Predictive factors of macroangiopathy in type 2 diabetic patients

Imen Sebai, Ibtissem Oueslati, Nadia Khessairi, Meriem Yazidi, Emna Talbi, Fatma Chaker Mélika Chihaoui Published in the journal : October 2019 Category : Diabétologie

Summary :

Cardiovascular complications are the first cause of mortality in patients with type 2 diabetes mellitus. The aim of our study was to determine the risk factors related to diabetic macroangiopathy. To meet this purpose, we conducted a cross-sectional study among 71 patients with type 2 diabetes mellitus. Patients were divided into two groups according to presence or absence of macroangiopathy. The examination included full medical histories, somatic examination and laboratory tests, in particular brain natriuretic peptide (BNP) measurements. The univariate analysis showed a significant association between macroangiopathy and male gender (p = 0.029), HbA1c > 9.5% (p = 0.008), a cumulative number of cardiovascular risk factors>5 (p <10-3), hypertension, presence of microangiopathy (p <10-3) and BNP plasmatic level > 24 pg/mL (p=0.007). In multivariate analysis, predictor factors were a cumulative cardiovascular risk factors > 5 (OR=13.9 [95%CI:1.4 -137.6], p = 0.024), presence of microangiopathy (OR=22 [95%CI: 2.2 - 215.4], p = 0.008) and HbA1c>9.5% (OR = 36.6 [95%CI:2.6 - 505]; p = 0.007). Thus, cardiovascular diseases were the consequence of the entanglement of traditional risk factors with the involvement of chronic hyperglycemia.

Key Words

Type 2 diabetes mellitus, cardiovascular disease, risk factors, HbA1c, hypertension

What is already known about the topic?

Cardiovascular diseases remain the leading cause of morbidity and mortality in patients with Type 2 diabetes mellitus. While the clustering of risk factors characterizing diabetic patients has been associated with increased cardiovascular risk, the involvement of chronic hyperglycemia in diabetic macroangiopathy is still controversial.

What does this article bring up for us?

This article demonstrates that the number of cardiovascular risk factors in Type 2 diabetic patients positively correlates with the risk of macroangiopathy. Moreover, regardless of its role in microangiopathy development, poor glycemic control was shown predictive of cardiovascular disease.