Assessment of cardiac biochemical markers cystatin C and lipoprotein(a) and their relationship with glycemic control in type 2 diabetes mellitus patients

Abstract

Introduction: Type 2 diabetes mellitus, is one of the predominant health emergencies of this century. Cardiovascular diseases are associated with raised morbidity and mortality in diabetes, contributing to substantial share of community health expenditure. This study was taken up to determine level of cardiac biomarkers cystatin C (CysC) and lipoprotein(a) (Lp(a)) & their association with glycemic control & lipid profile parameters to assess cardiovascular risk profile in type 2 diabetes mellitus. Materials and methods: This study included 100 type 2 diabetes mellitus patients and 100 apparently healthy controls. Diabetic patients were categorised as good glycemic control (50) - HbA1c ≤ 7.5% and poor glycemic control (50) - HbA1c > 7.5% groups. Biochemical parameters CysC, Lp(a), HbA1c and lipid profile were analysed in all participants. Results: Lp(a) and CysC were significantly increased in diabetic patients than in controls. CysC, total cholesterol (TC), low density lipoprotein (LDL), TC/HDL, LDL/ high density lipoprotein (HDL) ratio were significantly increased and HDL was decreased in poor glycemic control group than good glycemic control. CysC correlated positively with HbA1c, Lp(a), TC and LDL while negatively with HDL which was statistically significant. Correlation observed between Lp(a) and HbA1c was not significant. Conclusion: Our study denotes increased cardiovascular disease risk in diabetic patients particularly in those with poor glycemic control. Evaluation of CysC and Lp(a) together, would ameliorate cardiovascular disease (CVD) risk prediction and facilitate appropriate interventions. This study aids in stratification of high-risk diabetic persons for cardiovascular diseases at early asymptomatic phases which will prevent or delay disease advancement and improve clinical outcomes in diabetic patients.