Diabetes Mellitus in Very Elderly Russian Patients with Coronary Artery Disease

Abstract

Background: Conflicting data are available on prevalence and characteristics of diabetes mellitus in very elderly patients and centenarians; therefore, we evaluated features of this pathology in patients with coronary artery disease (CAD) over 75 years old. Material and Methods: 580 patients with CAD over 75 years old were enrolled in the study on the prevalence of diabetes mellitus. 190 patients with CAD and diabetes mellitus were included in the cross-sectional study of the diabetes mellitus characteristics in old age: 153 very elderly patients (mean age-85.7 ± 4.7 years)-in the main group, 37 patients < 70 years old-in the comparison group. Toassess the condition of patients, standard clinical and laboratory methods for coronary artery disease and diabetes mellitus were used. 24-hour plasma glucose profile and hemoglobin A1c (HbA1c) level were evaluated in all patients with diabetes mellitus. Results: Diabetes mellitus or impaired glucose tolerance was found in 22.2% of very elderly patients with CAD. Glucose levels in very elderly diabetic patients were lower at all time points than in patients < 70 years old. The largest differences were recorded for the blood glucose concentration at 6 a.m. (p = 0.00005). Glucosuria was registered in 29.7% of patients aged 51-69 years, while among elderly patients-in 11.1% (p = 0.004). The mean levels of HbA1c were 7.3% and 8.7%, respectively (p = 0.01). Correlation analysis revealed negative correlation between the age of patients and the glucose level (r = −0.4, p = 0.00002-for 6 AM glucose). The mean body mass index in very elderly patients was 30.8 ± 5.8 kg/m 2 , in patients < 70 years old-33.9 ± 6.5 kg/m 2 (p = 0.03). Significant differences between the groups of very elderly and younger patients were registered in terms of triglycerides (1.65 and 3.57 mmol/L, respectively, p < 0.00001), HDL-cholesterol (1.16 and 0.87 mmol/L, respectively, p = 0.03) and atherogenic index (3.45 and 6.73, respectively, p = 0.002). Conclusion: The study results indicate that diabetes mellitus is often diagnosed in very elderly patients with CAD. In very elderly pa-How to cite this paper: Topolyanskaya,