Title:Relationship between Diabetes Mellitus and Coronary Heart Disease
VOLUME: 12 ISSUE: 3
Author(s):Rabindra Nath Das
Affiliation:Department of Statistics, The University of Burdwan, Burdwan, West Bengal, India.
Keywords:Coronary heart disease, diabetes mellitus, gamma & log-normal models, HbA1c, non-constant variance, total cholesterol.
Abstract:Background: Diabetes mellitus (DM) and coronary heart disease (CHD) are in a complex
medical status which are closely associated and generally coexist. Many relationships of DM & CHD
are well-known but their precise nature still remains unknown.
Objectives: The present report aims to derive an appropriate probabilistic model between DM & CHD,
and also to identify their risk factors, based on a data set of 366 African Americans in rural Virginia,
USA.
Method: Both the positive responses glycosylated hemoglobin and total cholesterol are identified as
non-constant variance. Thus, they may be modeled by joint log-normal or gamma models, where both the mean and variance
are modeled by using two interlinked models for the mean and the variance, based on the observed data and gamma
deviance.
Results: Statistical significant causal factors, namely, total cholesterol (chol) (P=0.002), hdl-c (P=0.082), interaction effect
of tchol & hdl-c (P=0.032), stabilized glucose (stb.gl) (P=0.000), postprandial time when labs were drawn (tim.pn)
(P=0.024), interaction effect of stb.gl & tim.pn (P=0.008), age (P=2e-7), height (P=0.029), interaction effect of age &
height (P=0.003), waist (P=0.014), location (P=0.016), sex (P=0.007), frame of study (P=2e-4), have been identified as the
determinants of DM (based on glycosylated hemoglobin (HbA1c)). Identified statistical significant factors for CHD
(based on tchol) are interaction effect of hdl-c and ratio of tchol & hdl-c (P=0.000), HbA1c (P=0.045), tim.pn (P=0.020),
interaction effect of HbA1c & tim.pn (P=0.019), stb.gl (P=0.016), age (P=0.037), location (P=0.070), sex (P=0.005),
height (P=0.002), interaction effect of height and tim.pn (P=0.007), first diastolic blood pressure (bp.1d) (P=2e-4), interaction
effect of bp.1d & first systolic blood pressure (bp.1s) (P=0.084).
Conclusion: It has been established herein that the DM marker HbA1c is closely related with the CHD risk factors, so the
diabetic patients should be care on CHD.