Type2 diabetes mellitus
Background
Type2 diabetes mellitus
is one of the most common chronic diseases worldwide affecting nearly 200
million people, and is the fourth or fifth leading cause of death in the
developed world. Coronary artery disease (CAD)
represents a wide spectrum from angina pectoris, myocardial infarction and
sudden death to silent myocardial ischemia. Coronary artery disease has
been increased among Type II diabetes mellitus. The plasma
fibrinogen plays a vital role in coagulation cascade. Conversely, the increased
level of plasma fibrinogen and lipid abnormalities leads to coronary artery disease in type 2 diabetes
mellitus. Hence, the present study carried out the correlation of plasma
fibrinogen and serum lipid profile in non-diabetic subjects, type2 diabetic
without CAD and type2diabeticwith CAD patients.
Materials and Methods
A retrospective study
conducted in Sen Sok International University hospital, Phnom Penh, Cambodia,
from the period of August 2009 to December 2012. There were 100subjectsincluded
in this study were classified in to three groups of which 20healthy controls
(group I), 40 subjects (group II) were found to be type 2 diabetic without
coronary artery disease and 40 subjects (group III) were type 2 diabetic with
coronary artery disease. Coronary artery disease was diagnosed on the basis of
typical history of myocardial infarction, angioplasty, and coronary artery
bypass grafting and angiographic documentation of stenosis. Age and gender wise distribution of study
subjects were determined. The clinical symptoms were documented and the ECG
report was collected from type 2 diabetic with coronary artery disease
patients. The plasma samples were collected for the estimation of fibrinogen
and glucose levels and the serum samples were obtained for lipid profile
estimation using fully automated coagulation and Biochemistry analyzers. The
statistical data were analyzed using students “t” test for continuous
variable and results were obtained in the form of p (probability) value using statistical
software SPSS-16.
Results
The
present study observed that there were43% of cases were male and 58% were
female subjects in Type II diabetes without CAD group and in Type II diabetes
with CAD the male and female subjects were equal percentage (50%).It was found that the age group between 46-55 male and
56-65 female, there were more (22.5% and 15%) cases than other age groups in Type
II diabetes without CAD patients. In Type II diabetes
with CAD group between 66-75 male and35-45 female age
groups, there were higher numbers(20% and 17.5%) of subjects had found than
other age groups. It was observed
100% of cases had pressure, heaviness, squeezing and burning, 95% had pain radiation of arms, shoulder
and neck and90% of cases had teeth interscapular, epigastric and choking symptoms.
The ECG results show ST segment depression among all male and female Type II
Diabetes with CAD patients. The mean plasma fibrinogen levels were
significantly elevated in Type 2diabetic with CAD and Type 2 diabetic without
CAD patients than non-diabetic (p<0.0001). Likewise plasma fibrinogen level
was significantly increased in group III than group II subjects. The increased
glucose (p<0.0001), serum total cholesterol (p<0.0001), triglycerides
(p<0.0001), LDL cholesterol (p<0.0001), VLDL cholesterol (p<0.0001)
and low HDL cholesterol (p<0.0001) levels were observed in group II and
Group III than group I. The difference between group II and group III were
significant (p<0.0001) in the parameters including glucose, serum total
cholesterol, triglycerides, VLDL and HDL cholesterol. There was no significant
difference of LDL cholesterol levels (P = 0.0029) observed between group II and
group III patients.
Conclusion
In
conclusion the overall female Type II diabetes mellitus subjects are higher
number than male subjects. The male and female patients were equally affected by coronary artery disease during Type II
diabetes mellitus. The higher number of CAD cases observed age between 66-75 in
male and 35-45 in female patients. The ST segment depression was observed among
Type II diabetes mellitus with CAD patients. There was a significant elevation
of plasma fibrinogen and serum cholesterol, triglyceride, LDL and VLDL
cholesterol and lower HDL cholesterol levels were observed among Type II diabetes
mellitus with CAD patients than without CAD and control subjects. Plasma fibrinogen
was positively correlated with serum lipid profile in type2 diabetes with
coronary artery disease patients than without CAD in our study. Hence, the
plasma fibrinogen and serum lipid profile are better markers for coronary
artery disease in type 2 diabetes mellitus.
Key words: Fibrinogen, lipid
profile, Type 2 diabetes, Coronary
artery disease
