The diagnostic utility of inflammatory markers in the evaluation of cardiovascular risk among Ghanaians presenting with type 2 diabetes and hypertension
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Date
DECEMBER, 2014
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Abstract
It is suggested that inflammation is associated with hypertension and type 2 diabetes
occurring either before or as a consequence of the development of these diseases. Hence
inflammation measurement may provide additional information regarding a person’s risk
of cardiovascular morbidity and type 2 diabetes or contribute to the understanding of the
pathogenesis of these diseases. This study sought to explore the utility of inflammatory
markers in evaluating cardiovascular risk in Ghanaian type 2 diabetes and hypertensive
subjects attending the Battor Catholic Hospital in the Volta Region. It also sought to
determine the relative risk of developing cardiovascular disease among the different groups
in the study population. This case-control study was conducted between December 2012
and February 2013, involving 125 participants comprising 43 hypertensives, 40 type 2
diabetics and 42 with both conditions. The control group consisted of 62 age-matched
healthy individuals in the study area. Socio-demographic variables were obtained using a
semi-structured questionnaire whiles other study parameters were obtained using standard
methods. Inflammation was found to be associated with hypertensive and type 2 diabetic
subjects recording higher levels of inflammatory markers (hs-CRP, IL-6, ESR and WBC)
with the exception of TNF-α. Type 2 diabetes and hypertensive subjects also recorded
significantly higher cardiometabolic risk profiles compared to their control peers. Twenty-
five percent (25%) of participants had a high risk of developing coronary disease over the
next ten years. The percentage risk in general was higher in type 2 diabetes and
hypertensive subjects compared to the healthy population. Gender variation in percentage
ten year risk was observed with significant proportion of women recording high risk than
men. Measurement of inflammation may be useful to identify cohorts of patients for clinical
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trials to determine whether reduction/inhibition of hs-CRP reduces CHD events. Further
studies could expand the scope of biomarkers of inflammation and endothelial dysfunction,
compare oxidised LDL-Cholesterol levels between type 2 diabetes and hypertensive
individuals with their healthy counterparts in evaluating their future cardiovascular risk.
The sample size could also be increased substantially so that a generalised conclusion could
be made among the Ghanaian population
Description
A thesis submitted to the Department of Molecular Medicine,College of Health Sciences, in partial fulfillment of the requirements for the degree of Master of Philosophy.