COMPARISON OF SERUM LIPOPROTEIN (A) LEVEL IN TYPE 2 DM AND NON-DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROME
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 29
Abstract
BACKGROUND Coronary artery disease has multifactorial origin including hereditary and acquired risk factors. Newer risk factors which are elevated in Indian population include Lp (a), CRP and homocysteine levels. Lipoprotein (a) levels are consistently elevated in Indian population compared to other ethnic groups. The aim of this study is to estimate lipoprotein (a) level in type 2 diabetic and non-diabetic patients with acute coronary syndrome and to correlate its levels with severity of ACS. MATERIALS AND METHODS The present study was a case control study, conducted at MBS Hospital, Kota. The sample size was 50 in each group. 50 patients were type 2 diabetics and 50 patients were non-diabetics. They were categorised as Unstable Angina, NSTEMI and STEMI groups. Lp(a)-C estimation was performed with EDC Helena electrophoretic analyser. Lp(a) was calculated from Lp(a)-C by multiplying with 3. RESULTS Lp(a) level was significantly higher in type 2 diabetics compared with non-diabetic group (15.15 ± 5.3 vs 11.93 ± 5.7, p < 0.02). More number of diabetics had Lp(a)-C level > 10 mg/dL than non-diabetic group. This difference was found to be significant (82% vs 38, p < 0.05). Lp(a)-C levels in all three subgroups of ACS (NSTEMI; 12.85 ± 4.57 vs 11.05 ± 5.3, STEMI; 16.61 ± 3.11 vs 11.21 ± 5.8, UA; 15.76 ± 7.39 vs 13.61 ± 6.2) were significantly more in diabetic group compared to non-diabetic group (p < 0.05). Further Lp(a)-C levels were more in STEMI group (p < 0.001) compared to NSTEMI (p < 0.030) and unstable angina group (p < 0.002). The diabetic group had a significantly higher BMI (27.37 ± 3.39 vs 22.90 ± 2.4, p<0.05) and Waist Circumference (97.14 ± 4.93 vs 92.28 ± 5.90, p < 0.04) as non-diabetic group, in which males had a significantly higher waist circumference compared to females (90.64 ± 5.20 vs 85.54 ± 3.55, p < 0.05). Cardiac biomarkers (CK-MB, 80.32 ± 57.55 vs 62.56 ± 44.81; Troponin T, 0.021 ± 0.020 vs 0.014 ± 0.0002, p < 0.05) and random blood sugar (180.04 ± 46.75 vs 119.84 ± 18.99, p < 0.05) were significantly higher in the diabetic as compared to non-diabetic group. CONCLUSION Type 2 diabetic patients had 2.15-fold higher chance of having Lp(a)-C > 10 mg/dL than non-diabetic individual. Lp(a) may contribute to the higher risk of having CAD in type 2 diabetics as compared to non-diabetics. Higher level of Lp(a) directly correlates with severity of myocardial injury
Authors and Affiliations
Subhash Chand Meena, Girish Chandra Verma, Meena C. P. , S. R. Meena, Abdul Wahid Qureshi, A. R. Pathan, Fazil Hussain
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