Alteration of plasma proteinase-antiproteinase system in type 1 diabetic patients. Influence of sex and relationship with metabolic control

Diabetes Res Clin Pract. 1992 Oct;18(1):35-42. doi: 10.1016/0168-8227(92)90053-t.


The aim of the present study was to investigate whether or not alterations of the plasma proteinase-antiproteinase system were present in type 1 (insulin-dependent) diabetic patients and, if so, whether or not they were related to sex, age at onset and duration of the disease as well as to short- and long-term diabetic control. The plasma concentration of trypsin-like activity and two of the most important plasma serine proteinase inhibitors, alpha 1-antitrypsin and alpha 2-macroglobulin, were determined in 95 type 1 diabetic and 67 control subjects. The plasma concentration of alpha 1 antitrypsin was found to be markedly decreased (P < 0.001), whereas plasma alpha 2-macroglobulin and trypsin-like activity were increased in diabetics compared to controls (P = 0.009 and < 0.001, respectively). Sex also influenced the values of both proteinase inhibitors in diabetics, women showing higher values of plasma alpha 1-antitrypsin (P = 0.004) than men. In women, HbA1c was also positively correlated with blood glucose (P < 0.001), daily insulin dosage (P < 0.001), and trypsin-like activity of plasma (P = 0.02). On the contrary, in men, HbA1c appeared to be negatively correlated with plasma alpha 2-macroglobulin (P = 0.02). In addition to sex, age at onset (but not duration) of the disease revealed differences in plasma alpha 1-antitrypsin among diabetics, the lowest mean value of this inhibitor being present in men with age at onset below 15 years, who also showed a significant negative correlation between this inhibitor and HbA1c (P = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / enzymology
  • Electrolytes / blood
  • Endopeptidases / blood*
  • Female
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Male
  • Protease Inhibitors / blood*
  • Reference Values
  • Sex Characteristics
  • Trypsin / blood*
  • alpha 1-Antitrypsin / analysis*
  • alpha-Macroglobulins / analysis*


  • Blood Glucose
  • Electrolytes
  • Glycated Hemoglobin A
  • Protease Inhibitors
  • alpha 1-Antitrypsin
  • alpha-Macroglobulins
  • Endopeptidases
  • Trypsin