INFLAMMATORY MARKERS (SERUM FERRITIN, ERYTHROCYTE SEDIMENTATION RATE AND HIGH SENSITIVITY C-REACTIVE PROTEIN) AND ITS CORRELATION WITH GLYCATED HAEMOGLOBIN (HBA1C) IN ADULT PATIENTS WITH DIABETES MELLITUS – A PROSPECTIVE STUDY

Abstract

Introduction: Uncontrolled diabetes leads to increased risk of complications. Inammation is believed to have a role to greater extent, in the pathogenesis of complications of type 2 DM. Also Inammation (as predicted by inammatory markers) and chronic hyperglycaemia (as predicted by Glycated Haemoglobin (HbA1c) ) jointly contribute to the cardiovascular risk of patients. Hence this study was done to correlate markers of inammation which can be estimated readily (like hsCRP, serum ferritin and ESR) with glycaemic control (HbA1C) and understand the relationship between them. Material And Methods: A prospective cohort study was done in 70 adult patients with diabetes mellitus during December 2021 to September 2022 after taking informed consent from patient. Patients on medication which reduce CRP levels were excluded. Patients with heart failure, acute febrile illness, renal, hepatic & malignant disorders, chronic illnesses, asymptomatic infections and smokers were also excluded from the study. Patients were selected by purposive sampling method. A semi-structured questionnaire was used to record patients data, and ndings of examination and investigation. Based on HbA1C patients were grouped as good control (HbA1C <6.5%) and poor control (HbA1C ≥ 6.5%) and comparison was done. Data entered in Microsoft excel 2013 and analysed using SPSS version 22 package. Pearsons correlation coefcient, T test and chi-square test was used for statistical analysis. P < 0.05 was considered to be signicant statistically. Results: The mean age of the study patients was 51±23.1 years with male to female ratio being 48:32. HbA1C was ≥ 6.5% (poor control) in 50 patients and <6.5% in 20 patients which shows that diabetic control was good in only 20 patients. Mean ESR, serum ferritin and hsCRP was signicantly more in patients with poor diabetic control. Pearson's correlation of HbA1C versus ESR (R = 0.654, P <0.001), serum ferritin (R= 0.22, P value = 0.006) and hsCRP (R=0.685, P<0.001) of all the study participants was highly signicant. Conclusions: Inammatory markers like ESR, hsCRP and serum ferritin are positively correlated with high HbA1C levels or poor diabetic control. Other factors associated with poor diabetic control includes, increasing age and BMI