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Abstract
DM is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. Insulin resistance is directly involved in the pathogenesis of type 2 diabetes. The insulin resistance syndrome includes well-recognized cardiovascular risk factors such as low HDL levels, hypertension, hypertriglyceridemia, which is highly correlated with small dense LDL and increased plasminogen activator inhibitor-1 (PAI-1) levels, which is cardiovascular risk factor probably as it inhibits fibrinolysis. Impaired fibrinolysis is found in impaired glucose tolerance and type 2 diabetes, associated with components of the metabolic syndrome. There are no data concerning fibrinolysis in subjects with normal glucose tolerance that convert to diabetes. Therefore, the aim of work is to study the fibrinolytic activity, as measured by tPA activity and PAI-1 antigen as markers of endothelial dysfunction in normal and impaired glucose tolerance offspring of type 2 DM compared to subjects without family history of diabetes, firstly, to elucidate whether the increased prevalence of cardiovascular diseases present at the diagnosis of overt diabetes is related to clustering of cardiovascular risk factors including hypofibrinolysis in the prediabetic state, secondly, to find out any correlation of this fibrinolytic system to insulin resistance and glycemic state of those offspring.
One hundred and fifty subjects were included in this study, they were divided into two main groups;
group I: Included 50 apparently healthy subjects with no family history of diabetes mellitus, hypertension or obesity as control group.
group II: Included 100 non diabetic offspring of type 2 DM. They had +ve family history of diabetes mellitus. They were classified according to glucose tolerance test into: