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Cardiovascular morbidity and mortality are increased in non-insulin dependent diabetic patients, particularly if microalbuminuria or macroalbuminuria is present. A systemic endothelial dysfunction may be the pathogenic factor linking albuminuria to atherosclerosis in these patients, as originally suggested in insulin dependent patients. Previous studies have suggested that serum von Willebrand factor concentration is an indicator of generalised endothelial damage and contributes to platelet aggregation to the vascular endothelium, the first step in thrombosis. We evaluated the validity of this concept by measuring the serum concentrations of von Willebrand factor in non-insulin dependent diabetic patients with or without diabetic nephropathy.
Patients, methods, and results
We studied a prevalence cohort of white noninsulin dependent diabetic patients under 76. Patients were stratified into three groups: those with …