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The complex of activated protein C and Protein C inhibitor (APC-PCI)
in diabetics treated with atorvastatin.

C. Kluft, CJM van Leuven, P. Meijer, MA van de Ree, HMG. Princen, MV.Huisman on Behalf of the Dali-study
Good Biomarker Sciences,. Department of General Internal Medicine, Leiden University Medical Centre, TNO-Quality of
Life, Leiden, The Netherlands.


b) Atorvastatin effect on APC-PCI and s-TM
In steady state, the complex of activated protein C and Protein C inhibitor (APC-PCI) is considered to reflect the formation of activated protein C. We studied whether or not APC-PCI is related to diabetic or inflammation markers of the liver and endothelium and to fibrinolysis variables. In addition the effect of atorvastatin treatment was Figure 2A,B: % Changes in APC-PCI (A) and s-TM (B) for 3 dose groups: placebo, 10 and 80 mg atorvastatin A total of 24 type II diabetics (m/v 50/50) without manifest cardiovascular disease, mean age 59 y, mean Six month placebo, 10 or 80 mg atorvastatin BMI 31 were studied (DALI-study 1). APC-PCI was resulted in median changes in APC-PCI of +3%; -9% measured by EIA (Bioporto Diagnostics, Sweden). (n.s) and -12% (p= 0.012, Wilcoxon signed ranks Results
s-TM changed: -4.05% ; +2.3 (p=0.01) and + 5.2 % a) Baseline metabolic correlations for APC-PCI
APC-PCI is normally distributed: Mean (SD) 0.63 c) Further haemostatic changes.
No correlation with: • age and gender (σ²<6%) • lipids (LDL; HDL; TG; FFA; apoA , B ; σ²<6%) • endothelial markers: s-VCAM, s-selectin, vWF, Negative correlation with fibrinogen: Figure 3A,B. Associations between changes in s-TM,
APC-PCI, d-dimer 1, and PAI-1 1 analysed by
association (figA: σ²) and factor analysis (fig B).
The data in figure 3 indicate that associations between
changes follow two mechanisms.
Figure 3 suggests that the changes follow the model: Figure 1: pre-treatment fibrinogen vs APC-PCI The negative correlation with fibrinogen is supported by negative trends for IL-6 and SAA (σ²>10%). This collectively indicates reduced thrombin formation.
decreased thrombin formation. Increase in s-TM • By another mechanism fibrinolysis is enhanced.

It is suggested that reduced coagulation and increased fibrinolysis collectively associate with the reduced Szczeklik et al. JACC 33(1999) 1286 and Dangas et al. AJC 84(1999) 639 venous thrombosis rate under statin treatment Lind et al. Arch Intern Med 169 (2009) 1210.


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SUSANE - Sustainable, sanitary and efficient management of animal manure for plant nutrition Impact of medicated feed on the development of antimicrobial resistant bacteria in integrated pig-fish farms in Vietnam. 1. Introduction Use of animal manure as fertilizer of aquaculture ponds is practiced widely in Southeast Asia. Pigs are raised in houses on the edge of ponds and

Microsoft word - cdc key points_may 5 2009.doc

Novel H1N1 Flu Updated Key Points May 5, 2009: 11:00 a.m. Situation Update CDC is reporting 403 laboratory confirmed human infections with novel H1N1 flu in 38 states in the United States. CDC will be verbally reporting probable cases at the daily telebriefings. This virus is spreading from person-to-person without regard for borders, race or ethnicity. However, children have been more likely t

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