Markers of inflammation in patients with coronary artery disease are also associated with glycosylated haemoglobin A1c within the normal range

Abstract

Aims: Diabetes is a risk factor for atherosclerosis and low-degree inflammation may play a central role in both diseases. Glycosylated haemoglobin A(1c) (HbA(1c)) is an established measure of long-term glycaemic control but data on its correlation with markers of inflammation are limited, especially in patients with atherosclerotic manifestations. The aim of the present study was thus to investigate the associations between HbA(1c) and a panel of inflammation-sensitive parameters in patients with and without diabetes.

Methods and results: This single centre cross-sectional study comprised 314 consecutive subjects who underwent coronary angioplasty for stable coronary artery disease. Sixty-six patients had diabetes mellitus. Haemoglobin A(1c) and markers of inflammation, i.e., plasma levels of CRP, fibrinogen, and albumin, erythrocyte sedimentation rate and white blood cell count were measured. All inflammation markers were altered in a more inflammatory direction in diabetic patients. Furthermore, when non-diabetic patients with HbA(1c) levels within the normal range were studied separately, all inflammation-sensitive parameters except albumin correlated significantly with HbA(1c).

Conclusion: In subjects with known coronary atherosclerosis, low-degree inflammatory activity is not only increased in diabetic patients, but also increased with increasing HbA(1c) in non-diabetic individuals with HbA(1c) within the normal range, i.e., at a pre-diabetic level of glucose metabolism derangement.