CA Jayashankar¹, Henley Punnen Andrews², Vijayasarathi³, Venkata BharatKumar Pinnelli⁴, Basappaji Shashidharan¹, HN Nithin Kumar¹, Swaapnika Vemulapalli^1
1Department of General Medicine, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bangalore, Karnataka, India.
²Department of General Medicine, St John’s Hospital, Kattappana, Idukki, Kerala, India.
³Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bangalore, Karnataka, India.
⁴Department of Biochemistry, Vydehi Institute of Medical Sciences and Research Centre, Nallurhalli, Whitefield, Bangalore, Karnataka, India.
DOI: 10.4103/0976-9668.184703

ABSTRACT

Aim: We aimed to identify the predictors of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (type 2 DM). Methods: About fifty Asian Indian patients with type 2 DM patients aged >40 years and fifty sex- and age-matched nondiabetic controls were enrolled for this study. Following complete medical history and baseline clinical data, laboratory investigations were performed to assess fasting and postprandial plasma glucose levels, lipid profile, blood urea, serum creatinine, and serum uric acid levels. Results: Body mass index (BMI), waist-to-hip ratio, serum uric acid, serum total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, very LDL cholesterol were significantly higher among diabetic patients compared to controls. On univariate analysis, serum LDL cholesterol (odds ratio [OR]: 29.67, P < 0.001), serum uric acid (OR: 25.65, P < 0.001), low high-density lipoprotein (HDL) cholesterol (OR: 21.12, P < 0.001), hypertension (OR: 17.06, P < 0.001), family history of cardiovascular disease (CVD) (OR: 9.43, P = 0.002), and duration of diabetes (OR: 4.65, P = 0.03) were identified as predictors of CVD among diabetic patients. On multivariate regression, only LDL cholesterol (OR: 1.51, P = 0.002) and serum uric acid (OR: 1.21, P = 0.01) were the independent predictors of CAD among diabetic patients. Significant positive correlation of serum uric acid with duration of diabetes (r = 0.38, P = 0.006), BMI (r = 0.35, P = 0.01), triglycerides (r = 0.356, P = 0.01), LDL cholesterol (r = 0.38, P = 0.007), HDL cholesterol (r = −0.514, P < 0.001), and hypertension (r = 0.524, P < 0.001) was observed. Conclusion: Serum LDL cholesterol and hyperuricemia may serve as independent predictors of CAD among Asian Indian subjects with type 2 DM.

Keywords: Coronary artery disease, cardiovascular disease, hyperuricemia, low-density lipoprotein cholesterol, type 2 diabetes mellitus.