SULM – Schweizerische Union für Labormedizin | Union Suisse de Médecine de Laboratoire | Swiss Union of Laboratory Medicine

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C.H. Saely1 , S. Aczel1 , T. Marte1 , P. Langer1 , W. Moll2 , H. Drexel1

1Vorarlberg Institue for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria, 2Medical Central Laboratory, Feldkirch, Austria

Background: Data are scarce on inflammatory markers in patients with both CAD and diabetes. As impaired glucose tolerance (IGT) frequently precedes diabetes type 2 (DM2), inflammatory markers in patients with IGT are of particular interest.
Methods: We measured CRP, fibrinogen, and white blood cell count (WBC) in 468 patients with clinically stable, angiographically proven CAD. Patients with diabetes type 1 (n = 3) were excluded. Oral glucose tolerance tests (oGTT) were performed in patients without established diabetes.
Results: DM2 had previously been established in 100 patients. In oGTT another 34 patients proved diabetic, 69 had IGT, and glucose tolerance was normal in 262 patients. Inflammatory markers were similar in patients with established diabetes and in patients with newly diagnosed diabetes; these patients were thus pooled to a single diabetic group. Between patients with normal glucose tolerance and with IGT, CRP (0.30 ± 0.53 vs. 0.30 ± 0.60 mg/dl; p = 0.822), fibrinogen (377 ± 68 vs. 386 ± 65 mg/dl; p = 0.206), and white blood cell count (6.5 ± 1.8 vs. 6.8 ± 2.2 G/l; p = 0.741) were not significantly different. However, all these inflammatory markers were significantly elevated in patients with DM2 (0.49 ± 0.68 mg/dl, 412 ± 83 mg/dl, 7.5 ± 2.1 G/l; p values were 𕟨.001 for the comparisons vs. normal glucose tolerance and 0.014, 0.102, and 0.007 for the comparisons vs. IGT). In leukocyte subtype analyses only neutrophils were significantly higher in diabetic patients than in patients with normal glucose tolerance and IGT (p < 0.001 and p = 0.015, respectively).
Conclusions: Among patients with clinically stable and angiographically proven CAD, CRP, fibrinogen, and white blood cell count are significantly higher in diabetic than in non-diabetic patients, but patients with IGT do not significantly differ from non-diabetic individuals. An increase of neutrophils accounts for the overall increase of white blood cell count in diabetic patients with stable CAD.

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