The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Association of Fibrinogen with Glycemic Control and Albumin Excretion Rate in Patients with Non-Insulin-Dependent Diabetes Mellitus

Graziella Bruno, MD; Paolo Cavallo-Perin, MD; Giuseppe Bargero, MD; Milena Borra, MD; Nicola D'Errico, MD; and Gianfranco Pagano, MD
[+] Article, Author, and Disclosure Information

From University of Torino, Torino, Italy; and Santo Spirito Hospital, Casale Monferrato, Italy. Grant Support: In part by a grant from Ministero della Universita' e della Ricerca Scientifica e Tecnologica (MURST), Italy. Acknowledgments: The authors thank A. Caramellino, MD, A. Rosso, MD, I. Camona, RN, A. Raimondi, RN, and G. Comoglio, RN, for their collaboration. The authors also thank the members of the Casale Monferrato General Practitioners Study Group, all of whom are from Casale Monferatto, Alessandria, Italy: A. Alesso, A. Angelini, M. Annarotone, C. Arena, F. Aviotti, A. Bagna, L. Balbo, G. Barigazzi, F. Barone, G. Battezzati, R. Bedon, M. Bertiglia, G. Bertinetti, P.L. Bigliati, G. Bocchino, F. Boero, F. Botto, U. Bozzelli, M. Busca, E. Cabiati, A. Calcagno, R. Caprioglio, G. Caprino, B. Carelli, G. Casalino, G. Casalone. G. Castelli, G. Coggiola, G.F. Coppo, N. Corda, P.M. Croce, G. Croppi, G. Crosio, M. Dealessi, N. Del Boca, P. Demarchi, P. Deregibus, M. Fasano, L. Formaggio, N. Forno, F. Gabba, M. Gallesi, D. Gavazza, G. Giorcelli, B. Giordano, C. Grangiotti, P. Graziano, R. Guaschino, F. Iacometti, G.P. Irico, P.L. Lavagno, L. Lavazza, P. Lavazza, M. L. Liverani, F.P. Longo, D. Maggi, N. Maltoni, L. Martinelli, M. Mazzucco, G. Mortara, M.L. Mosso, L. Musso, G. Negri, A. Oglietti, P. Ollandini, F. Ombra, E. Orcesi, V. Ottavis, S. Ottolenghi, A. Panattoni, F. Papili, V. Pasolini, R. Patrucco, G. Perani, G.D. Picasso, P.G. Pisano, L. Poy, P. Poncina, P.L. Porta, L. Ramezzana, C. Rendo, D. Robotti, L. Rondano, F. Rossi, G. Rosso, C. Spatazza, E. Spinoglio, F. Tedesco, E. Tosco, M. Tribocco, G. Trinchero, G. Vallaro, G. Varaldo, C. Verrua, G. Verrua, C. Zanello, G. Zavattaro, and M. Zola. Requests for Reprints: Graziella Bruno, MD, Dipartimento di Medicina Interna, corso Dogliotti 14, I-10126 Torino, Italy. Current Author Addresses: Drs. Bruno, Cavallo-Perin, Borra, D'Errico, and Pagano: Dipartimento di Medicina Interna, corso Dogliotti 14, I-10126 Torino, Italy.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1996;125(8):653-657. doi:10.7326/0003-4819-125-8-199610150-00005
Text Size: A A A

Background: The high prevalence of classic cardiac risk factors in patients with non–insulin-dependent diabetes mellitus does not explain the increased cardiovascular-related morbidity and mortality in these patients. Fibrinogen may have a role in this excess risk.

Objective: To evaluate the following in patients with non–insulin-dependent diabetes mellitus: 1) the distribution of plasma fibrinogen levels and the prevalence of hyperfibrinogenemia and 2) the association of fibrinogen level with hemoglobin A1c value and albumin excretion rate.

Design: Cross-sectional study of a population-based cohort.

Setting: Rural area in northern Italy.

Patients: 1574 patients with non–insulin-dependent diabetes mellitus who represented 81% of the initial cohort of 1967 patients.

Measurements: Albumin excretion rate was measured in urine samples obtained during an overnight collection. Venous blood samples were collected while patients fasted.

Results: Fibrinogen levels were available for 1525 of the 1574 patients who were examined (669 men and 856 women). The mean age (±SD) was 67.3 ± 10.3 years for men and 70.7 ± 10.7 years for women. The mean plasma fibrinogen level (±SD) was 3.6 ± 0.9 g/L; levels slightly differed between men and women. In 50.3% of patients, plasma fibrinogen level exceeded 3.5 g/L. In men, fibrinogen level increased with age (P < 0.001). In both men and women, fibrinogen level adjusted for age and sex was significantly and linearly related to hemoglobin A1c value (P < 0.001) and albumin excretion rate (P < 0.001). In a multiple regression analysis, hemoglobin A1c value (b = 0.06; P < 0.001) and albumin excretion rate (b = 0.09; P = 0.005) were associated with fibrinogen level independent of other cardiovascular risk factors (sex, age, hypertensive status, total cholesterol level, smoking habit, and body mass index).

Conclusions: Patients with non–insulin-dependent diabetes mellitus had a high prevalence of hyperfibrinogenemia. Fibrinogen level was independently associated with hemoglobin A1c value and albumin excretion rate, which suggests that fibrinogen may be involved in the increased cardiovascular risk of patients with diabetes mellitus.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.