title: Glycaemic indices and non-traditional biochemical cardiovascular disease markers in a diabetic population in Nigeria.
abstract: OBJECTIVE
  To determine the frequency of hyperfibrinogenaemia, elevated C-reactive protein, hyperuricaemia and elevated lipoprotein A in a clinic population of patients with type 2 Diabetes mellitus (DM) compared with healthy controls; and determine the interrelationship between fasting plasma glucose levels and indices of long-term glycaemic control (fructosamine and glycosylated haemoglobin) in DM.
  
  
  METHODS
  Cross-sectional, analytical study.
  
  
  METHODS
  The study was conducted at the Lagos State University Teaching Hospital, Ikeja, from April to June 2009.
  
  
  METHODS
  A total of 200 patients with type 2 DM and 100 age and gender matched healthy controls were recruited for the study. Glycaemic control was assessed using fasting blood glucose, fructosamine and glycosylated haemoglobin levels. The non-traditional risk factors studied included C-reactive protein (CRP), Lipoprotein a (Lpa), serum uric acid (SUA), microalbuminuria and fibrinogen. Mann-whitney, chi-square and Pearson's correlation tests were used for analysis as applicable.
  
  
  RESULTS
  Hyperfibrinoginaemia, elevated CRP, LPa, microalbuminuria and hyperuricaemia were present in 3.5%, 65%, 12%, 6% and 57% respectively in type 2 DM. The mean levels of these CV risk factors were significantly higher in subjects with type 2 DM than that of the control subject. There was a positive and significant correlation between HbA1c and FBS (r=0.46, p=0.0001) and HbA1c and fructosamine (r=0.49, p=0.0001). All studied CVS risk factors were related to indices of glycaemic control which were found to be interrelated. Fasting blood glucose significantly correlated with both HbA1c and fructosamine but HbA1c showed better correlation to FPG than fructosamine (r=0.51 vs. 0.32).
  
  
  CONCLUSIONS
  Glycosylated haemoglobin and fasting plasma glucose but not fructosamine are significantly associated with microalbuminuria, fibrinogen SUA and CRP in type 2 DM. HbA1c was found to be better than fructosamine in monitoring overall long-term glycaemic control.
authors.affiliation: Department of Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. oogbera@yahoo.co.uk
authors.forename: Okeoghene Anthonia
authors.initials: OA
authors.lastname: Ogbera
authors.forename: Ogbera Anthonia
authors.initials: OA
authors.lastname: Okeoghene
authors.forename: Alfred
authors.initials: A
authors.lastname: Azenabor
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000473:pathology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000473:pathology; D005260:Female; D015241:Fibrinogens, Abnormal / Q000032:analysis*; D019270:Fructosamine / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D018570:Risk Assessment; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014527:Uric Acid / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D002097:C-Reactive Protein; D015241:Fibrinogens, Abnormal; D019270:Fructosamine; D006442:Glycated Hemoglobin; D017270:Lipoprotein(a); D014527:Uric Acid