Association between Serum Fibrinogen Level in Type-2 Diabetes Mellitus Patient with or without Microvascular Complication

BackgroundVarious studies have shown that Hemostatic disturbance, including high fibrinogen levels, are associated with coronary heart disease in patients with diabetes. However relation between fibrinogen level and microangiopathic complications is not clear. So we choose this sudy. Aims and objectives-To correlate the association of serum fibrinogen level with different clinical parameters and complication of diabetes. To correlate the level of serum fibrinogen with glycemic control (HbA1C).To correlate the association of serum fibrinogen level with duration of Diabetes mellitus. To correlate the association of serum fibrinogen level with different biochemical parameters. To compare the serum fibrinogen level in patient of type-2 DM with oral hypoglycemic agent and insulin therapy. Material and methods – All the patients were diagnosed case of Type 2 diabetes mellitus patient or newly detected Type 2 diabetes mellitus patient with or without microvascular complications (age group 25-85 yrs either sex) which admitted J.A. Group of Hospitals Gwalior M.P. and who attend Medicine OPD were included. Total no. of 88 patients were selected randomly divided in three groups. Group A – (n=34) type-2 diabetes mellitus with microvascular complication, Group B– (n= 26 type-2 diabetes mellitus without microvascular complication, Group C(n=28) non diabetic healthy control. Results Maximum number of patients in study were between 40-60 yrs age group. Mean age was 53±13, 48±15 and 49±12 among group A, B and C.M:F ratio was almost equal in all three group was 2.9:2, 3.2:2 & 2.7:2 in group A,B & C respectively. Most common presenting symptom was tingling & numbness (41.17%) followed by polyuria (38.23%) and blurring of vision (29.41%) in group A patient while polyuria (29.92%) was presenting symptom of group B. Most common microvascular complication found was nephropathy followed by retinopathy and neuropathy in type-2 DM patient. Mean duration of diabetes was 5.5±3.14 yrs and 2.8±1.8 yrs among group A and B respectively. Micro vascular complication (nephropathy, retinopathy & neuropathy) increased with duration of diabetes. Serum fibrinogen level was found higher in Type-2 DM patient with microvascular complication as compared to non diabetic control (515±138.7, 308.53±52.65 p value <0.003).Type-2 DM without microvascular complication group patients also had higher fibrinogen level in comprasion of non diabetic control (437±137, 308.53±52.65 p value-0.002).Serum fibrinogen level was more elevated in type-2 DM patients with microvascular complication groups as compared to patients without microvasuclar complication (515±138.7 vs 437±137, p value 0.02).No statistically significant positive correlation was found between serum fibrinogen and age, gender and duration of diabetes.. Serum fibrinogen level was higher in overweight (23-27.49) patients as compared to the normal patient (18.5-22.94) in all groups. A positive correlation was seen with BMI. Serum fibrinogen level was linearly related to urine albumin excretion rate (p <0.001). A significant positive correlation was observed between hyperfibrinogenemia and hypercholesterolemia (p value <0.01) but did not found any correlation with LDL, HDL and TG. Glycosylated hemoglobin (HbA1c) was positively correlated with fibrinogen level. A majority of type-2 DM patients had poor diabetic control and had high fasting and post prandial blood sugar. No significant linear relationship was seen between serum fibrinogen and FBS & PPBS. Serum fibrinogen level was higher in patient who taking insulin. ConclusionOn the basis of observations of present study its concluded that Serum fibrinogen level was found to be higher in Type-2 diabetic patients as compared to non diabetic controls and further increase in patients who having microvascular complication.