Risk Factors Associated with Hypercoagulability in Type 2 Diabetes Mellitus Patients at Ndola Central Hospital Zambia

Abstract

Background: Thrombosis, attributed to atherosclerosis, is the leading cause of morbidity and mortality in patients with diabetes mellitus. Pathogenesis of atherosclerosis in diabetes mellitus is not entirely clear and conventional
risk factors such as smoking, obesity, blood pressure and serum lipids fail to explain fully this excess risk. We set out a cross-sectional study to determine the risk factors and patient attributes that may predispose type 2 Diabetes Mellitus (T2DM) patients to be in hypercoagulable state.

Methods: A structured questionnaire was used to capture Age, Sex, duration of diabetes mellitus and knowledge on T2DM of study participants. Body weight and height were also measured and BMI calculated.VWF, Cholesterol, and Glycated haemoglobin were measured in 213 T2DM patients. VWF was used as a proxy marker for hypercoagulability in T2DM patients. Participants with VWF of >2.0 IU/ml plasma concentration were regarded to be in hypercoagulable state.

Results: Chi-square analysis revealed that hypercoagulability in T2DM patients was associated with Age (P=0.001), Sex (P=0.000), glycaemic control (P=0.003), duration of diabetes (P=0.000), BMI (P=0.000) and knowledge on type 2 diabetes mellitus (P=0.001). In multivariate analysis after adjusting for confounders, knowledge on T2DM was not independently associated with hypercoagulability AOR being 1.00(CI 95% 0.80-2.20). However Age, sex, glycaemic control, duration of diabetes and BMI were found to be independent r i sk f a c tor s for hypercoagulability in T2DM patients giving AOR of 1.45(95%CI[1.19-3.16]), 4.42 (95% CI [2.77-10.63]), 6.12 (95% CI 2.27-8.36) 5.28(CI 95% 3.01-8.21) and 1.05(95% CI 0.75-2.86) respectively.

Conclusion: Age, Sex, poor glycaemic control, duration of diabetes and obesity should be taken into account in the management of T2DM patients as these variables are independent risk factors of hypercoagulability in T2DM patients.