PREVALENCE OF DIABETES MELLITUS AMONG OBESE AND NON-OBESE PATIENTS WITH CORONARY ARTERY DISEASE
Abstract
Background: Globally, obesity is now recognised as an epidemic. The degree of obesity isproportional to the rate of development of cardiovascular diseases, hence, resulting in a dramaticincrease in morbidity and mortality. Apart from obesity, diabetes mellitus is another wellrecognised risk factor contributing to coronary artery disease. The precise prevalence of obesityrelated diabetes varies with age, race and gender; and is yet unknown in our population. Wetherefore, carried out this study with the aim to determine the prevalence of diabetes mellitus inobese and non-obese patients with diagnosed coronary artery disease. Methods: This hospitalbased cross-sectional comparative study was conducted in Cardiology Department of PostgraduateMedical Institute, Lady Reading Hospital, Peshawar, from 15th March 2005 to 30th May 2006. Atotal of 200 patients with diagnosed coronary artery disease were enrolled, 100 were classified asobese and 100 as non-obese. Results: Among these, 139 patients were male and 61 female. A totalof 88 were found to be diabetic, 54 of these were obese and 34 non-obese (p=0.004). Conclusion:Diabetes mellitus was significantly more frequent among obese patients with coronary arterydisease as compared to non obese patients with coronary artery disease.Keywords: Coronary Artery Disease, Body Mass Index, Obesity, Diabetes MellitusReferences
Abbas S, Abbas S, Riaz A, Malik N. Risk factors for CAD in
Pakistan. Pak Armed Forces Med J 2003;53:12–9.
Thomas F, Bean K, Pannier B, Oppert JM, Guize L, Benetos A.
Cardiovascular mortality in overweight subjects. The key role of
associated risk factors. Hypertension 2005;46:654–5.
Zahid A. General aspects of human obesity. J Pak Med Assoc
;53:564.
World Health Organization. WHO world wide health report:
Reducing risks promoting healthy life. Geneva: World Health
organization; 2002. viii.
World Health Organization. WHO Reports 2004, WHO global
NCD infobase [Online] 2004 [Cited on August 13, 2006].
Available from: http://www.who.int/ncd_surveillance/infobase
Dawber TR. The Fragmington study: the epidemiology of
Atherosclerotic disease. Cambridge: Harvard University press;
Liuzzo G, Biasucci LM, Gallimore JR, Grillo RL, Rebuzzi AG,
Pepys MB, et al. The prognostic value of C-reactive protein and
serum amyloid a protein in severe unstable angina. N Engl J Med
;331:417–24.
J Ayub Med Coll Abbottabad 2010;22(3)
http://www.ayubmed.edu.pk/JAMC/PAST/22-3/Sher.pdf 67
Danesh J, Collins R, Appleby P, Peto R. Association of
fibrinogen,C-reactive protein, albumin, or leukocyte count with
coronary heart disease: meta-analyses of prospective studies.
JAMA 1998;279:1477–82.
Mohamed-Ali V, Goodrick S, Rawesh A, Katz DR, Miles JM,
Yudkin JS, et al. Subcutaneous adipose tissue releases interleukin-
, but not tumor necrosis factor-alpha, in vivo. J Clin Endocrinol
Metab 1997;82:4196–4200.
Esposito K, Pontillo A, Ciotola M, Di Palo C, Grella E, Nicoletti
G, et al. Weight loss reduces interleukin-18 levels in obese
women. J Clin Endocrinol Metab 2002;87:3864–6.
Heinrich PC, Castell JV, Andus T. Interleukin-6 and the acute
phase response. Biochem J 1990;265:621– 36.
McLaughlin T, Abbasi F, Lamendola C, Liang L, Reaven G,
Schaaf P, et al. Differentiation between obesity and insulin
resistance in the association with C-reactive protein. Circulation
;106:2908–12.
Festa A, D’Agostino R Jr, Howard G, Mykkanen L, Tracy RP,
Haffner SM. Chronic subclinical inflammation as part of the
insulin resistance syndrome: the Insulin Resistance
Atherosclerosis Study (IRAS). Circulation 2000;102:42–7.
Kuller LH, Tracy RP, Shaten J, Meilahn EN. Relation of Creactive protein and coronary heart disease in the MRFIT nested
case-control study. Multiple Risk Factor Intervention Trial. Am J
Epidemiol 1996;144:537–47.
Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein
and other markers of inflammation in the prediction of
cardiovascular disease in women. N Engl J Med 2000;342:836–43.
Wise BC. The inflammatory syndrome: The role of adipose tissue
cytokine in metabolic disorders linked to obesity. J Am Soc
Nephrol 2004;15:2792–800.
Laaksonen DE, Lakka HM, Niskanen LK. Metabolic syndrome
and development of diabetes mellitus: application and validation
of recently suggested definitions of the metabolic syndrome in a
prospective cohort study. Am J Epidemiol 2002;156:1070–7.
Hanley AJ, Karter AJ, Festa A. Factor analysis of metabolic
syndrome using directly measured insulin sensitivity: the insulin
resistance atherosclerosis study. Diabetes 2002;51:2642–7.
Sjostrom CD,Peltonen M,Sjostrom L. Blood pressure and pulse
pressure during long term weight loss in obese: the Swedish obese
subjects (SOS) Intervention study.Obese Res 2001;9:188–95.
Basit A, Hakeem R, Hydrie MZ, Ahmedani MY, Masood Q.
Fatness, lipid, insulin sensitivity, life style of children from high
low risk families. J Ayub Med Coll 2003;15:6–9.
Nishtar S. Prevention of coronary artery diseases in South Asia.
Lancet 2002;360:1015–8.
Harris MI, Flegal KM, Cowie CC. Prevalence of diabetes,
impaired fasting glucose and impaired glucose tolerance in US
adults. The Third National Health and Nutrition Examination
Survey, 1988–1994. Diabetes Care 1988;21:518–23.
Hanson L. Primary prevention of coronary heart disease: what is
left to be done? Medicographia 1998;20:183–6.
Aziz-ur-Rahman, Sattar A, Abaidullah S, Hassan M. Evaluation
of cardiovascular risk factors in patient with essential
hypertension. Ann KE Med Coll 1999;5:134–7.
Ishaq M, Beg MS, Ansari SA, Hakeem A, Ali S. Coronary artery
disease risk profiles at a specialized tertiary care centre in
Pakistan. Pak J Cardiol 2003;14:61–8.
Maggioni AP, Franzosi MG, Santoro E, The risk of stroke in
patients with acute myocardial infarction after thrombolytic
therapy and anti thrombotic treatment: Gruppo Italiano per lo
studio della Superavvivenza nell ‘Infarcto Micocardico II (GISSI-
and the international study group. N Eng J Med 1992;327:1–6.
Tofler GH, Stone PH, Machure M. Analysis of possible triggers of
acute myocardial infarction (The MILLIS study). Am J Cardiol
;22:66–7.
The GUSTO investigator. An international randomised trial
comparing four thrombolytic strategies for acute myocardial
infarction. N Eng J Med 1993;329:673–82.
Postmenopusal hormone replacement therapy for the primary
prevention of chronic condition: recommendations and rationale,
US Preventive Services Task Force. Am Fam Physician
;67:358–64.
Khan H, Hafizullah M, Ihtesham-ul-Haq. A hospital based study
on frequency of risk factors of coronary artery disease in
Peshawar. J Postgrad Med Inst 2005;19:270–5.
Hubert HB, Feinleib M, McNamara PM, Castelli WP. Obesity as
an independent risk factor for cardiovascular disease: a 26-year
follow-up of participants in the Framingham Heart Study.
Circulation 1983;67:968–77.
Hassan M, Awan ZA, Gul AM, Sahibzada WA, Hafizullah M.
Prevalence of coronary artery disease in rural areas of Peshawar.
J Postgrad Med Inst 2005;19:14–22.
Chaudhary GM. Metabolic syndrome X in diabetic patients,
Experience in 3275 diabetic patients at Jinnah Hospital, Lahore. J
Coll Physicians Surg Pak 2000;10:278–80.
Colditz GA, Willett WC, Rotnitzky A, Manson JE. Weight gain as
a risk factor for clinical diabetes mellitus in women. Ann Intern
Med 1995;122:481–6.
Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC.
Obesity, fat distribution, and weight gain as risk factors for clinical
diabetes in men. Diabetes Care 1994;17:961–9.
Turner RC, Holman RR. Lessons from UK prospective diabetes
study. Diabetes 1996;45(Suppl 3):S87–S90.
Kuulasmaa K, Kunstall-pedoe H, Dobson A, Fortmann S, Sans S,
Tolonen H, et al. Estimation of contribution of changes in classic
risk factors to trends in coronary–event rates across the WHO
MONICA project population. Lancet 2000;355:675–87.
Downloads
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
