Vol 4, No 4 (2003): Practical Diabetology
Research paper
Published online: 2003-09-18
Fibrinogen as a coronary risk factor in patients with type 2 diabetes mellitus
Diabetologia Praktyczna 2003;4(4):265-272.
Abstract
INTRODUCTION. Epidemiological and clinical studies have demonstrated that
increased plasma fibrinogen concentration is an independent cardiovascular risk
factor. Patients with type 2 diabetes mellitus more frequently and earlier than
others develop atherosclerotic lesions and their clinical manifestations, including
coronary artery disease; mortality due to atherosclerotic complications is also
increased. Elevated fibrinogen with subsequent hypercoagulability and subclinical
inflammatory state may account for increased atherosclerotic risk in these patients.
Aim of the study. Evaluation of changes fibrinogen in patients with type 2 diabetes
mellitus and nondiabetics in relation to coronary artery disease, effect of metabolic
normalisation, sex, age, smoking, BMI and WHR on fibrinogen and assessment of
independent coronary risk factors in the two study groups.
MATERIAL AND METHODS. The study was conducted in 114 patients, including 61 with type 2 diabetes mellitus, aged 58.6 ± 7.8 years, 26 males and 35 females, and 53 patients aged 53.2 ± 8.6 years, 20 males and 33 females, without carbohydrate abnormalities. Clinical and biochemical parameters were analysed. Plasma fibrinogen was measured using the modified Clauss method (Fibrintimer, Behringwerke).
RESULTS. Fibrinogen concentration in patients with diabetes mellitus and coronary artery disease was significantly higher than in diabetics without coronary artery disease (3.05 ± 0.75 vs. 2.45 ± 0.85 g/ P < 0.01) and in diabetics irrespective of the presence of coronary artery disease (2.61 ± 0.66 and 2.30 ± 0.56 g/l; P < 0.01). Multiple regression analysis revealed that smoking (P < 0.001) and age (P < 0.05) independently modify fibrinogen concentration. Multiple regression analysis also revealed that independent risk factors associated with coronary artery disease in diabetics are microalbuminuria (P < 0.01) and fibrinogen (P < 0.05), whereas nondiabetics it is total cholesterol (P < 0.05).
CONCLUSIONS. In this study type 2 diabetics with coronary artery disease had significantly higher fibrinogen concentration. Fibrinogen concentration was independently modified by smoking and age. Independent risk factors associated with coronary artery disease in diabetics were microalbuminuria and fibrinogen, whereas in nondiabetics it was total cholesterol.
MATERIAL AND METHODS. The study was conducted in 114 patients, including 61 with type 2 diabetes mellitus, aged 58.6 ± 7.8 years, 26 males and 35 females, and 53 patients aged 53.2 ± 8.6 years, 20 males and 33 females, without carbohydrate abnormalities. Clinical and biochemical parameters were analysed. Plasma fibrinogen was measured using the modified Clauss method (Fibrintimer, Behringwerke).
RESULTS. Fibrinogen concentration in patients with diabetes mellitus and coronary artery disease was significantly higher than in diabetics without coronary artery disease (3.05 ± 0.75 vs. 2.45 ± 0.85 g/ P < 0.01) and in diabetics irrespective of the presence of coronary artery disease (2.61 ± 0.66 and 2.30 ± 0.56 g/l; P < 0.01). Multiple regression analysis revealed that smoking (P < 0.001) and age (P < 0.05) independently modify fibrinogen concentration. Multiple regression analysis also revealed that independent risk factors associated with coronary artery disease in diabetics are microalbuminuria (P < 0.01) and fibrinogen (P < 0.05), whereas nondiabetics it is total cholesterol (P < 0.05).
CONCLUSIONS. In this study type 2 diabetics with coronary artery disease had significantly higher fibrinogen concentration. Fibrinogen concentration was independently modified by smoking and age. Independent risk factors associated with coronary artery disease in diabetics were microalbuminuria and fibrinogen, whereas in nondiabetics it was total cholesterol.
Keywords: type 2 diabetes mellitusfibrinogencoronary heart disease