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Associations between Inflammation, Hemoglobin Levels, and Coronary Artery Disease in Non-Albuminuric Subjects with

Javier Donate-Correa1,2,3,4, Ernesto Martín-Núñez1,2, Carmen Mora-Fernández1,2,4

  • 1Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria (HUNSC), 38000 Santa Cruz de Tenerife, Spain.

International Journal of Molecular Sciences
|September 28, 2023
PubMed

Insights

Reduced hemoglobin levels, not inflammation, are linked to coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) patients with normal kidney function. Lower hemoglobin indicates higher CAD risk in T2DM individuals with normoalbuminuria.

Area of Science:

  • Cardiology
  • Endocrinology
  • Nephrology

Background:

  • Coronary artery disease (CAD) is a major complication of type 2 diabetes mellitus (T2DM).
  • Inflammation and hemoglobin levels are potential risk factors for CAD.
  • Kidney function, assessed by glomerular filtration rate (GFR) and albuminuria, plays a role in cardiovascular health.

Purpose of the Study:

  • To investigate the association of inflammation and hemoglobin levels with CAD severity in T2DM patients with preserved kidney function.
  • To compare these associations in T2DM patients versus non-diabetic individuals.

Main Methods:

  • Cross-sectional study of 638 participants, including 254 with T2DM, undergoing coronary angiography.
  • Measurement of hemoglobin, high-sensitivity C-reactive protein (hs-CRP), and other inflammatory markers.
  • Multivariable analyses to assess relationships between markers, CAD severity, and T2DM status, adjusting for confounding factors.

Main Results:

  • Inflammatory markers were not associated with stenosis severity in T2DM patients.
  • Albuminuria and inflammatory cytokines correlated with stenosis severity in non-T2DM subjects.
  • T2DM patients exhibited lower hemoglobin levels, especially those with significant CAD (p=0.03).
  • Hemoglobin levels and albuminuria were inversely related to stenosis severity exclusively in T2DM patients (R²=0.081, p<0.001).

Conclusions:

  • Reduced hemoglobin levels, rather than inflammation, appear to be a more significant risk factor for CAD in T2DM patients with normoalbuminuria.
  • These findings highlight the importance of monitoring hemoglobin in T2DM patients for cardiovascular risk assessment.

Keywords:
albuminuriacardiovascular riskcoronary artery diseasediabetes mellitushemoglobininflammation

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