Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Advertise | Login 
 
Search Article 
  
Advanced search 
  Users Online: 3782 Home Print this page Email this page Small font sizeDefault font sizeIncrease font size  

 
Table of Contents
LETTER TO THE EDITOR
Year : 2012  |  Volume : 16  |  Issue : 6  |  Page : 1061-1062

Cardiovascular diseases risk evaluation in newly diagnosed type-2 diabetics: An association of novel biomarkers apo proteins and C-peptide


Department of Biochemistry, Reader, Faculty of Medicine and Health, Jodhpur National University, Jodhpur, India

Date of Web Publication31-Oct-2012

Correspondence Address:
Purvi Purohit
Department of Biochemistry, Reader, Faculty of Medicine and Health, Jodhpur National University, Jodhpur
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.103052

Rights and Permissions

How to cite this article:
Purohit P. Cardiovascular diseases risk evaluation in newly diagnosed type-2 diabetics: An association of novel biomarkers apo proteins and C-peptide. Indian J Endocr Metab 2012;16:1061-2

How to cite this URL:
Purohit P. Cardiovascular diseases risk evaluation in newly diagnosed type-2 diabetics: An association of novel biomarkers apo proteins and C-peptide. Indian J Endocr Metab [serial online] 2012 [cited 2019 Nov 19];16:1061-2. Available from: http://www.ijem.in/text.asp?2012/16/6/1061/103052

Sir,

Cardiovascular diseases (CVD) such as coronary heart disease (CHD) and stroke are the largest causes of death in developing countries and are one of the main contributors to the disease burden. [1],[2] With an ever increasing incidence of both, type-2 diabetes mellitus (DM) and CVD in most urban populations, there has been a demand for newer techniques that could help in the early detection of the risk of this disease complex. Premature cardiovascular morbidity and mortality is reportedly high in diabetic subjects. [3] Control of the cardiovascular diseases will require modification of risk factors that have two characteristics:

  1. The risk factor must have high attributable risk or high prevalence or both
  2. Most or all of the risks must be cost-effectively reversible [4]


The primary cause of CVD is the atherosclerosis observed either due to genetic predisposition or secondary to a disease like diabetes mellitus; > 80% of deaths in diabetic subjects are due to CVDs (two-third of which are due to coronary artery disease (CAD). [5] Various studies have reported the development of atherosclerosis-related complications in type-2 DM due to hyperinsulinemia, insulin resistance, and raised C-peptide levels. [6],[7] The basal C-peptide level is reportedly a surrogate marker of subclinical atherosclerosis in type-2 diabetic patients, owing to a positive correlation between basal C-peptide and intima-media thickness (IMT). Type-2 DM has an increased conversion of low-density lipoprotein (LDL) to smaller, more atherogenic lipoproteins, termed as 'small dense LDL'. This pattern has been reported in insulin-resistant pre-diabetics as well. [8]

A deranged lipid profile is one of the major risk factors for CVDs, which the physicians have been focusing on. The newly diagnosed diabetic patients may or may not present with a severely deranged lipid profile. However, such patients too are at a high risk of CVDs. Different markers have been used for evaluating the risk of CVD in different studies. However, there is still no gold standard biochemical marker for evaluating the risk, and the search is still on for a marker that will help in an early detection of CVD risk.

In newly diagnosed type-2 diabetics, serum apo-proteins, especially cardio protective apo-A1 and apo-B (of LDL and Very-low-density lipoprotein (VLDL) can prove to be of great significance in assessing the CVD risk, as there is a strong association of C-peptide with the CVD risk ratio, apo-B / apo-A1, and also with apo-B. Diabetic dyslipidemia, complexed with raised atherogenic apo-protein, apo-B, and reduced levels of cardio protective high density lipoprotein cholesterol (HDLc) and its apo-protein, apo-A1, increases the risk of atherogenic complications of DM. Similarly, an association of blood pressure and C-peptide further contributes to CVD risk evaluation and reduction, as hypertension is a controllable disease.

Thus, type-2 diabetic patients, at the time of diagnosis, should be evaluated for serum C-peptide levels, as it would hint at the possibility of CVD, owing to a strong association with both traditional risk factors (serum lipid profile and hypertension) and novel markers like apo-proteins.

 
   References Top

1.World Health Organization. Preventing chronic diseases: A vital investment. WHO, Geneva, Switzerland: World Health Organization; 2005.  Back to cited text no. 1
    
2.Gaziano T, Reddy KS, Paccaud F, Horton S, Chaturvedi V. Cardiovascular disease. In: Jamison DT, Breman JG, Measham AR, Alleyene G, Cleason M, Evans DB, Jha P, Mills A, Musgrove P, editors. Disease Control Priorities in Developing World. 2 nd ed. Oxford: Oxford University Press; 2006. p. 645-62.  Back to cited text no. 2
    
3.Swerdlow AJ, Jones ME. Mortality during 25 year follow up of a cohort with diabetes. Int J Epidemiol 1996; 25: 1250-61.  Back to cited text no. 3
[PUBMED]    
4.Gupta R, Gupta VP. Hypertension epidemiology in India: Lessons from Jaipur Heart Watch. Curr. Sci 2009;97:349-54.  Back to cited text no. 4
    
5.Dawson KG, Gomes D, Gerstein H, Blanchard JF, Kahler KH. The economic cost of diabetes in Canada, 1998. Diabetes Care 2002;25:1303-7.  Back to cited text no. 5
[PUBMED]    
6.Kim ST, Kim BJ, Lim DM, Song IG, Jung JH, Lee KW, et al. Basal C-peptide level as a surrogate marker of subclinical atherosclerosis in type 2 diabetes patients. Diabetes Metab J 2011; 35:41-9.  Back to cited text no. 6
[PUBMED]    
7.Barakat HA, Carpenter JW, McLendon VD, Khazanie P, Leggett N, Heath J, et al. Influence of obesity, impaired glucose tolerance, and NIDDM on LDL structure and composition. Possible link between hyperinsulinemia and atherosclerosis. Diabetes 1990;39:1527-33.  Back to cited text no. 7
[PUBMED]    
8.Goldberg IJ. Clinical review 124: Diabetic dyslipidemia: Causes and consequences. J Clin Endocrinol Metabol 2001;86:965-71.  Back to cited text no. 8
[PUBMED]    




 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    References

 Article Access Statistics
    Viewed889    
    Printed19    
    Emailed0    
    PDF Downloaded253    
    Comments [Add]    

Recommend this journal