[Prevalence of non-conventional cardiovascular risk factors in Tunisian diabetics]

The cardiovascular risk appears very early in the history of diabetes mellitus and is related not only to hyperglycemia but mainly to the other risk factors associated to diabetes mellitus.

To evaluate the prevalence of non-conventional cardiovascular risk factors in a Tunisian diabetic population.

The prospective study enrolled 120 type 2 diabetic patients recently diagnosed and 60 healthy people, sex and age matched. All have benefited from blood sampling in order to analyze biological parameters routinely undertaken in diabetes. Non-conventional cardiovascular risk factors were also determined such as: microalbuminuria of 24 hours, high sensitivity C-reactive protein (hs CRP), homocysteinemia, vitamin B12, folate and insulinemia. The participants have also benefited from abdominal echography to search nonalcoholic hepatic steatosis.

Diabetics were aged 51.4 ± 8.9 years in comparison with healthy people (50.1 ± 6.39 years). A positive microalbuminuria was observed in 27.5% of diabetics versus 6.9% in healthy people (OR=5.1; P=0.001). The two third of diabetics had metabolic syndrome versus 25% of healthy people (OR=6.0; P<0.001) and insulinoresistance evaluated by HOMA-IR, was 3.4 ± 0.2 in diabetics versus 2 ± 0.1 in healthy people; P<0.001. HsCRP level was significantly higher in diabetics in comparison with healthy people (3.7 ± 0.2mg/L versus 1.9 ± 0.3mg/L; P<0.001) and hyperhomocysteinemia was more frequently found in diabetics. Also, we noted that 69.6% of patients had hepatic steatosis versus only 24.6% of healthy people (OR=7.1; P<0.001).

The non-conventional cardiovascular risk factors were more frequently found in early diagnosed type 2 diabetic patients than in healthy people. These non-conventional factors could be helpful in stratification of the cardiovascular risk level and also in the screening of ischemic heart diseases.