Comparative Assessment of Serum Homocysteine and High Sensitivity C-reactive Protein in type 2 Diabetic and non Diabetic Patients with ACS
Keywords:Homocysteine (Hcy), high sensitivity C reactive protein (hs-CRP), type 2 Diabetes mellitus (T2DM), acute coronary syndrome (ACS).
Background: Increased level of serum homocysteine (Hcy) and high sensitivity C-reactive protein (hs-CRP) have a proven implication with epithelial injury leading to coronary artery disease ((CAD). These are strongly associated with different metabolic syndrome variables, although different studies have shown both positive and negative responses when correlated with type 2 diabetes malitus (T2DM). In this study we explored the role of these markers of CAD in type II diabetic and non diabetic patients with newly diagnosed acute coronary syndrome (ACS) at a tertiary care hospital among Bangladeshi population.
Methods: We wanted to identify whether Hcy and hs- CRP link positively or negatively with type 2 diabetes in this cross sectional observentional study. A total of 260 patients with new onset ACS were included in the study, out of which 72 patients with T2DM and 188 patients without diabetes were considered as group I and group II respectively. Clinical and biochemical data were compared in between the groups.
Results: The mean age of the study population was 50.33±15.50 years and 45.86±18.76 years in group I and II respectivly. Male female ratio was 4:1 among the whole study subjects. There was significantly higher level of serum homocysteine in group II than group I 18.41±15.49 μmol/L vs. 14.11±6.48 μmol/L respectively (p <0.05). Similarly hs-CRP in group I was 26.84±30.30 mg/L and in group II 37.48±37.99mg/L, higher in group II (p<0.05). Both Hcy and hs-CRP were higher in male and female patients in group II. Dyslipidaemia was significant risk factor in group I and smoking in group II (p<0.05).
Conclusion: In patients with ACS serum Hcy and hs-CRP were significantly higher in non-daibetic patients then in patients with type 2 diabetes. This association may be population or ethenicity specific which provide further scope for future elaborate studies.
Bangladesh Heart Journal 2020; 35(2) : 114-120
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