Combined effects of type 2 diabetes mellitus and cigarette smoking increase the risk of cardiovascular complications

ABSTRACT

Premature atherosclerosis may result from conditions such as hypercholesterolaemia, diabetes, hypertension and cigarette smoking. Any of these four conditions alone or in combination, stimulates the atherosclerotic process through mechanisms associated with a state of increased vascular oxidative stress. In this study, we investigated the combined effect of type 2 diabetes [DM] and smoking on lipid peroxidation and total antioxidant status, the primary risk factors of atherosclerosis. A total of 85 subjects were included in this study. Out of these, 65 were patients who attended the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders [BIRDEM] for regular medical check up and 20 were healthy non-smoker volunteers. To investigate the effect of smoking and DM on the risk factors of cardiovascular complications, we divided the study subjects into three groups. Group I consists of healthy non-smoker control subjects, group II was diabetic patients but non-smoker and group III was diabetic and smoker. In group III, the proatherogenic lipid profile [total cholesterol, triglycerides, and LDL cholesterol] increased with a decrease in HDL cholesterol compared to control groups. Thiobarbituric acid reactive substance [TBARS] and lipid hydroperoxide [LHP] increased in group III a sign indicative of increased lipid oxidation. Total antioxidant status [TAS] and antioxidant vitamin [vitamin-C] were significantly lower in group III [p<0.001] compared to other groups