Name: Nadmy Arrivabene Zavaris Gonçalves
Type: MSc dissertation
Publication date: 15/07/2014
Advisor:

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Daniela Amorim Melgaço Guimarães do Bem Advisor *

Examining board:

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Breno Valentim Nogueira Internal Examiner *
Daniela Amorim Melgaço Guimarães do Bem Advisor *
ISABELE BESERRA SANTOS GOMES External Examiner *

Summary: The study aims to characterize biochemically and hemostatic mellitos patients with diabetes mellitus type 2 (DM2) who developed insulin regimen. Composed group under analysis, 40 patients attended the Basic Health Unit of Consolation, Vitória / ES, aged 25 to 80 years, diagnosed with DM2 and that were already evoluted to insulinization. As controls, 40 patients were selected in the same age group without laboratory and / or clinical diagnosis of DM. Markers of inflammation, hypercoagulability and fibrinolysis were measured: Fibrinogen, D-dimer (D-Di) and plasminogen activator type 1 inhibitor (PAI-1). The polymorphism (-675 4G/5G) in the promoter region of the PAI-1 gene was correlated with their serum levels. Biochemical parameters were measured: plasma glucose (PG), glycated hemoglobin (A1C), total cholesterol (TC), HDL cholesterol (HDL-C), LDL (LDLc) cholesterol, triglycerides (TGC), ultrasensitive C reactive protein (hsCRP), urea and serum creatinine. There was still checking BMI, obesity, smoking, hypothyroidism, hypertension, dyslipidemia and insulin resistance. Statistical analysis showed significant differences (p <0.05) between groups with regard to mean values of HDL-C, VLDL-C, TGC, urea, hsCRP and fibrinogen. There was significant difference between groups for VLDLc, TGC, creatinine and fibrinogen. Controls present correlations between: fibrinogen and glucose, hsCRP and fibrinogen, PAI-1 and glucose, PAI-1 and BMI. In insulinization DM2 group correlation was observed correlation between: fibrinogen and D-di, hsCRP and fibrinogen, D-Di and glucose (negative), PAI-1 and triglycerides, PAI-1 and BMI. PAI-1 levels were higher in the control group in subjects with genotype 5G5G, 4G5G and 4G4G followed. Binary Logistic Regression confirmed that the variables hypertension and fibrinogen were significant at p-value (0.009) and (0.049) and adjusted odds ratio (4.184, 1.426 to 12.276) and (3.293, 1.006 to 10.775), respectively, showing that hypertensive patients have a risk 4.18 times more likely to have insulinization type 2 diabetes and that individuals with hyperfibrinogenemia have a 3.29 times greater risk. With this study we hope to contribute to better understanding of the complex changes that accompany the user insulinization type 2 diabetic patients in expectation of seeking appropriate treatment and prevention for the macrovascular complications of diabetes.

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