Proinflammatory and prothrombotic state in subjects with different glucose tolerance status before cardiovascular
Irma Isordia-Salas1, María Eugenia Galván-Plata2, Alfredo Leaños-Miranda3
1Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, Apartado Postal B 32, Coahuila No. 5, 06703 México, DF, Mexico.
Background:
Inflammation has been associated with insulin resistance, type 2 diabetes mellitus (T2DM), and atherothrombosis.
Aim:
To determine differences in levels of proinflammatory and prothrombotic markers such as high sensitivity C-reactive protein (hs-CRP) and fibrinogen in subjects with normal glucose tolerance (NGT), prediabetes, and T2DM and to establish their relationship with other cardiovascular risk factors before clinical manifestations of cardiovascular disease.
Methods:
We conducted a nonrandomized, cross-sectional assay in a hospital at México City. The levels of hs-CRP and fibrinogen were measured and compared according to glucose tolerance status.
Results:
We enrolled 1047 individuals and they were distributed into NGT n = 473, pre-DM n = 250, and T2DM n = 216. There was a statistical difference between NGT and T2DM groups for fibrinogen (P = 0.01) and hs-CRP (P = 0.05). Fibrinogen and hs-CRP showed a significant positive correlation coefficient (r = 0.53, P<0.0001). In a multiple stepwise regression analysis, the variability in fibrinogen levels was explained by age, HbA1c, and hs-CRP (adjusted R² = 0.31, P<0.0001), and for hs-CRP it was explained by BMI and fibrinogen (adjusted R² = 0.33, P<0.0001).
Conclusion:
Inflammation and prothrombotic state are present in people with T2DM lacking cardiovascular disease. Fibrinogen and Hs-CRP are positively correlated. Fibrinogen and hs-CRP concentrations are predominantly determined by BMI rather than glucose levels.
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