Plasma Fibrinogen in Type 2 Diabetic Patients with Metabolic Syndrome and its Relation with Ischemic Heart Disease (IHD) and Retinopathy.
BACKGROUND
Metabolic syndrome or Syndrome X is characterized by hyperlipidemia, increased blood pressure, abdominal obesity and hyperglycemia, which increases the risk of cardiovascular complications. In addition to these, it is also associated with nontraditional risk factor like C- reactive protein, Plasminogen activator and fibrinogen. Various studies have documented association of these nontraditional risk factor, in Type 2 diabetes mellitus. Thus patients with diabetes mellitus are higher risk of developing micro and macro vascular complications like ischemic heart disease (IHD) and diabetic retinopathy. Diabetic retinopathy is the leading cause of decreased visual acuity, which is associated with maculopathy and profierative complications of it. Chronic hyperglycemia and its associated nonenzymatic glycation play an important role in the development of microangiopathy.


OBJECTIVE
To study the prevalence of the metabolic syndrome in type 2 diabetes mellitus. To study the plasma fibrinogen and its relationship with IHD and retinopathy in type 2 Diabetes mellitus patients with metabolic syndrome.


METHODS
Patients of type 2 diabetes Mellitus were recruited based on the inclusion and exclusion criteria. History of IHD and ECG evidence of ischemia was obtained. Retinopathy was diagnosed by direct opthalmoscopy. Fasting glucose, lipid profile and plasma fibrinogen were analyzed. Stastical analysis was carried by Chi square test and student't' test.


RESULTS
The prevalence of metabolic syndrome in study population of 100 type 2 diabetic patients is 58% and is significantly associated with duration of the disease (p<0.001). Fifty eight patients have hyperfibrinogenemia and mean fibrinogen level is significantly high in diabetic patients with metabolic syndrome when compared to diabetic patients without metabolic syndrome (p<0.001). Diabetic patient with metabolic syndrome and hyperfibrinogenemia have higher prevalence of IHD and retinopathy in comparison with diabetic patients without metabolic syndrome (p<0.05).


CONCLUSIONS
The prevalence of metabolic syndrome is higher in type 2 Diabetes mellitus patients. The combination of metabolic syndrome and hyperfibrinogenemia increases the risk of developing micro and macro vascular complications.
Associate Professor, Department of Neurology, M.S Ramaiah Medical College , Bangalore, India .
J V
JV
Mahendra
Associate Professor, Deparment of Biochemistry, ESIC Medical College , Gulbarga, India .
Satish D
SD
Kumar
Senior Resident, Deparment of Radio Diagnosis, Rajrajeshwari Medical College , Bangalore, India .
T S
TS
Anuradha
Assistant Professor, Deparment of Biochemistry, ESIC Medical College , Gulbarga, India .
Prashanth
P
Talikoti
Tutor, Deparment of Biochemistry, ESIC Medical College , Gulbarga, India .
R S
RS
Nagaraj
Associate Professor, Department of Neurology, M.S Ramaiah Medical College , Bangalore, India .
V
V
Vishali
Diabetes mellitus; Fibrinogen; Metabolic syndrome