The effect of acute submaximal exercise on fibrinolytic and coagulation systems in diabetic patients

Alterations in coagulation and fibrinolytic system increase the risk of cardiovascular morbidity and mortality in diabetic patients. We studied the effect of acute submaximal exercise on fibrinolysis parameters in Type 2 diabetes patients regarding few studies in literature about exercise and diabetes.MATERIAL AND METHODS:15 type 2 diabetic and 12 healthy male non-smoking, sedentary patients whose ages between 30 and 60 were included in the study. All the type 2 diabetic patients had BMI<30, HbA1C<8, normal tyroid function tests, liver function tests and renal function tests. All the patients were taking oral antidiabetic drugs. Type 2 diabetic patient group and control group had similar body fat proportion, body mass index, waist-hip proportion. All participants initially attented to a maximal exercise test in a walking splint in order to find out the anaerobic thresold value. Blood lactate levels were measured from fingertips by 3 minutes intervals and O2 consumptions were calculated with mask to detect the density of exercise in which the anaerobic thresold value were achieved. After 3-7 days from the exercise, 30 minute submaximal exercise test in walking splint was applied at threshold value. CBC, PT, APTT, INR, D-dimer, Fibrinogen, PAI-1ag and activity, TAFI ag and activity levels were measured before exercise, immediately after exercise and an hour later than exercise.RESULTSPAI antigen levels after acute submaximal exercise decreased significantly in control group during exercise (p.0,041) however increased significantly during rest (p.0,010). In patient group the PAI-1 antigenic response was obtuse and unsignificant minimal increment was detected (p.0,125). The PAI-1 activity in both groups was not significantly changed.TAFI antigenic levels increased in both groups markedly in patient group however they weren?t statistically significant. TAFI activity significantly decreased during exercise in the control group (p.0,005). On the other hand in diabetic group it didn?t change during exercise and significantly increased in rest (p.0,031).DISCUSSIONAlterations in fibrinolytic parameters in diabetic patients during exercise shows a different model from the healthy control group. The undecreased or not normalized PAI-1 and TAFI ag and activity in diabetic patients can indicate that the fibrinolytic activity during submaximal exercise test is reduced.