ELEVATED SERUM AND URINARY THROMBOMODULIN LEVELS IN PATIENTS WITH NON-INSULIN-DEPENDENT DIABETES-MELLITUS

Increased plasma levels of soluble thrombomodulin have been reported in several disorders as a marker for vascular endothelial damage. Serum and urinary thrombomodulin levels were measured in 79 patients with non-insulin-dependent diabetes mellitus. Both levels were significantly higher (23.5 +/- 6.1 ng/ml and 146.6 +/- 64.9 ng/ml, respectively) than those of normal healthy controls (18.8 +/- 3.1 ng/ml, P < 0.001, and 96.8 +/- 60.3 ng/ml, P < 0.01). Serum thrombomodulin levels increased in keeping with urinary albumin levels. In urine, thrombomodulin was lower in the macroalbuminuria group than in the microalbuminuria group, suggesting two mechanisms intravascular overproduction and impaired renal clearance. Both serum and urinary thrombomodulin levels in diabetic patients might be predictors for very early nephropathy.