Study of plasma fibrinogen level and its relation to glycemic control in type-2 diabetes mellitus patients attending diabetes clinic at a tertiary care teaching hospital in Madhya Pradesh, India

Abstract

INTRODUCTIONDiabetes mellitus comprises a group of common metabolic disorders that share the phenotype of hyperglycemia. The worldwide prevalence of diabetes mellitus has risen dramatically over the past two decades and the prevalence of type 2 diabetes mellitus is expected to rise more rapidly in future because of increasing obesity and reduced activity levels. 1 In the past decade, the potential role of hemostatic factors, particularly fibrinogen, in atherosclerosis and its complications has generated considerable attention. Studies have shown that formation of an occlusive thrombus, on a damaged atherosclerotic lesion is the most common precipitating factor of acute myocardial infarction. Evidence also suggests that fibrinogen has a role; both in the early stages of plaque formation and late complications of cardiovascular disease. The excess cardiovascular morbidity and mortality among diabetics have not been fully explained by major risk factors such as hypertension, cigarette smoking and hypercholesterolemia. Increased attention is being paid ABSTRACT Background: Diabetes mellitus comprises a group of common metabolic disorders where increased fibrinogen levels can act as a thrombogenic factor. Diabetic patients have higher cardiovascular morbidity than non-diabetic subjects. Several studies have shown that haemostatic factor especially hyperfibrinogenemia is implicated as a source of atherosclerosis and its complications. Methods: A comparative observational study was conducted to compare fibrinogen levels between type 2 diabetes patients and healthy controls. Their fibrinogen levels were compared and co-related with glycemic status and other risk factors and parameters like glycosylated haemoglobin, age, sex, smoking, body mass index (kg/m 2 ), hypertension and ischemic heart disease. Results: It was seen that in the diabetic subset, the plasma fibrinogen levels are significantly higher than the nondiabetic subset (386.04±132.87 vs. 314.38±97.42; p<0.001). Our study re-established correlation between HbA1c and fibrinogen levels of the diabetic patient is positive i.e., poorer the glycemic status, higher the fibrinogen levels (r=0.24). Conclusions: It can be concluded from the study that fibrinogen levels are in-creased in type 2 diabetic subjects with and without CHD. Plasma fibrinogen levels usually increased in type 2 diabetes, thus suggesting that hyperfibrinogenemia could contribute to the excess cardiovascular morbidity and mortality in this disease.

Study of Plasma Fibrinogen Levels in Acute Stroke

“…30 Also that plasma fibrinogen levels were significantly higher in diabetics than the non diabetic subset (386.04±132.87 vs. 314.38±97.42; p<0.001). 31 The exact mechanism of increased fibrinogen levels in diabetics is unknown. Insulin stimulates cholesterol synthesis in smooth muscle cells stimulates the proliferation and migration of smooth muscle cells.…”

Correlation of fibrinogen level with lipid profile in type 2 diabetes mellitus

“…[1][2][3][4] Increasing evidence from epidemiological studies suggest that elevated plasma fibrinogen levels are associated with an increased risk of cardiovascular disorders, especially in diabetic patients. 5,6 Impaired glucose tolerance exerts an influence by enhancing thrombogenic factors such as, fibrinogen in the diabetics. Fibrinogen, itself is determined by several modifiable and non-modifiable determinants like age, sex, smoking, body mass index (BMI), hypertension, alcoholism, glycemic control, lipid profile and urine albumin excretion rate.…”