Abstract:
Background: Vascular dysfunction caused by metabolic abnormalities in patients with type-2
diabetes mellitus is associated with accelerated atherosclerosis, myocardial infarction (MI),
stroke, and increased risk of coronary heart disease. In spite of all these complications, there is
no literature revealing the cardiac status and associated factors using cardiac troponin as a
biomarker in study area and Ethiopia too. This study aimed to assess cardiac troponin-I and
associated factors in type-2 diabetic patients on anti-diabetic drug treatment at Jimma Medical
Center, Jimma, Southwest Ethiopia.
Methods: Facility based cross-sectional study was conducted among type-2 diabetic patients on
follow-up at Jimma Medical Center chronic illness clinic from August 1 to September 30/2020.
Systematic sampling technique was used to select 82 study participants, and face-to-face
interview was carried out using semi-structured questionnaires during data collection. Five
milliliters of venous blood was drawn from each participant after overnight fasting using an
aseptic technique and centrifuged at 3000 rpm for 10 minutes. Multiple logistic regression
analysis and one way ANOVA were used for statistical data analysis. P-value <0.05 was
considered as statistically significant.
Result: The mean age of the subjects was 53.41± 13.85 years with a range of 23-85 years. The
prevalence of elevated cardiac troponin-I was 25.6 % in the study population. Age greater than
or equal to 60 years (AOR=13.735, 95% CI= 2.849-16.622, P= 0.013), SBP (AOR= 2.004, 95%
CI=2.000-4.455, P=0.022), TC (AOR= 6.022, 95% CI= 1.225-12.961, P=0.039), LDL (AOR=
2.416, 95% CI= 1.744-3.346, P= 0.018) and TG (AOR= 2.468, 95% CI= 1.032-5.903, P= 0.048)
were predictors of elevated cardiac troponin-I. Metformin drug treatment (AOR= 0.015, 95%
CI= 0.001-0.435, P=0.015) was negatively associated with cardiac troponin-I. The mean value
of serum cardiac troponin-I was lower in patients who were receiving metformin monotherapy
as compared to patients on insulin monotherapy (11.654 ± 1.6795 vs 20.573 ± 1.8402, P<0.01),
and metformin +glibenclamide (11.654 ± 1.6795 vs 21.094 ± 2.4062, P<0.01).
Conclusion: About one fourth of the study participants had elevated serum cardiac troponin-I
level. Older age, systolic blood pressure and dyslipidemia were positively associated with
elevated cardiac troponin-I. Metformin significantly reduced serum cTnI levels as compared to
insulin monotherapy and metformin + glibenclamide. Regular screening for cardiac injury using
cardiac troponin-I is recommended for type-2 diabetic patients.
