International Journal of General Medicine (Mar 2022)
Lower Plasma Albumin, Higher White Blood Cell Count and High-Sensitivity C-Reactive Protein are Associated with Femoral Artery Intima-Media Thickness Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus
Abstract
Nga Phi Thi Nguyen,1,2,* Thuc Luong Cong,3,4,* Thi Thanh Hoa Tran,5 Binh Nhu Do,6 Son Tien Nguyen,1,2 Binh Thanh Vu,7,* Lan Ho Thi Nguyen,8 Manh Van Ngo,9 Hoa Trung Dinh,10 Hoang Duong Huy,11 Nghia Xuan Vu,12 Kien Nguyen Trung,13 Duong Ngoc Vu,14 Nghia The Pham,14 Tuan Dinh Le2,15,* 1Department of Endocrinology, Military Hospital 103, Hanoi, Vietnam; 2Department of Rheumatology and Endocrinology, Vietnam Military Medical University, Hanoi, Vietnam; 3Cardiovascular Center, Military Hospital 103, Hanoi, Vietnam; 4Department of Cardiology, Vietnam Military Medical University, Hanoi, Vietnam; 5Emergency Resuscitation Department, National Hospital of Endocrinology, Hanoi, Vietnam; 6Division of Military Science, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam; 7Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 8Department of General Internal Medicine, National Hospital of Endocrinology, Hanoi, Vietnam; 9Postgraduate Training Management Department, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 10Department of Requested Treatment, National Hospital of Endocrinology, Hanoi, Vietnam; 11Department of Neurology, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 12Department of Blood Transfusion, 108 Military Central Hospital, Hanoi, Vietnam; 13Department of Science Management, Thai Binh University of Medicine and Pharmacy, Thai Binh, Vietnam; 14Department of Imaging Diagnosis, Hanoi Medical University, Hanoi, Vietnam; 15Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, Hanoi, Vietnam*These authors contributed equally to this workCorrespondence: Tuan Dinh Le, Center of Emergency, Critical Care Medicine and Clinical Toxicology, Military Hospital 103, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Ward, Ha Dong District, Hanoi, Vietnam, Tel +84 388166078, Email [email protected] Binh Thanh Vu, Department of Internal Medicine, Thai Binh University of Medicine and Pharmacy, 373 Ly Bon Street, Ky Ba Ward, Thai Binh, Vietnam, Tel +84 334588298, Email [email protected]: Low albumin levels, high levels of high-sensitivity C-reactive protein (hs-CRP), and high white blood cell count were risk factors for changes in arterial intima-media thickness (IMT). Femoral artery IMT damages were one of the common peripheral artery type 2 diabetes. This study was conducted to determine the association between femoral artery IMT and plasma albumin, hs-CRP levels, and white blood cell count in newly diagnosed patients with type 2 diabetes mellitus (nT2D).Materials and Methods: From January 2015 to May 2020, 306 patients with nT2D were recruited for this cross-sectional descriptive study at Vietnam’s National Endocrinology Hospital. We measured IMT by Doppler ultrasound.Results: There was a statistically significant difference in albumin, hs-CRP levels, hs-CRP-to-albumin ratio, and white blood cell counts between three different IMT groups namely normal IMT, thick IMT, and atherosclerosis (p = 0.003, p = 0.001, p = 0.001 and p = 0.049, respectively). In the multivariate linear regression analysis, white blood cell count, and hs-CRP levels showed a significantly positive correlation to IMT (standardized B and p of 0.17, 0.015 and 0.163, 0.024, respectively), but albumin levels were a significantly negative correlation to IMT (standardized B = – 0.151, p = 0.029). The multivariate logistic regression analysis showed that albumin (OR = 0.79, 95% CI 0.65– 0.90, p = 0.018), hs-CRP (OR = 1.09, 95% CI 1.01– 1.18, p = 0.026), and white blood cell count (OR = 1.36, 95% CI 1.03– 1.81, p = 0.033) had correlation to atherosclerosis of femoral artery.Conclusion: Reduced plasma albumin, elevated hs-CRP, and white blood cell count associated with IMT increased the odds for atherosclerosis of femoral artery among nT2D.Keywords: plasma albumin, high-sensitivity C-reactive protein, white blood cell count, newly diagnosed type 2 diabetes mellitus, intima-media thickness, atherosclerotic plaque, femoral artery