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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/14489

Title: Evaluation of the levels and activities of protein c, protein s and antithrombin iii in well managed and poorly managed type 2 diabetes mellitus
Authors: Nsafoah, Frederick Obeng
Addai-Mensah, Otchere
Keywords: Protein C
Protein S
Antithrombin
Diabetes Mellitus
Issue Date: 22-Jul-2021
Abstract: Background: Type 2 Diabetes Mellitus (T2DM) patients are predisposed to several complications partly due to dysregulation of the haemostatic mechanisms. This study was conducted to evaluate the effect of poorly-managed T2DM on the levels and activities of protein C (PC), protein S (PS) and antithrombin III (AT III). Method: This cross-sectional study was conducted at the Diabetic clinic of the Cocoa Clinic, Kumasi, Ghana. A total of 242 T2DM patients, comprising 152 patients with poorly-managed diabetes mellitus and age- and sex-matched with 90 patients with well-managed diabetes, were recruited for the study. Fasting blood glucose, liver function tests (Albumin, Total Protein, Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, AST, ALT, ALP, and GGT) and lipid profile (Total Cholesterol, Triglyceride, HDL, LDL) was performed for each respondent. Glycated haemoglobin (HbA1c) was estimated by turbidimetric inhibition immunoassay. Levels and activities of PC, PS and AT III were measured by solid phase Sandwich ELISA method. Results: There was a negative correlation between HbA1c and the levels and activities of PC, PS and AT III. The levels and activities of PC, PS and AT III were significantly increased in patients with well-managed T2DM compared to patients with poorly-managed diabetes. Likewise, the levels and activities of PC, PS, and AT III were higher among T2DM patients using statins than patients who are statin-naïve. Furthermore, among patients with well-managed diabetes, those who were on statins had significantly higher levels and activities of PC, PS, and AT III compared to well-managed T2DM patients not on statins. Nonetheless there was no statistically significant differences between the level and activities of PC, PS, and AT III among patients with poorly-managed diabetes with respect to the use or non-use of statin. Conclusion: The levels of PC [5.78 ug/ml (4.26-7.19) vs 4.64 ug/ml (4.35-5.41) respectively, p<0.0001], PS [22.55 ug/ml (17.61-28.31) vs 20.29 ug/ml (16.72-21.23) respectively, p=0.010] and AT III [16.28 ug/ml (12.82-19.18) vs 14.41 ug/ml (11.75-15.44) respectively, p<0.0001] are significantly increases in well-managed T2DM compared to poorly-managed patients. The Activities of PC [42.22 U/ml (33.69-44.33) vs 36.21 (33.0-40.19) respectively, p=0.01], PS [235.94 U/ml (206.11-279.71) vs 211.67 U/ml (195.68-213.03) respectively, p<0.0001] and ATIII [176.01 U/ml (145.0-211.47) vs 160.09 U/ml (140.99-178.04) respectively, p=0.03] arev significantly increased in well-managed T2DM patients compared to poorly-managed patients. Use of statins enhances the levels and activities of PC, PS and AT III in T2DM, however, this association is limited in the face of poor diabetes management., Proper management of diabetes is thus essential to reduce the likelihood of thrombotic events among type 2 diabetic patients
Description: Thesis presented to the Department of Medical Diagnosis in partial fulfillment of the requirements for the Award of a Master of Philosophy Degree (Mphil) in Haematology. Kwame Nkrumah University of Science and Technology College of Health Sciences Faculty of Allied Health Sciences Department of Medical Diagnostics .April 2019
URI: http://hdl.handle.net/123456789/14489
Appears in Collections:College of Health Sciences

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