A Correlative Study of Metabolic Syndrome and Coronary Artery Disease among Type 2 Diabetics And Non-Diabetics

Vadivukkarasi, T (2007) A Correlative Study of Metabolic Syndrome and Coronary Artery Disease among Type 2 Diabetics And Non-Diabetics. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.

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Abstract

INTRODUCTION : Over the decades, there has been a phenomenal rise in the incidence of CAD in India. The quantum rise in the prevalence of CAD in urban-India is very likely due to changes in lifestyle and food habits. The twin epidemics of Diabetes mellitus and Heart disease are a major threat to the well being as well as the economic development of India. It is believed that a combination of factors, genetic and environmental including newer risk factors like the metabolic syndrome and hyper coagulability in addition to traditional risk factors like smoking, hypertension and hyper cholesterolemia is the culprit behind the explosive rise in the incidence of these diseases. WHO shows that India has 32 million diabetic subjects and this is projected to increase to 100 million by the year 2035. It is obvious that we need to put in place preventive measures. But before instituiting preventive measures we must know who is at risk for these diseases. Here comes Metabolic syndrome, a deadly combination of Hypertension, Diabetes mellitus, Dyslipidemia and abdominal obesity. The concept of the metabolic syndrome is perhaps the most significant development in the management of cardiovascular diseases in the last 10 years. AIMS AND OBJECTIVES : 1. To study the prevalence of metabolic syndrome among Type 2 Diabetics and Non-Diabetics. 2. To study the sex distribution and Age distribution in patients with metabolic syndrome among Type 2 Diabetics and Non-Diabetics. 3. To study the influence of metabolic syndrome on risk of CAD among Type 2 Diabetics and Non-Diabetics. 4. To study the risk of individual components of Metabolic syndrome on occurrence of CAD among Type 2 Diabetics and Non-Diabetics. 5. To study the influence of glycemic control in CAD among Type 2 Diabetics. MATERIALS AND METHODS : This study is an observational study conducted in a major public hospital from June 2004 to September 2006 and included total of 70 Diabetics and 50 Non-diabetics. The reference population is Tamil speaking population belonging to lower and low middle socio-economic status attending government hospitals. The experimental population were all > 40yrs and taken from Diabetic outpatients department, general OPD and general wards. Inclusion criteria : 1. Males and females >40 yrs attending OPD for other illness [for Non-Diabetic population], 2. Known Diabetics on treatment/not on treatment; Newly detected Diabetics according to American Diabetes Association guidelines. Exclusion criteria : 1. Smokers, alcoholics, 2. Age <40 yrs, 3. Type1 Diabetics, 4. Diseases that affect lipid profile like hypothyroidsm, cushing’s syndrome, chronic Renal failure, Nephrotic syndrome, and those with TGL levels >350 mg /dl, 5. Family history of premature CAD [< 45 years in first degree male relatives and < 55 years in female relatives], 6. Patients with Valvular heart disease, primary cardiomyopathies, 7. Pregnant ladies and those who are on oral contraceptives, 8. Those who are on Drugs affecting lipid profile (Thiazides and Metformin and Tniazolidinediones β-blockers, statins, Nicotinic acid, fibric acid derivatives). CONCLUSIONS : 1. (a) The prevalence of metabolic syndrome among Type 2 Diabetics in our study is 70%. (b) The prevalence of metabolic syndrome among non-Diabetics is 30%. 2. There was no significant difference found in prevalence of metabolic syndrome in males and females among both Diabetics and non-Diabetics. 3. There was a clear increase in prevalence of metabolic syndrome found with increasing age in both the study population. 4. No statistically significant association between glycaemic control and CAD occurrence. 5. A Statistically significant association was found between MS and CAD among Diabetics and Non-Diabetics. 6. Among all the components of Metabolic syndrome low HDL was found to be the strong predictor of CAD in both the study population. Thus it is concluded that: 1. Presence of metabolic syndrome influences risk of CAD among both Diabetics and Non-diabetics. 2. HDL can be used as a surrogate marker for CAD occurrence among diabetics and general population.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Metabolic Syndrome ; Coronary Artery Disease ; Type 2 Diabetics ; Non-Diabetics ; Correlative Study.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 16 Feb 2018 16:01
Last Modified: 16 Feb 2018 16:01
URI: http://repository-tnmgrmu.ac.in/id/eprint/5765

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