Proinflammatory and prothrombotic state in subjects with different glucose tolerance status before cardiovascular disease

Abstract

Background. Inflammation has been associated with insulin resistance, type 2 diabetes mellitus (T2DM), and atherothrombosis. Aim. 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). Conclusion. 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. © 2014 Irma Isordia-Salas et al.