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A study on the blood levels of homocysteine,
fibrinogen and hsCRP in diabetic patients with
ischaemic stroke from eastern India
1389-1392
Correspondence
Rudrajit Paul
Junior Resident, Department of Medicine,
Medical College Kolkata
15/5, Bose Pukur Road, Kolkata-700 039. West Bengal
Phone : 91-9433824341
E-mail : docr89@gmail.com
Introduction: Diabetes is an important risk factor for ischaemic stroke. Newer risk markers like C - reactive protein, fibrinogen and homocysteine levels are now being considered for better risk predication.
Aim: To study these new risk markers in diabetic patients with ischaemic stroke and to study any association of these markers with other blood parameters. This was thus a case control study.
Methods: Patients who were proved (by imaging) to be suffering from cerebral ischaemic events were chosen after proper screening and after their consent was taken. The diabetic subset was compared with the non-diabetic subset by doing blood tests which included blood glucose, lipids and newer markers. This was done 2 months after the index event to avoid false positive results.
Statistical analysis: We analyzed the data by using online software. Pearson’s correlation coefficient was used for finding the correlation between the variables.
Results: 82 patients were included in the study, of which 42 were diabetic (ADA Criteria). The diabetic subset had significantly higher levels of total serum cholesterol (186 ± 50.3 vs. 167± 30.6; p=0.041) and LDL levels (112 ± 33.3 vs. 92± 15.2; p=0.0008). The triglyceride levels were also higher (165± 19.35 vs. 124.6± 9.22; p=0.0010). The HsCRP and fibrinogen levels were higher in diabetic patients with ischaemic stroke (p<0.05), while the homocysteine levels were higher in the non-diabetic subsets. The high hsCRP levels also correlated significantly with blood glucose (for FBS; r= 0.288; for PPBS, r=0.407) and blood pressure. There was also a positive correlation between hsCRP and the fibrinogen levels (r=0.307; p<0.05). The ROC curve analysis showed that LDL values which were >110 mg/dl had a high sensitivity in predicting high levels of plasma homocysteine. The logistic regression model showed that hsCRP had the strongest correlation with increasing age (OR=1.1).
Conclusion: This case control study has shown significantly higher hsCRP and fibrinogen levels in ischaemic stroke patients who had diabetes, as compared to the non-diabetic subsets. These newer parameters were also correlated with blood glucose and the lipid values. Thus, these can be used as surrogate markers in diabetic patients for the prediction of ischaemic stroke. However, a prospective study is needed to identify the risk factors and their predicative value better.