D-dimer identifies stages in the progression of diabetes mellitus from family history of diabetes to cardiovascular complications

Pathology. 2007 Apr;39(2):252-7. doi: 10.1080/00313020701230658.


Aim: The aim of the study was to ascertain whether there is variation in the fibrinolytic/coagulation component of diabetes associated with disease progression to macrovascular complications and whether D-dimer can discriminate such variation.

Methods: A total of 343 participants were selected based on clinical status and divided into 7 groups: control, family history of diabetes, pre-diabetes with/without CVD, diabetes with/without CVD and CVD only. Plasma D-dimer was tested. Statistical analysis was performed on log normalised data by ANOVA, Fisher's LSD post hoc test. After the initial analysis, data were classified and re-analysed by quartiles, interquartile range and 95(th) percentile.

Results: An overall significant difference between groups (p<0.002) and a steady rise in D-dimer levels that became increasingly higher than control as the disease progressed from pre-diabetes to cardiovascular complications was observed. A statistically significant difference was observed between control versus diabetes (p<0.0005). Analysis of data by quartiles and percentiles gave qualitatively similar results, but a greater significant difference between control versus pre-diabetes at 3rd quartile and interquartile range (p<0.014).

Conclusion: We report changes in D-dimer levels that may indicate diabetes disease progression to macrovascular complications. Using D-dimer in conjunction with other biomarkers to identify stages of disease progression, commencing from pre-diabetes and continuing to development of asymptomatic and clinical cardiovascular disease in diabetes mellitus, is worthy of consideration.

MeSH terms

  • Biomarkers / blood
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / complications*
  • Diabetes Complications / blood*
  • Diabetes Mellitus / blood*
  • Disease Progression
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Humans
  • Male


  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D