Work

Association of fibrinogen αE, fibrinogen γ', and sialylated fibrinogen with development of ischemic stroke in patients with recently diagnosed type 2 diabetes

Year: 2025

Type: article

Abstract: Background Stroke is a major cause of death globally, especially in type 2 diabetes (T2D) patients. Fibrinogen is known to predict stroke risk, but fibrinogen is a highly variable protein and we hypothesized that fibrinogen variants can improve stroke prediction. Objectives To investigate the association of total fibrinogen and fibrinogen variants with risk of ischemic stroke in T2D patients. Methods In a nested case-control study with a median follow-up of 4.1 years, we included 144 T2D patients with ischemic stroke (cases) and 144 matched T2D patients without ischemic stroke (controls). We measured total fibrinogen, absolute and relative (ratio between variant and total fibrinogen) levels of three fibrinogen variants (fibrinogen α E , fibrinogen γ′, and sialylated fibrinogen) and compared levels between cases and controls. We used logistic regression to determine the association with stroke risk. Results Total fibrinogen and absolute levels of fibrinogen α E , fibrinogen γ′, and sialylated fibrinogen were higher in stroke cases than controls (total fibrinogen 3.55 and 3.44 g/l; fibrinogen α E : 8.95 and 8.55 µg/ml; fibrinogen γ′: 638 and 626 µg/ml; sialylated fibrinogen: 1.32 and 1.18 arbitrary units). Absolute levels of fibrinogen positively associated with risk of stroke, both for total fibrinogen (highest vs lowest tertile; adjusted odds ratio (OR) 1.9 (95% CI 0.9-4.2)), fibrinogen γ′ (OR 1.8 (0.8-3.8)), and sialylated fibrinogen (OR 2.5 (1.1-5.8)). Relative levels of fibrinogen variants did not convincingly associate with stroke risk. Conclusion Patients with T2D who developed stroke had increased levels of total fibrinogen, fibrinogen α E , fibrinogen γ′, and sialylated fibrinogen compared with T2D controls. Total fibrinogen and absolute, but not relative, levels of fibrinogen γ′ and sialylated fibrinogen prospectively associated with a 2-fold increased risk of ischemic stroke.

Source: Journal of Thrombosis and Haemostasis

DOI: 10.1016/j.jtha.2025.03.023