title: Glycemic control in type 2 diabetes mellitus prevents coronary arterial wall infection.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a very well-known risk factor for development of atherosclerosis, and it has been hypothesized that poor glycemic control and hyperglycemia plays a major role in this process. In the current study, we aimed to evaluate the associates of poor glycemic control in Iranian patients who have already undergone coronary artery bypass grafting (CABG), with especial focus on the inhabitation of infectious agents within the coronary arterial wall.
  
  
  METHODS
  In January 2010, 52 consecutive patients with type 2 DM who undergone CABG at the Department of Cardiovascular Surgery of Baqiyatallah University of Medical Sciences (Tehran, Iran) were included into this cross-sectional study and biopsy specimens from their coronary plaques were taken and analyzed by polymerase chain reaction (PCR) methods for detecting Helicobacter species, cytomegalovirus (CMV) and Chlamydia pneumoniae, and their potential relation to the glycemic control status in these patients.
  
  
  RESULTS
  Compared to that in diabetic patients with mean fasting blood sugar (FBS) levels FBS < 126, atherosclerotic lesions in type 2 diabetic patients with poor glycemic control (FBS > 126) were significantly more likely to be positive for CMV PCR test (41% vs. 9%, respectively; P = 0.05). In laboratorial test results, mean triglyceride level was significantly higher among patients of poor glycemic control (168 ± 89 vs. 222 ± 125 mg/dl, respectively; P = 0.033). Hypertension was also significantly more prevalent in this population (73% vs. 36%, respectively; P = 0.034).
  
  
  CONCLUSIONS
  Type 2 diabetic patients with poor glycemic control can be at higher risk for developing CMV infection in their coronary arterial wall, which can promote atherosclerosis formation process in this patient population. According to the findings of this study, we recommend better control of serum glucose levels in type 2 diabetic patients to prevent formation/progression of atherosclerosis.
authors.affiliation: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Izadi
authors.affiliation: International Travel Medicine Center of Iran, Tehran, Iran.
authors.forename: Mojgan
authors.initials: M
authors.lastname: Fazel
authors.affiliation: Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Karbasi-Afshar
authors.affiliation: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Hassan
authors.initials: SH
authors.lastname: Saadat
authors.affiliation: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Hassan
authors.initials: MH
authors.lastname: Nasseri
authors.affiliation: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Nematollah
authors.initials: N
authors.lastname: Jonaidi-Jafari
authors.affiliation: Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Ranjbar
authors.affiliation: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Kazemi-Saleh
keywords: Coronary Artery; Cytomegalovirus; Diabetes Mellitus; Hyperglycemia; Infection