Association between Serum Osmolarity and Coronary Artery Stenosis Grade

Research Article

J Fam Med. 2017; 4(6): 1128.

Association between Serum Osmolarity and Coronary Artery Stenosis Grade

Süleyman Ozsari* and Mehmet Ungan

Department of Family Medicine, Ankara University Hospital, Ankara, Turkey

*Corresponding author: Dr. Süleyman Ozsari, Department of Family Medicine, Ankara University Hospital, Ankara, Turkey

Received: August 29, 2017; Accepted: September 25, 2017; Published: October 02, 2017


Background: In our study, we investigated whether serum osmolarity, which is shaped by feeding style, is related to CAD and whether it is a reliable parameter in the progressive stages of the disease.

Methods: Our study was conducted on 399 patients with coronary angiography under elective condition with suspected CAD and 152 healthy control groups. Patients were divided into three groups using Gensini Score. Patient and control group were compared in terms of Osmolarity (calculated), sodium, BUN.

Results: The data obtained from routine blood measurements before coronary angiography the mean osmolarity was calculated as 293.34±4.39mOsm/L. In the control group, mean osmolarity were calculated as 291.81±4.00mOsm/L. As a result of analysis between patient and control group, there was a significant difference between sodium, BUN and calculated osmolarity (p<0.05). There was no significant difference in the osmolarity values among the GENSINI score groups (p: 0.025).

Conclusion: The calculation of osmolarity can be recorded in long-term follow-ups and used as a risk assessment until symptoms occur during the development of CAD. Thus, the arrangements regarding the feeding of the individuals can be based on concrete data and more effective interventions can be made. Once the diagnosis of CAD is established, osmolarity is not a measurement that can be used following the disease.

Keywords: Serum Osmolarity; Coronary Artery Stenosis; Long term followup; Family Medicine


According to the death statistics of the Turkish Statistical Institute (TURKSTAT), it seems that there is a tendency to increase in the total number of deaths together with the fact that heart diseases maintain their proportion over the years [1]. The positive aspect of cardiovascular diseases is that they are "preventable" to a large extent. The most prevalent stages and risk factors are the effects on the formation of atherosclerosis.

Serum osmolarity measurement is an easy and noninvasive method that is easily calculated in primary care centers and family health centers. Normal value is 280-295mOsm/kg H2O and this value is measured by osmometer. But with the formula, it can be calculated very close to normal:

Osmolality (mOsm/kg H2O) = 2 [Na +] + Glucose / 18 + BUN / 2.8 '' [2].

It has been suggested that consumption of osmotic burdenincreasing nutrients induces atherosclerotic process by increasing body temperature [3].

There are several studies showing that there is a significant correlation between coronary artery disease and measurable and computable osmolality [2]. In this study; Which is one of the goals of planning in the short term as part of the fight against cardiovascular diseases, which is considered as the most important cause of mortality in our country; "To work to increase the awareness of cardiovascular diseases and risk factors in the community to reduce the risk of developing these diseases " and " to gain nutrition habits that reduce the risks of collecting cardiovascular diseases" [4]; In this context, to put forward the parameters leading to preventable causes at an early stage.


In our study, 399 patients who underwent elective coronary angiography were included in the Cardiology Clinic of Ankara University between 01 March 2016 and 31 August 2016. Between the same dates, 152 healthy control groups who applied to the Ankara University Family Medicine clinic were included in the study. Patients who agreed to participate in the study was signed consent forms. When the patient sample was constructed, according to the results of angiography, patients were divided into 3 groups by using GENSINI score in terms of the presence and severity of CAD. A total of 118 patients with a total score of 0, 123 patients with score scores 1-19, and 158 with a score of 20 and over were included in the study. Patients with known glucose metabolism disorders (anamnesis, clinical diagnosis, chronic illness report), patients with blood glucose level (FPG> 110mg/dl) measured before or during the last month, patients with apparent renal insufficiency (GFH = 60 ML/min/ 1.73m²), patients with mental or cognitive impairment, those who had received alcohol within the last 24 hours, and those who did not want to participate in the study were not included in the study.

Statistical analyses

Analysis of the data was done in SPSS 15 package program. Descriptive statistics are shown as median (min-max) for variables with normal distribution, nominal variables as number of cases and (%). Statistical significance was investigated with the T-test for the averages between the groups and the Mann-Whitney U test for the median values. If the number of groups is more than twice in the subsequent evaluation; Statistical significance was investigated by Kruskal Wallis test for the mean between groups. Nominal variables were assessed by Pearson Chi-Square or F exact test. A multivariate logistic regression analysis was performed to determine independent risk factors for coronary artery disease. In logistic regression analysis, risk parameters and confidence interval were determined by taking parameters affecting as a result of univariate analysis. P value lower than 0.05 is considered as statistically significant.


The study included 399 patients who applied to cardiology clinic and underwent elective coronary angiography. The mean age of the patients was 60.51 ± 11.09 years (22-89), 67.2% (n = 268) of these patients were male and 32.8% (n=131) of these patients were female. Between the same dates, family medicine clinic; 152 patients with no clinical signs and symptoms of cardiovascular disease and no diagnosis were taken as a control group. While the mean age of the control group was 54.57 ± 11.42 (20-88), 33.6% (n = 51) were male and 66.4% (n = 101) were female.

The mean values of sodium levels of the patients from routine blood measurements before coronary angiography were 141.42 ± 2.12mEq/mL, mean BUN value was 15.35 ± 4.03mg/dL, blood sugar value was 90.39 ± 9.18mg/dL. The mean osmolarity calculated from these parameters was calculated as 293.34 ± 4.39 (mOsm/L) (Table 1).