Laboratory parameters associated with elevated coronary artery calcium burden in patients with newly diagnosed type 2 diabetes mellitus

Introduction Cardiovascular complications are not exclusive to long-standing diabetes mellitus (DM); newly diagnosed type 2 diabetes mellitus (NDT2DM) may also be associated with cardiac problems, although this aspect has been less thoroughly explored. The computed tomography calcium score (CTCS) in the coronary arteries has become a widely available, accurate, and dependable tool for determining the risk of major cardiovascular events, particularly in asymptomatic individuals. Individuals with DM are expected to undergo regularly routine laboratory examinations. Purpose The objective of this study was to determine the laboratory parameters related to occurrence of subclinical atherosclerotic plaques in coronary arteries, as detected by Computed Tomography (CT), in patients with NDT2DM. Methods In this prospective cross-sectional study 101 patients with NDT2DM, according to the criteria of the American Diabetes Association, were included. CTCS was performed on all patients by 64-slice cardiac CT, with a thickness of 2-5 mm. Calcification was identified as a structure >1 mm attached to or located within the lumen of a coronary vessel with intensity >130 HU. The Agatston method was used to determine the CTCS. Patients were categorized into five groups based on their calcium levels (0, 0-. 10, 11-100, 101-400 and >400), and all obtained parameters were subsequently compared between the five groups. With Spearman’s correlation test we also analyzed the relationship between laboratory parameters and the level of CTCS. Exclusion criteria were: stable angina pectoris, acute coronary disease, severe anemia, patients with history of stroke, moderate/severe renal insufficiency, liver insufficiency, claustrophobic patients, and pregnant women. Results Of the 101 asymptomatic patients with NDT2DM, 53 (52.5%) were males, with mean age of 54.4 ± 11.6 years and mean duration of diabetes of 2.8 ± 5.3 months. In table 1 the differences between the 5 groups regarding laboratory parameters are presented. Statistical significance is shown for erythrocyte sedimentation rate (ESR) (P=0.044). With Spearman's correlation, we obtained a significant correlation between the CTCS and the following laboratory parameters: ESR [r= 0.280 (95% CI 0.083-0.455), P=0.0046] and triglyceride level [r= 0.196 (95% CI -0.005 - 0.382), P=0.049]. Conclusions Individuals diagnosed with NDT2DM who exhibit elevated erythrocyte ESR and triglyceride levels may be susceptible to an increased burden of coronary artery calcium. Consequently, these patients should undergo careful management, focusing on both glycemic control and cardiovascular prevention. Comparison between the five groups.