrome (MS). It results from various factors including hyperhomocysteinemia, endothelial dysfunction, non-enzymatic glycation of proteins etc. The aim of this study was to assess clinical correlates of thrombodynamics in insulin resistant and non insulin resistant men with metabolic syndrome. Methods. We investigated 79 patients with MS diagnosed in accordance with IDF criteria (2009). The main group consisted of 44 men with MS including insulin resistance. The control group consisted of 35 men with MS not including insulin resistance. In addition to routine clinical tests we performed thrombodynamics assay and measured serum levels of asymmetric dimethylarginine (ADMA) and homocysteine. Mann-Whitney U-test and Spearmen’s correlation coefficient (rs) were used for statistical analysis. Results. There was no significant difference between thrombodynamics parameters, ADMA and homocysteine levels between the two groups. In both groups thrombodynamics parameters had no correlations with body mass index, hemoglobin level, platelet count and serum ADMA level. In patients with insulin resistance clot density correlated positively with serum level of C-reactive protein (rs=0.621, p=0.007); average and initial rates of clot growth correlated positively with homocysteine level (rs=0.539, p=0.017, and rs=0.554, p=0.014, respectively). In patients with insulin resistance clot density and rates of clot growth were not interrelated with the above mentioned parameters. Conclusions. The results of the study suggest that insulin resistant men with MS are characterized by clinical correlates between thrombodynamics parameters, homocysteine and C-reactive protein levels while patients without insulin resistance have other, unestablished determinants of clot density and rates of clot growth.