Proinflammatory and prothrombotic state in subjects with different glucose tolerance status before cardiovascular disease.
BACKGROUND
Inflammation has been associated with insulin resistance, type 2 diabetes mellitus (T2DM), and atherothrombosis.


OBJECTIVE
To determine differences in levels of proinflammatory and prothrombotic markers such as high sensitivity C-reactive protein (hs-CRP) and fibrinogen in subjects with normal glucose tolerance (NGT), prediabetes, and T2DM and to establish their relationship with other cardiovascular risk factors before clinical manifestations of cardiovascular disease.


METHODS
We conducted a nonrandomized, cross-sectional assay in a hospital at México City. The levels of hs-CRP and fibrinogen were measured and compared according to glucose tolerance status.


RESULTS
We enrolled 1047 individuals and they were distributed into NGT n = 473, pre-DM n = 250, and T2DM n = 216. There was a statistical difference between NGT and T2DM groups for fibrinogen (P = 0.01) and hs-CRP (P = 0.05). Fibrinogen and hs-CRP showed a significant positive correlation coefficient (r = 0.53, P<0.0001). In a multiple stepwise regression analysis, the variability in fibrinogen levels was explained by age, HbA1c, and hs-CRP (adjusted R² = 0.31, P<0.0001), and for hs-CRP it was explained by BMI and fibrinogen (adjusted R² = 0.33, P<0.0001).


CONCLUSIONS
Inflammation and prothrombotic state are present in people with T2DM lacking cardiovascular disease. Fibrinogen and Hs-CRP are positively correlated. Fibrinogen and hs-CRP concentrations are predominantly determined by BMI rather than glucose levels.
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, Apartado Postal B 32, Coahuila No. 5, 06703 México, DF, Mexico.
Irma
I
Isordia-Salas
Servicio de Medicina Interna, UMAE, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, 06720 México, DF, Mexico.
María Eugenia
ME
Galván-Plata
Unidad de Investigación Médica en Medicina Reproductiva, UMAE H.G.O. No. 4, Instituto Mexicano del Seguro Social, 01070 México, DF, Mexico.
Alfredo
A
Leaños-Miranda
Servicio de Medicina Interna, H.G.Z. A 2 "Francisco del Paso y Troncoso", del Instituto Mexicano del Seguro Social, 08400 México, DF, Mexico.
Eberth
E
Aguilar-Sosa
Servicio de Medicina Interna, H.G.R. No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 México, DF, Mexico.
Francisco
F
Anaya-Gómez
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, Apartado Postal B 32, Coahuila No. 5, 06703 México, DF, Mexico.
Abraham
A
Majluf-Cruz
Unidad de Investigación Médica en Trombosis, Hemostasia y Aterogénesis, H.G.R. No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, Apartado Postal B 32, Coahuila No. 5, 06703 México, DF, Mexico ; Servicio de Urgencias, H.G.R. No. 1 "Dr. Carlos Mac Gregor Sánchez Navarro" Instituto Mexicano del Seguro Social, 03100 México, DF, Mexico.
David
D
Santiago-Germán
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D042241:Early Diagnosis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D011236:Prediabetic State / Q000097:blood / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D012307:Risk Factors; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D014657:Vasculitis / Q000150:complications / Q000175:diagnosis / Q000209:etiology*
D015415:Biomarkers; D002097:C-Reactive Protein; D005340:Fibrinogen; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human