Coronary artery calcification in Type 2 diabetes mellitus: biochemical and inflammatory insights from the Pakistani Population - a case-control study.

BACKGROUND

Patients with Type 2 diabetes mellitus (T2DM) are at increased risk of atherosclerotic cardiovascular disease, and coronary artery calcium score (CACS) serves as an important tool for cardiovascular risk assessment in this population. This study examines the correlation of CACS with biochemical and inflammatory parameters in individuals with T2DM.

METHODS

This case-control study was conducted at Baqai Medical University and comprised 184 individuals with T2DM and 184 healthy people. CACS was assessed with cardiac non-contrast computed tomography. The Agatston method was used to determine CACS, while biochemical markers, such as lipid profiles and HbA1c, were analyzed using enzymatic colorimetric method and high-performance liquid chromatography. Inflammatory parameters, including hs-C reactive protein (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF- α) were measured using immunoassays.

RESULTS

Significant differences were observed in median values of age (p < 0.0001), HbA1c (p < 0.0001), cholesterol (p = 0.001), triglycerides (p < 0.0001), hs-CRP (p < 0.0001), and IL-6 (p < 0.0001) in persons with T2DM compared to healthy subjects. Individuals with T2DM exhibited significantly higher CACS in both mild to moderate (1-100) and moderate to severe (> 100) categories compared with healthy controls (p-value < 0.0001). The CACS positively correlated with age (p < 0.0001), HbA1c (p < 0.0001), and low-density lipoprotein levels (p = 0.041). Binary logistic regression showed that elevated HbA1c and hs-CRP were independent predictors of coronary artery calcification in T2DM patients. Other factors, including age, BMI, family history, and lipid levels, were not significant after multivariate adjustment.

CONCLUSION

Poor glycemic control and systemic inflammation, reflected by elevated HbA1c and hs-CRP, are key independent predictors of calcified coronary arteries in patients with T2DM, underscoring importance of targeting hyperglycemia and inflammation to reduce cardiovascular risk.

TRIAL REGISTRATION: Clinical trial no. not applicable.