Djindjic Boris
University in Nis, Serbia
Title: The impact of fasting and postprandial blood glucose increments on atherosclerosis via lipid composition and oxidative stress in patients with type 2 diabetes mellitus and coronary heart disease
Biography
Biography: Djindjic Boris
Abstract
Objectives: Impact of fasting and postprandial blood glucose increments on atherosclerosis through changes of apolipoproteins and oxidative stress in patients with diabetes mellitus (T2DM) and coronary heart disease (CHD) was evaluated.
Methodology: Ninety T2DM patients (60 with CHD and 30 without CHD) treated with metformin and/or sulphonylureas were enrolled in cross-sectional nested case-control clinical study. The areas under the six-point daily glucose curve above the fasting glucose concentrations (AUCpp) and over 5.5 mmol/L (AUCbg) were calculated to determine postprandial (AUCpp) and fasting (AUCbg-AUCpp) glucose increments. Apolipoproteins AII and B (ApoAII and ApoB), serum lipids and malondialdehyde (MDA) were determined.
Results: AUCbg-AUCpp 58.2 (95% CI 40.6-75.8) was higher in CHD group compared to non-CHD 36.9 (95% CI 23.5-50.2) mmol*h/L. They had similar Apo AII (mean±SD) 1.630±0.69 vs. 1.55±0.55 mg/dl and Apo B 1.48±0.48 vs. 1.43±0.62 mg/dl (CHD vs. non-CHD). The MDA was significantly higher in CHD 16.47±4.5 compared to non-CHD patients 13.42±4.01 μmol/g plasma proteins. The values of PCO were similar in booth groups as well as serum lipids (HDL, LDL, total cholesterol and triglycerides). AUCpp positively correlates with MDA (r=0.45) and Apo B (r=0.49) in presence of CHD, AUCbg-AUCpp negatively correlate with Apo AII (r=-0.44) in absence of CHD. The analysis revealed that AUCpp over turning point of 0 mmol*h/L was associated with high MDA and Apo B in CHD.
Conclusion: In T2DM patients with stable CHD, AUCpp at any point significantly contributes to increasing of Apo B and MDA. Serum lipids did not show significant difference according to presence of CHD.