Determination and Evaluation of the S‬erum Levels of Some Cardiac Markers and Lipid Profile among Sudanese with Type 2 Diabetes Mellitus in Khartoum State

Abstract

A cross-sectional study conducted during the period from February 2008 to February 2011 to determine and to evaluate the serum levels of cardiac troponin I (CTnI), myoglobin, total creatine kinase (CK), creatine kinase isoenzyme MB (CK-MB) and lipid profile in Sudanese with type 2 diabetes mellitus. Two hundred Sudanese with type 2 diabetes mellitus were selected as a test group from Jabir Abulizz Diabetes Centre in Khartoum state, Sudan. The test group was compared with a control group, which included 100 apparently healthy volunteers. Blood specimens were collected from both groups, and the serum levels of CTnI, myoglobin, total CK, CK-MB, creatinine and lipid profile (total cholesterol, triglycerides, high density lipoprotein cholesterol (HDLc) and low density lipoprotein cholesterol (LDLc), in addition to fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) were determined. Age and gender of the test group were matched with the control group. The serum levels of CTnI were measured using i-chromaTM system (immunoassay) and for the serum levels of myoglobin ELISA technique was used. Serum total CK and CK-MB were measured using an autoanalyzer with commercial kits from Biosystem Company, and spectrophotometeric methods were used for measuring plasma glucose, HbA1C and serum levels of total cholesterol, HDLc, LDLc, triglycerides and creatinine. Statistical Package for Social Science (SPSS version 11.5) computer software was used for data analysis. The results of this study indicated to significantly raised means of the serum levels of CTnI, myoglobin, total CK, CK-MB, total cholesterol, triglycerides, LDLc, and creatinine of the test group when compared with the control group, whereas the mean of the serum levels of HDLc of the test group showed a significant reduction when compared with that of the control group. The results of this study also indicated to significant elevations of the mean of the serum levels of CTnI, myoglobin, total CK, CK-MB, total cholesterol, triglycerides, LDLc, and creatinine among diabetic patients with ischemic heart disease when compared with those without ischemic heart disease, whereas the mean of the serum levels of HDLc among diabetic patients with ischemic heart disease showed significantly decreased when compared with those without ischemic heart disease. The means of the serum levels of CTnI, myoglobin, total CK, CK-MB, total cholesterol, triglycerides, LDLc, and creatinine among diabetic patients with hypertension or having renal insufficiency or liver disease were significantly raised when compared with those without these diseases, whereas the means of the serum levels of HDLc among diabetic patients with hypertension or having renal insufficiency or liver disease were found to be significantly decreased when compared with diabetics without these diseases. In this study there is no significant difference between the means of the serum levels of CTnI, myoglobin, total CK, CK-MB, total cholesterol, triglycerides, HDLc, LDLc, and creatinine among diabetic patients with gout when compared with those without gout. The results of the current study indicated to significant strong positive correlations between the duration of diabetes (in year) and the serum levels of CTnI, myoglobin, CK-MB and creatinine, and showed significant moderate positive correlations between the duration of diabetes (in year) and the serum levels of total CK, total cholesterol, LDLc and triglycerides, whereas there was a significant moderate negative correlation between the duration of diabetes (in year) and the serum levels of HDLc. The present study, showed significant strong positive correlations between the body mass index (BMI) of diabetic patients and the serum levels of CTnI, myoglobin, CK-MB, total cholesterol, LDLc, triglycerides and creatinine, and also showed a significant moderate positive correlation between the BMI of diabetic patients and the serum levels of total CK, and a significant moderate negative correlation between the BMI of diabetic patients and the serum levels of HDLc. This study showed insignificant weak positive correlations between the HbA1C and the serum levels of CTnI, myoglobin, total CK, CK-MB, total cholesterol, LDLc, triglycerides and creatinine, and insignificant weak negative correlation between the HbA1C and the serum levels of HDLc. The present study also showed a significant strong positive correlation between FPG and the HbA1C. In conclusion; the current study indicated that the serum levels of CTnI, myoglobin, total CK and CK-MB are important markers for evaluation of atherosclerosis, because they are significantly correlated with the duration of diabetes and BMI which are a risk factors for atherosclerotic disease, so they can be used as prognostic markers and for prediction of myocardial infarction and in follow up of diabetic patients especially in those with complications such as hypertension, ischemic heart disease, renal insufficiency, lipid abnormalities and liver disease .