Affiliation:
1. Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife
Abstract
Abstract
Aims
This study aimed to evaluate the clinical significance of inflammation and hemoglobin in relation to the risk of coronary artery disease in subjects with type 2 diabetes mellitus (T2DM) and preserved kidney function.
Methods
In this cross-sectional study, we recruited 638 participants − 254 with T2DM- with no known cardiovascular disease, normal glomerular filtration rates and without albuminuria that were subjected to coronary angiography. Hemoglobin and serum levels of inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF) α and interleukin (IL) 6, were measured.
Results
Patients with diabetes and significant CAD presented increased levels of hs-CRP (46% increase, P = 0.02). However, neither the hs-CRP levels nor the cytokines were related to the severity of the stenosis in the group of subjects with diabetes in a multivariable analysis. Conversely, both inflammatory cytokines and albuminuria were directly related to the percentage of stenosis in subjects without T2DM (R2 = 0.038, P < 0.001). Patients with diabetes presented lower hemoglobin levels, particularly in those who also had significant CAD (14.4 [13.6–15.1] vs. 13.6 [12.2–14.8] g/dL, P = 0.03). Thus, subjects with diabetes and anemia presented increased coronary stenosis when compared with those without anemia (45% increase, P < 0.01). Similarly, hemoglobin levels and albuminuria were inversely related with the severity of stenosis exclusively in subjects with diabetes, even after adjusting for multiple confounding factors (R2 = 0.081, P < 0.001).
Conclusions
The results suggest that reductions in hemoglobin levels in subjects with T2DM and normoalbuminuria may constitute a more relevant risk factor for CAD than inflammation.
Publisher
Research Square Platform LLC