Calcified Coronary Lesions in Diabetes – Culmination of Dyslipidaemia and Inflammation
Objectives: Cardiovascular diseases are the major cause of mortality amongst diabetic patients. This study was conducted to compare anthropometric, haematological and lipid variables in diabetic and non-diabetic Indians. The presence of coronary calcifications on the angiogram was further associated with above variables.
Methods: Prospective study in 1000-bedded hospital in North-India, comprising 105 (30 diabetic, 75 non-diabetic) patients undergoing coronary angiography. Hypertension, smoking, alcohol intake, statin >6 months, previous MI were excluded. Lipid profile, HbA1c, BMI, waist-hip ratio, complete blood count, mean platelet volume (MPV), was measured. Continuous variables were correlated using correlation coefficients, and compared between diabetes and coronarycalcification groups, using a t-test. Chi-square-test used for associating diabetes with coronary calcifications.
Results: Triglyceride-HDLc-ratio, Neutrophil-Lymphocyte-Ratio, WHR and MPV most significantly differed between diabetics and non-diabetics (p<0.01) and correlated well with HbA1c (p<0.001).Total cholesterol and LDLc were not significant. Patients with coronary calcifications had higher neutrophil-lymphocyte-ratio (p<0.01), as compared to TLC (p<0.05). Diabetics were more likely to have coronary calcifications (p<0.05, OR3.25 95%CI 1.184-8.920).
Conclusion: Central obesity and dyslipidaemia contribute to chronic inflammation in diabetes with cardiac complications. Triglyceride-HDLc-ratio, Neutrophil-Lymphocyte-Ratio, and MPV are simple, inexpensive markers for dyslipidaemia and inflammation, assuming significance in low-resource settings.
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