Contents lists available at BioMedSciDirect Publications Journal homepage: www.biomedscidirect.com International Journal of Biological & Medical Research Int J Biol Med Res. 2013; 4(1): 2952-2957 Role of MAP and AIP in prediction of CVD risk in type 2 diabetic patients with and without metabolic syndrome. a b c a Priya. K.Dhas , G.Ramani , G.Kavitha , Rita Mary Aruna a Department of Molecular Medicine, Penang International Dental College, Salem. b Department of Biochemistry, VMKV Medical College, Salem. c Department of Biochemistry, Ultra Best Dental College, Salem. A R T I C L E I N F O ABSTRACT Keywords: Type 2 Diabetes Mellitus Metabolic syndrome Mean Arterial pressure(MAP) Atherogenic Index of plama(AIP) Cardiovascular disease (CVD) Original Article Abstract: Metabolic stress is associated with increased risk of cardiovascular morbidity and mortality. Aim: To analyze the role of MAP and AIP in predicting CVD risk in type 2 diabetic patients with metabolic syndrome and inclusion of these parameters in defining MS. Materials and Methods: 120, Type 2 diabetic patients aged between 40-60 yrs were included in this study. They are categorized as diabetic patients with metabolic syndrome (n=60) and diabetic patients without metabolic syndrome (n=60) by fulfilling at least 3 criteria of NCEP (ATP) III. Their anthropometric characteristics were measured and MAP was calculated. FBS, lipid profile were estimated and atherogenic index of plasma was calculated. Result: A significant increase was observed in waist circumference, BP, MAP, lipid profile and AIP of diabetic patients with metabolic syndrome when compared to diabetic patients without metabolic syndrome. Hence the study suggests that MAP and AIP may serve as a better indicator in assessing metabolic syndrome among type 2 diabetes mellitus. BioMedSciDirect Publications International Journal of BIOLOGICAL AND MEDICAL RESEARCH www.biomedscidirect.com Int J Biol Med Res Volume 3, Issue 1, Jan 2012 1. Introduction Copyright 2010 BioMedSciDirect Publications IJBMR - All rights reserved. ISSN: 0976:6685. c Evidence shows the presence of metabolic syndrome increases cardiovascular risk and mortality. Studies have also shown metabolic syndrome and diabetes had the highest prevalence of cardiovascular disease when compared to those with neither MS nor diabetes (Alexander 2003). Metabolic syndrome is a multifactorial disorder characterized by abdominal obesity, atherogenic dyslipidemia, increased blood pressure, insulin resistance, proinflammatory and prothrombotic state (Das UN 2007). Based on the definitions proposed by several organizations MS can be assessed by a fasting blood glucose of >110mg/dl, central obesity measured as waist hip ratio or BMI or WC, triglycerides >150mg/dl, HDL < 35 mg/dl (male) and<40 mg/dl (female) and blood pressure >140/90mm Hg by WHO and EGIR and >135/85 by NCEP ATP III criteria (Expert panel Detection-third report NCEP ATP III 2001, Albert KG 1998, Balkau B 1999).Studies also suggest the inclusion of the inflammatory marker CRP in the definition of metabolic syndrome. However less data are available regarding the use of MAP and AIP in relation to metabolic syndrome. The mean arterial pressure (MAP) is the average over a cardiac cycle and is determined by the cardiac output (CO), systemic vascular resistance (SVR), and central venous pressure (CVP) (Klabunde, RE 2007). It is so important that it reflects the hemodynamic perfusion pressure of the vital organs. MAP = [(2 x diastolic) + systolic] / 3 (Zheng L etal 2008). Diastole counts twice as much as systole because 2/3 of the cardiac cycle is spent in diastole. A MAP of about 60 is necessary to perfuse coronary arteries, brain, kidneys. Usual range is 70-110 mm Hg. Several studies have reported the possibility that newly addressed lipid ratio like T-C/HDL-C, TGLHDL-C, and LDL-C/HDL- C be more useful than the traditional ones used for CVD prediction (Kimm H, 2010). The Atherogenic Index of Plasma (AIP) has recently been proposed as a marker of plasma atherogenicity because it is increased in people at higher risk for coronary heart disease and is inversely correlated with LDL particle size (Tan MH 2004). Universally, atherogenic index of plasma (AIP) calculated as log (TG/HDL-C) has been used by few practitioners as a significant predictor of atherosclerosis (Dobiasova M, 2001, Tan MH, 2004). At this scenario the present study is aimed to analyze the role of MAP and AIP in predicting CVD risk in type 2 diabetic patients with metabolic syndrome and inclusion of these parameters in defining metabolic syndrome. * Corresponding Author : Priya K. Dhas Assistant Professor, Department of Molecular Medicine Penang International Dental College, Salem Tamilanadu E.mail: priyapide@yahoo.co.in Copyright 2010 BioMedSciDirect Publications. All rights reserved. c