1NTERRLAT1ON BETWEEN FREE RADICAL REACTIONS, ENDOTHELIAL INJURY, AND HYPERCOAGULABELITY IN THE DEVELOPMENT OF CORONARYHEARTDISEASEIN NIDDM:ROLEOFVITAMIN E.
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A comparative study of some risk factors for coronary heart disease (CHD) was performed in 80 patients (43 males and 37 females) with noninsulin diabetes mellitus (NIDDM) with good glycemic control. They were divided into 48 diabetics without CHD and 32 diabetics with CHD. The two diabetic groups were compared to each other and to a control group (n-30) of healthy, age and sex matched individuals. NIDDM patients with CHD had a longer duration of diabetes, a higher prevalence of microalbuminurea, ahigherLDL and a lower HDL cholesterol levels than patients without CHD. Serum levels of Malondialdchyde (MDA), a major breakdown product of lipid peroxides was significantly higher in diabeticpatientswithandwithoutCHIDas comparedto the control (p O.001), being higher in presence than in absence ofCHD(p <0.01). Plasma levels ofthrombomodulin(TM), amarker ofendothelial injury, were measured by ELISA and showed si^iificant elevation only in diabetics with CHD but not without and inmicroalbuminuricbutnot in nonalbuminuric patients as compared to the control group (P<0.0001 p< 0.05 respectively), plasma fibrinogen (FB) levels were significantly elevated in. both diabetic patients with (p<0.01) and without (p<0.001) CHD as compared to the control group, being higher in presence than in absence of CHD (P O.001)- A significant positive correlation was found betweenTMand FB levels (r= 0.26, p <0.05). Only diabetics with CHD showed significantly increased platelet aggregation response to ADP (5uM) as compared to the control group (p <0.05).Serum a tocopherol (vit.E) levelsweremeasured by HPLC and showed nonsignificant difference between diabetics and controlswhether in presence or absence of CHD (p> 0.05). They were positively correlated to the total cholesterol .