ABSTRACT
Background: One of the leading causes of diabetic mortality is cardiovascular disease. Diabetes progression is preceded by pre-diabetic phase which is also at higher cardiovascular risk. Both hyperglycemia and atherosclerotic processes are inflammatory phenomenon. Keeping this in view, it was aimed to evaluate atherogenic indices and correlate them with inflammatory mediators.Methods: This study included 80 controls, 80 pre-diabetic and 80 diabetic patients. Anthropometric parameters (BMI, WHR) and blood parameters like fasting glucose, HbA1c, lipid profile (cholesterol, HDL, LDL TG, VLDL), adiponectin, IL-6, CRP, fibrinogen and uric acid were analysed.Results: Significantly high atherogenic indices were observed in pre-diabetic and diabetic subjects compared to healthy controls. The indices were also significantly correlated with BMI, fasting sugar, HbA1c, cholesterol, HDL, TG and LDL. The correlation with HDL was negative and with other parameters, the correlation was positive. In pre-diabetic patients, adiponectin showed significant negative correlation while fibrinogen and CRP showed significant positive correlation with cardiac risk indices. IL-6 was positively correlated only with AIP while correlation of uric acid with these indices was insignificant. In case of diabetic patients, the cardiac risk indices were significantly correlated with adiponectin, IL-6, CRP, fibrinogen and uric acid. The correlation with adiponectin was negative.Conclusions: The altered atherogenic indices and their significant association with inflammatory markers signify the direct association of inflammation with CVD risks. Thus, there is requirement of novel approaches that can retard inflammatory responses and arrest unwanted cardiac health outcomes.
ABSTRACT
Diabetes is a metabolic disorder associated with chronic inflammation. It is preceded by pre-diabetic phase that is also influenced with the inflammatory mechanisms which finally culminate into diabetes and its associated complications. Thus the main objective of this study was to assess the level of inflammatory mediators in pre-diabetic and diabetic patients. Methods: This case control study was conducted with 100 controls, 145 pre-diabetic patients and 126 diabetic patients in Santosh medical College and Hospital, Ghaziabad. Serum routine parameters like fasting glucose, HbA1c, lipid and inflammatory mediators like adiponectin, fibrinogen, IL-6, CRP and uric acid were estimated using kit based methods. Results: We observed significantly low adiponectin and significantly high CRP, IL-6, fibrinogen and uric acid in pre-diabetic and diabetic patients compared to controls. The level showed gradual decrease from control-prediabetic-diabetic groups in case of adiponectin while the trend was increasing in case of CRP, IL-6, fibrinogen and uric acid. We also found significant negative correlation of adiponectin with CRP, IL-6, fibrinogen and uric acid in both the patient groups but the correlation with uric acid in pre-diabetic patients was insignificant. Conclusion: These results reveal the involvement of inflammatory mechanisms in progression from normoglycemia to impaired fasting glucose and finally to hyperglycemia. Therefore the development of mechanisms that aid in reducing pro-inflammatory and alleviating ntiinflammatory mediators may be fruitful in reducing diabetes risks.