Abnormalities in Plasma Concentration of Lipids and Fibrinogen of Egyptian Microalbuminuric NIDDM Type 2 Diabetic Patients

Introduction: Diabetes mellitus is associated with derangements in the serum levels of several biochemical parameters. Fibrinogen is a strong cardiovascular risk factor in the general population, and increased fibrinogen plasma concentrations have been reported in type 2 diabetic patients. Purpose: To assess fibrinogen, lipids and lipoprotein composition and the relationship between fibrinogen and lipoprotein abnormalities and urinary albumin excretion (UAER) in type 2 diabetic patients. Study Design: 48 control persons (24 male, 24 female), 96 diabetic patients (48 male: 24 normoalbuminuric, 24 microalbuminuric, 48 female: 24 normoalbuminuric, 24 microalbuminuric). They were divided into 9 groups. All groups were matched for age, sex, BMI. The diabetic patients were matched with the duration of diabetes. Diabetic patients were classified according to their level of urinary albumin excretion rate (UAER) into normoalbuminuric (<20 μg/min), microalbuminuric (20-200 μg/min). Diabetic patients with other complications were excluded. Materials and Methods: Blood and urine samples were collected from the diabetic patients and non-diabetic healthy controls. Glucose, HbA1C, Hb, creatinine, fibrinogen, urinary albumin excretion rate, cholesterol, HDL-C, LDL-C, VLDL-C, Ch/HDL-C, HDL-C/LDL-C, LDLC/HDL-C, triacylglycerol and phosphlipids were determined. Results and Discussion: A significant elevation of glucose, HbA1C, fibrinogen, urinary albumin excretion rate, cholesterol, LDL-C, VLDL-C, Ch/HDL-C HDL-C/LDL-C, LDL-C/HDL-C, triacylglycerol and phosphlipids and a significant decrease in HDL-C were obsereved in the diabetic groups in comparison with control group and the same was found for microalbuminuric vs normoalbuminuric diabetic groups. Conclusion: Albuminuria is the best predictor of fibrinogen plasma levels in type 2 diabetic patients. Plasma fibrinogen level is increased in type 2 normoalbuminuric diabetic patients (without detectable microand macrovascular complications), which indicate that hyperfibrinogenemia may precede the onset of clinical vascular complications and might therefore contribute to the increased cardiovascular risk in type 2 diabetes.