Factors participating in development of bleeding varices in portal hypertension - part 2: Possible impact of kidney damage and malnutrition, mortality
Abstract
The patients with diabetes mellitus and another risk factors have significantly higher risk to suffer from ischemic heart disease. Myocardial stress SPECT represents the examination which correlates very well with the results of selective coronary angiography even in asymptomatic diabetic patients.
The aim of our study was to evaluate the relation of SPECT result to diabetes compensation, presence of micro/macroalbuminuria, blood level of fibrinogen, CRP, homocystein and uric acid. Out of 126 diabetic 2. type abnormal SPECT has been found in 33 (26 %).
Fasting blood sugar (9.3 +- 1.4 mmol/l in patients with abnormal SPECT vs. 9.7 +- 1.9 mmol/l in the other diabetics, n.s.) and HbA1c (7.5 +- 1.3 % vs. 7.5 +- 1.3 %, n.s.) are not significantly different in the patients with abnormal SPECT to the other diabetics without this finding. Micro/macroalbuminurie was significantly more frequently seen in patients with abnormal SPECT (60 % of patients with abnormal SPECT and 29 % in the rest of diabetics, p = 0.01).
Fibrinogen was significantly more elevated in diabetics with abnormal SPECT (3.76 +- 0,5 g/l in the group with abnormal SPECT vs. 3.23 +- 0.43 g/l, p = 0.0003). In the diabetics with abnormal SPECT we have found significantly higher CRP (3.84 +- 1.51 mg/l vs. 2.79 +- 1.13 mg/l, p = 0.024) and homocystein (13.78 +- 3.26 μmol/l vs. 10.98 +- 2.33 μmol/l, p = 0.006).
Uric acid level was not significantly different in the group of diabetics with abnormal SPET to the rest of the patients (361 +- 64 μmol/l in abnormal SPECT vs. 353 +- 51 μmol/l, n.s.). When we analyse our results we have found that abnormal SPECT is rarely discovered in the asymptomatic 2nd type diabetics with the combination of negative micro/macroalbumiburie and fibrinogen level below 3.5 g/l.