Dizdarevic-Bostandic Amela, Burekovic Azra, Velija-Asimi Zelija, Godinjak Amina
Clinic for endocrinology, diabetes and metabolic diseases, Clinical center of Sarajevo University, Sarajevo, B&H.
Med Arch. 2013;67(3):160-1. doi: 10.5455/medarh.2013.67.160-161.
The accumulation of macrophages what happens in atherosclerotic process is associated with increased concentration of fibrinogen and CRP (C-reactive protein), and these two markers of inflammation are considered early signs of atherosclerosis.
The aim of the study was to compare levels of inflammatory markers (CRP and fibrinogen) and HbAlc as a parameter of quarterly blood glucose control in patients with both diabetes mellitus type 1 and hypothyroidism who have ischemic heart disease with the patients with same autoimmune diseases, but without ischemic heart disease.
This prospective study included 30 patients who were all diagnosed with both hypothyroidism and diabetes mellitus type 1. Patients were divided into two groups according to the persistence of ischemic hearth disease. The first group (I) included patients with previously diagnosed ischemic heart disease (N = 12), and second group( II) was without ischemic heart disease (N = 18). CRP, fibrinogen and HbA1c as a parameter of quarterly glycemic control were measured in all patients.
CRP level in group I was higher than in group II, and the difference between groups is statistically significant (t = -4125, p = 0.0001). Fibrinogen level was also significantly higher in first group (t = -4.7; p = 0.0001). Both, CRP and fibrinogen levels were in two groups above the upper reference values. The average value of HbAlc as a parameter of quarterly glycemic control in both groups showed bad controlled diabetes mellitus, 8.77% (+/- 1.89) vs. 8.16% (+/- 1.71), but among the groups there were not statistically significant differences (t = -0.921 p = 0.365).
Patients with both type 1 diabetes mellitus and hypothyroidism who have ischemic heart disease had significantly higher levels of inflammatory markers: CRP and fibrinogen, than patients with the same diseases who did not have coronary heart disease, while HbAlc as a parameter of quarterly blood glucose control did not differ between groups, but in both groups showed values that corresponded to poor disease control. While future medical research has not reached full answers to the atherosclerotic process, seems reasonable therapeutic affect all identified biochemical markers associated with this process. Key
动脉粥样硬化过程中巨噬细胞的积累与纤维蛋白原和CRP(C反应蛋白)浓度升高有关,这两种炎症标志物被认为是动脉粥样硬化的早期迹象。
本研究的目的是比较1型糖尿病和甲状腺功能减退且患有缺血性心脏病的患者与患有相同自身免疫性疾病但无缺血性心脏病的患者的炎症标志物(CRP和纤维蛋白原)水平以及作为季度血糖控制参数的糖化血红蛋白(HbAlc)水平。
这项前瞻性研究纳入了30名均被诊断为甲状腺功能减退和1型糖尿病的患者。根据是否存在缺血性心脏病将患者分为两组。第一组(I组)包括先前诊断为缺血性心脏病的患者(N = 12),第二组(II组)无缺血性心脏病(N = 18)。对所有患者测量CRP、纤维蛋白原和作为季度血糖控制参数的HbA1c。
I组的CRP水平高于II组,两组之间的差异具有统计学意义(t = -4.125,p = 0.0001)。第一组的纤维蛋白原水平也显著更高(t = -4.7;p = 0.0001)。两组的CRP和纤维蛋白原水平均高于参考上限值。作为季度血糖控制参数的HbA1c平均值在两组中均显示糖尿病控制不佳,分别为8.77%(±1.89)和8.16%(±1.71),但两组之间无统计学显著差异(t = -0.921,p = 0.365)。
患有缺血性心脏病的1型糖尿病和甲状腺功能减退患者的炎症标志物CRP和纤维蛋白原水平显著高于患有相同疾病但无冠心病的患者,而作为季度血糖控制参数的HbA1c在两组之间无差异,但两组均显示出与疾病控制不佳相符的值。虽然未来医学研究尚未完全解答动脉粥样硬化过程,但对所有与该过程相关的已识别生化标志物进行治疗似乎是合理的。关键