Abstract: Objective To explore the effects of fracture on the activity of blood coagulation in patients with type 2 diabetes mellitus and the relationship between fracture and thrombotic diseases. Methods A total of 90 patients with type 2 diabetes mellitus and lower limb fracture (diabetic and fracture group), 90 patients with type 2 diabetes (diabeticgroup) and 90 healthy controls with comparable of sex, age and body mass index (control group) were recruited. The contents or activity of plasma fibrinogen (Fib), D-dimer (D-dimer), von willebrand factor (vWF), platelet membrane glycoprotein 140 (GMP-140), prothrombin fragment 1+2 (F1+2), thrombin activation of fibrinolysis inhibitor(TAFI) and tissue factor pathway inhibitor (TFPI), were compared. Results In the diabetic and facture group, the values of Fib, D-dimer, vWF, GMP-140, F1+2 and TAFI were (5.3±1.4) g/L, (1 350.1±88.3) ng/mL, (161.9±6.6) IU/dL, (21.8±2.5) μg/L, (1.6±0.5) nmol/L and (30.5±3.8) μg/mL, respectively. In the diabetic group, the values were (4.1±1.2) g/L, (880.5±35.6) ng/mL, (123.6±5.5) IU/dL, (18.9±2.3) μg/L, (1.3±0.3) nmol/L, (28.3±2.9) μg/mL, respectively. In the control group, the values were (2.5±0.6) g/L, (145.7±22.5) ng/mL, (96.8±4.5) IU/dL, (13.8±2.1) μg/L, (0.8±0.2) nmol/L, (26.4±2.5) μg/mL, respectively. The values of the former two groups were significantly higher than those of the control group, and the values of the diabetic and fracture group were higher compared to those of the diabetic group (F=141.70, 10 396.17, 3 072.95, 277.67, 116.05, 277.67, P<0.001). The plasma TFPI activity of the former two groups was lower than that of the control group (16.2±1.3, 17.3±2.1, 18.5±2.7, U/mL). And it was the lowest in the diabetic and fracture group (F=26.68, P<0.001). Conclusion Fractures can lead to blood clotting activity and high coagulation state in diabetic patients, thus such patients are prone to thromboembolic disorders.

Key words: Type 2 diabetic patients, Low extremity fractures, Coagulation molecular markers, Thrombosis