Methodology: Two hundred T2DM patients who were on standard glucose lowering agents and who may be on lipid and blood pressure lowering agents were optimised for conventional CV risk markers and followed for a period of 2 years. We evaluated CV risk using markers like BMI, HbA1c, Systolic blood pressure (SBP), diastolic BP (DBP), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TG), non-HDL cholesterol, cholesterol remnant, highly sensitive CRP (hsCRP), serum creatinine, eGFR and urine microalbumin/creatinine ratio (UACR). At the end of 2 years, N-terminal pro-b type natriuretic peptide (NTpro-BNP) was measured to assess its role as a residual CV risk marker. T2DM patients with recent history (<1 years) of revascularization or any major surgery were excluded. Data was analysed using SPSS version 20 and represented as Mean + 2SD with 95% confidence interval, paired t test was used and p value of 0.was considered significant.
Results: Baseline characteristics were: 101(50.5%) males and 99 (49.5%) females, mean age was 61.63 ± 9.84 years, mean age since diagnosis 11.89 ± 7.3y and mean BMI 30.53 ± 5.7 kg/m2. There was an overall significant reduction from baseline to 2 years in HbA1c (7.61 ± 1.7 to 6.8 ± 1.05; p-<0.001), TC (142.55 ± 42.79 to 134.88 ± 40.56, p-0.01), LDL (79.79 ± 35.98 to 70.37 ± 30.69, p-<0.001), TG (133.31 ± 74.27 to 121.68 ± 74.11, p-0.018), Serum creatinine (0.97 ± 0.29 to 0.93 ± 0.26, p-<0.001), UACR (91.43 ± 34.4 to 56.49 ± 16.74), hsCRP (7.02 ± 2.77 to 4.1 ± 1.85, p-0.001). There was no significant change observed with respect to BMI, SBP, DBP, HDL and eGFR from baseline to 2 years. The mean NTpro-BNP at the end of 2 years was 166.33 ± 23.6.
Conclusion: In the present study, inspite of reduction in various CV risk markers over a period of 2 years, mean NTpro-BNP level remained high. Hence, this may suggest the role of NT pro BNP to be of additional value as a CV risk assessment tool in T2DM patients.
V. Gupta: None. V. Teli: None.