PREVALENCE OF DIABETES MELLITUS AMONG OBESE AND NON-OBESE PATIENTS WITH CORONARY ARTERY DISEASE

Authors

  • Sher Bahadar Khan
  • Hafiz -ur- Rehman
  • Lubna Noor
  • Hameed Ullah
  • Mohammad Hafeezullah
  • Adnan Mahmood Gul
  • Abdul Hadi

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 Mellitus

References

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.

Published

2010-09-01

Most read articles by the same author(s)

<< < 1 2 3 > >>