Correlation of Blood Inflammatory Markers to Ankle Brachial Index in Asymptomatic Atherosclerosis in Type 2 Diabetes Mellitus patients – A Cross Sectional Study

Abstract

Background and objectives ABSTRACT Atherosclerosis remains the major cause of death and premature disability worldwide. Diabetes mellitus is a major risk factor for the evolution of atherosclerosis. The objective of the present study was to compare the efficacy of blood inflammatory markers, hs-CRP and fibrinogen with ABI in detecting asymptomatic atherosclerosis in type 2 DM patients. Methodology The present One year cross sectional study was conducted in Department of Medicine, Jawaharlal Nehru Medical College, Belgaum on 38 patients with T2 DM, attending KLES Dr. Prabhakar Kore Hospital and Medical Research Centre during the period between January 2009 and December 2009. Investigations such as FBS, serum hs-CRP, serum fibrinogen, lipid profile, HbA1c were done. ABI was determined as the ratio of ankle systolic blood pressure to the brachial systolic blood pressure, with both determined using a hand held Doppler. Results In this study, 29 patients ( 76.32% ) were males whereas 9 patients ( 23.68% ) were females. Majority of the patients ( 34.21% ) were between 35 and 50 years of age and were diabetic for a period of less than 5 years ( 63.16% ) . The HbA1c levels were between 6.4 to 7.5 gm% in 57.89% patients and 28.95% had hs CRP levels above 12 mg/L. The fibrinogen levels in 42.11% patients were between 401 to 600 mg/dL. The sensitivity of hs-CRP and fibrinogen in detecting asymptomatic atherosclerosis was 0.88 and 0.73 respectively whereas their NPV V was 0.86 and 0.63 respectively. Comparison of the sensitivities of hs-CRP, fibrinogen, LDL, non-HDL and total cholesterol to HDL ratio showed hs-CRP had the best sensitivity ( 88% ) towards detecting asymptomatic atherosclerosis followed by non-HDL. Interpretation and conclusion This study found a statistically significant difference between the sensitivities of hs-CRP and fibrinogen in detecting asymptomatic atherosclerosis. ( p=0.017) .