A STUDY OF SOME NONTRADITIONAL RISK FACTORS FOR THE DEVELOPMENT OF CORONARY HEART DISEASE IN PATIENTS WITH INSULIN DEPENDENT DIABETES MELLITUS
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Major risk factors explain much of the excess risk for coronary heart disease produced by dintiPtes, but nontraditional factors may also relarp to incident coronary heart disease. This study was conducted on 35 patients with 1DDM and coronary heart disease (CHD) (10 femrilPs and 25 males, aged 45-70 years), 35 patients with IDDM and without CHD (17 females and 18 males. aged 35-65 years) as well as 20 age and sex matched apparently healthy individuals as a control group. Every individual was subjected to clinical evaluation ncluding history taking and linical examination with special stress on the presence of risk factors as well as measurement of fasting and postprandial blood glucose levels. lipid profile, serum albumin level, glycosylated hemoglobin (HbA l c), C-reactive protein (CRP), fibrinogen level. von Wille and factor antigen level (vWF Ag), total leucocyte count and albumin excretion rate (AER) in wine. Insulin dependent diabetics with CHD had higher levels of total cholesterol. LDL-c and triglycerides and had lower levels of HDL-c when compared with diabetics without CHD and with controls. They also showed higher levels of fibrinogen. vWF Ag level, CRP and total leucocyte count and tower levels of serum albumin. Microalbumirturia was present in 71.4% of diabetics who developed CHD while it was present in 31.4% of diabetics without CHD. In diabetics with CHD, fibrinogen was correlated with vWF at r=0.52 and Pc 0.05. vWF Ag level is weakly correlated to lipid parameters, being significantly correlated to riglycerides. It was also positively correlated to AER (microalburninuria) (r=0.84, P< 0.003), while it was negatively correlated to sewn albumin (r = -0.4, P.< 0.05). In the type I diabetic group with CHI.) C-reactive protein correlated significantly with vWF (r=0.43, P< 0.005) and with fibrinogen (r=0.60. P< 0.001). In conrinsion levels of fibrinogen, von illebrand factor. CRP, albumin and leucocyte count were predictors of coronary heart disease among patients with IDDM. These associations may reflect the underlying inflammatory reaction or rnicrovascular injury related to therosclerosis and a tendency toward thrombosis.