Interrelationship of Micro- and Macrovascular Complications in Hypertensive Type 2 Diabetics

Type 2 diabetes is associated with serious progressive micro- and macrovascular complications. The present work was undertaken to study interrelation of fibrinogen, lipoprotein(a) (Lp(a)) and left ventricular mass index (LVMI) in type 2 diabetic patients with or without nephropathy and hypertension.

A total of 150 type 2 diabetic patients attending outpatient/in-patient department of tertiary care hospital were included. They were divided into three groups. Group I: 50 patients without microalbuminuria (MAU); Group II: 50 patients with MAU; Group III: 50 patients with MAU and hypertension. Fibrinogen, Lp(a) and microalbumin levels were estimated. LVMI was estimated by echocardiography.

Type 2 diabetic patients with MAU had significantly raised levels of fibrinogen, Lp(a) and LVMI as compared to normoalbuminuric diabetics (P<0.01). Diabetes with hypertension and MAU had further significantly raised levels of fibrinogen, Lp(a) and LVMI as compared to Group I and II (P<0.01). Group II patients had significant positive correlation between Lp(a) and LVMI. No significant relation was found between fibrinogen and LVMI in any of the three groups.

MAU, a marker of microangiopathy, is associated with higher fibrinogen and Lp(a) levels. This becomes basis of increased cardiovascular risk as demonstrated by higher LVMI in group II and III patients. Direct relation in Lp(a) and LVMI could be observed in group II patients only, all other associations are indirect.