Evaluation of cardiac risk by oxidative stress and inflammatory markers in diabetic patients

ABSTRACT

To evaluate the diabetic patients for cardiac risk by measuring oxidative stress and inflammatory markers in relation with glycaemic control. A total of 140 subjects were included in this case-control study, comprising of 70 diabetic patients with coronary heart disease [CHD] and an equal number, age and sex matched controls. The patients were non-alcoholic and had age >40years, BMI < 30 kg/m2 and glycated hemoglobin [HbA1c] 7-10%. Serum total cholesterol [TC] and gamma glutamyltransferase [GGT] were analyzed on selectra-E auto analyzer. Serum nitrate was measured at 540nm on ELISA. HbA1c on was analyzed by using Human kit. Serum high sensitivity C-reactive protein [hS-CRP] was analyzed on immulite 1000. Patients mean age was 51 [range 40-73] years. Diabetic patients had significantly elevated median of HbA1c [7.9 vs 4.9], hS CRP [6.0 vs 2.12], TC [5.95 vs 4.45], nitrate [19.20vs 10.70] and GGT [29.50 vs 22.50] as compared to controls [p< 0.001]. HbA1c showed a positive correlation [p <0.001] with hS-CRP [r=0.49], TC [r=0.69], nitrate [r=0.41] and GGT [r=0.30]. Oxidative stress and inflammatory markers should be used in addition to HbA1c for assessment of increased cardiac risk in un-controlled diabetic patients because of accelerated atherosclerosis due to free radical injury