Study of Plasma Fibrinogen Levels in Type 2 Diabetes Mellitus And Its Correlation With HbA1c Levels

Abstract

Background: Type 2 diabetes mellitus is associated with metabolic abnormalities and alterations in the coagulation system that contribute to an increased risk of vascular complications. Plasma fibrinogen, an important coagulation factor and acute-phase reactant, may be elevated in patients with diabetes mellitus and may be associated with glycemic control and other cardiovascular risk factors. Aim: To estimate plasma fibrinogen levels in patients with type 2 diabetes mellitus and compare them with non-diabetic controls and to assess their association with glycemic status and other clinical and biochemical parameters. Methods: This hospital-based case-control study was conducted at SVS Medical College and Hospital, Mahabubnagar, from October 2020 to October 2022. A total of 100 participants were included, comprising 50 patients with type 2 diabetes mellitus and 50 non-diabetic controls. Detailed clinical evaluation was performed, and body mass index, blood pressure, fasting blood glucose, postprandial blood glucose, HbA1c, lipid profile, and plasma fibrinogen levels were assessed. The association of plasma fibrinogen with glycemic control and other clinical and biochemical variables was analysed using appropriate statistical methods. Results: The study group had significantly higher body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, LDL cholesterol, fasting blood glucose, postprandial blood glucose, and HbA1c levels compared with the control group, whereas HDL cholesterol levels were significantly lower. Poor glycemic control, defined as HbA1c ≥7%, was observed in 30 (60%) diabetic participants. The mean plasma fibrinogen level was significantly higher in patients with type 2 diabetes mellitus than in controls, measuring 420.22±56.88 mg/dL and 268.80±51.20 mg/dL, respectively (p<0.001). In the diabetic group, plasma fibrinogen levels showed significant positive correlations with body mass index, systolic blood pressure, diastolic blood pressure, lipid parameters, fasting blood glucose, postprandial blood glucose, and HbA1c. Patients with poor glycemic control had significantly higher plasma fibrinogen levels than those with good glycemic control. Participants with abnormal fibrinogen levels also had significantly higher body mass index, blood pressure, total cholesterol, triglycerides, LDL cholesterol, postprandial blood glucose, and HbA1c levels, while HDL cholesterol levels were significantly lower. Conclusion: Plasma fibrinogen levels were significantly elevated in patients with type 2 diabetes mellitus compared with non-diabetic controls and were associated with poor glycemic control and an adverse cardiovascular risk profile. Assessment of plasma fibrinogen along with conventional metabolic and cardiovascular risk parameters may help identify diabetic individuals with an increased procoagulant state.

Keywords: Type 2 diabetes mellitus; Plasma fibrinogen; Glycemic control; HbA1c; Dyslipidemia; Cardiovascular risk.