HbA1c as screening biomarker of dyslipidemia in type 2 diabetes mellitus patients

S. P. Tejaswi Pullakanam, Krishna Barla, Ramakrishna Nekkala, Pullaiah Pasupeleti


Background: Patients with diabetes are considered to be at high risk for dyslipidemia and hypertension and therefore vulnerable to cardiovascular diseases. This study describes the possible role of Glycated Hemoglobin (HbA1c) and serum lipid profile as a biomarker for detecting cardiovascular diseases. The aim of present work is to study the role of HbA1c as a screening biomarker for dyslipidemia in patients with type 2 Diabetes Mellitus (T2DM).

Methods: Present study consists of 100 Type 2 DM patients between age 30-75 years along with age and sex matched 100 healthy controls. Fasting Blood samples were collected from all participants for measuring lipid profile, blood sugar (FBS) and HbA1c.

Results: Present study revealed a significantly increased level of glycated hemoglobin (HbA1c) in cases compared to control. HbA1c showed direct and significant correlations with cholesterol, triglycerides and LDL and inverse correlation with HDL in cases when compared to controls.

Conclusions: HbA1c can be used as a potential biomarker for the prediction of Dyslipidemia and CVD.


Dyslipidemia, HbA1c, Type 2 diabetes mellitus

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Berry C, Tardif JC, Bourassa MG. Coronary heart disease in patients with diabetes: part I: recent advances in prevention and noninvasive management. J Am Coll Cardiol. 2007;49(6):631-42.

Sandhu HS, Koley S, Sandhu KS. A study of correlation between lipid profile and waist to hip ratios in patients with diabetes mellitus. Anthropol. 2008;10(3):215-8.

Anjana RM, Pradeepa R, Deepa M, Datta M, Sudha V, Unnikrishnan R, et al. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research–INdia DIABetes (ICMR-INDIAB) study. Diabetologia. 2011;54(12):3022-7.

Chandramohan P, Mohan V. High prevalence of diabetes and metabolic syndrome among policemen. J Asso Physician India. 2008;56(11):837-9.

King H, Revers M; Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. Diab Care.1993;16:157-77.

O’ Doherty R, Stein D, Foley J. Insulin resistance. Diabetologia. 1997;40(Suppl) 3:B10-15.

Lillioja S, Mott DM, Spraul M, Ferraro R, Foley JE, Ravussin E, Knowler WC, Bennett PH, Bogardus C. Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus: prospective studies of Pima Indians. N Eng J Med. 1993;329(27):1988-92.

Kumar V, Abbas AK, Fausto N, Aster JC. Robbins and Cotran pathologic basis of disease. 2005.

Basavanthappa BT. Medical Surgical Nursing. 1st Edition. Jaypee Brothers Medical Publishers. 2005; 687.

Peterson KP, Pavlovich JG, Goldstein D, Little R, England J, Peterson CM. What is hemoglobin A1C? An analysis of Glycated hemoglobins by electospray ionization mass spectrometry. Clin Chem. 1998;44(9):1951-8.

Vasudevan DM, Sreekumari S. Textbook of Biochemistry for medical students. Jaypee Brothers Medical Publishers (P) LTD, 8th ed: New Delhi; 2014.

Selvin E, Coresh J, Golden SH, Brancati FL, Folsom AR, Steffes MW. Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study. Archi Internal Med. 2005;165(16):1910-6.

Selvin E, Coresh J, Shahar E, Zhang L, Steffes M, Sharrett AR. Glycaemia (haemoglobin A1c) and incident ischaemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Lancet Neurol. 2005;4(12):821-6.

Gardiner HM, Pasquini L, Wolfenden J, Kulinskaya E, Li W, Henein M. Increased periconceptual maternal glycated haemoglobin in diabetic mothers reduces fetal long axis cardiac function. Heart. 2006;92(8):1125-30.

Selvin E, Wattanakit K, Steffes MW, Coresh J, Sharrett AR. HbA1c and peripheral arterial disease in diabetes: the Atherosclerosis Risk in Communities study. Diabetes Care. 2006;29(4):877-82.

Kawasumi M, Tanaka Y, Uchino H, Shimizu T, Tamura Y, Sato F, Mita T, et al. Strict glycemic control ameliorates the increase of carotid IMT in patients with type 2 diabetes. Endocrine J. 2006;53(1):45-50.

Ohtsubo K, Chen MZ, Olefsky JM, Marth JD. Pathway to diabetes through attenuation of pancreatic beta cell glycosylation and glucose transport. Nature Medicine. 2011;17(9):1067.

Marchetti P. Advanced glycation end products (AGEs) and their receptors (RAGEs) in diabetic vascular disease. Medicographia. 2009;31(3):257-65.

Vaag AA. Glycemic control and prevention of microvascular and macrovascular disease in the Steno 2 study. Endocrine Pract. 2006;12(Supplement 1):89-92.

Rosediani M, Azidah AK, Mafauzy M. Correlation between fasting plasma glucose, post prandial glucose and glycated haemoglobin and fructosamine. Med J Malaysia. 2006;61(1):67-71.

Ito C, Maeda R, Ishida S, Sasaki H, Harada H. Correlation among fasting plasma glucose, two-hour plasma glucose levels in OGTT and HbA1c. Diabetes Res Clin Prac. 2000;50(3):225-30.

Ko GT, Chan JC, Woo J, Lau E, Yeung VT, Chow CC, Li JK, et al. Glycated haemoglobin and cardiovascular risk factors in Chinese subjects with normal glucose tolerance. Diab Med. 1998;15(7):573-8.

Ravipati G, Aronow WS, Ahn C, Sujata K, Saulle LN, et al. Association of hemoglobin A1c level with the severity of coronary artery disease in patients with diabetes mellitus. Am J Cardiol. 2006;97(7):968-9.

Nishimura R, Nakagami T, Sone H, Ohashi Y, Tajima N. Relationship between hemoglobin A1c and cardiovascular disease in mild-to-moderate hypercholesterolemic Japanese individuals: subanalysis of a large-scale randomized controlled trial. Cardiova Diabetol. 2011;10(1):58.

Peterson KP, Pavlovich JG, Goldstein D, Little R, England J, Peterson CM. What is hemoglobin A1c? An analysis of glycated hemoglobins by electrospray ionization mass spectrometry. Clin Chem. 1998;44(9):1951-8.

Sicee R, Shaw J, Zimmet P; Diabetes and impaired glucose tolerance. Int Diab Federatio. 2006;15-103.

Sultan A, Thuan JF, Avignon A. Primary prevention of cardiovascular events and type 2 diabetes: should we prioritize our interventions?. Diabetes Metabol. 2006;32(6):559-67.

American Diabetes Association. The absence of a glycemic threshold for the development of long-term complications: the perspective of the Diabetes Control and Complications Trial. Diabetes. 1996;45(10):1289-98.

Avogaro A, Giorda C, Maggini M, Mannucci E, Raschetti R, Lombardo F, et al, DAI Study Group. Incidence of coronary heart disease in type 2 diabetic men and women: impact of microvascular complications, treatment and geographic location. Diabetes care. 2007;30(5):1241.

Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, et al. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. 2004;141(6):421-31.

Erciyas F, Taneli F, Arslan B, Uslu Y. Glycemic control, oxidative stress, and lipid profile in children with type 1 diabetes mellitus. Arch Med Res. 2004;35(2):134-40.

Khan HA, Sobki SH, Khan SA. Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA 1c predicts dyslipidaemia. Clin Exp Med. 2007;7(1):24-9.

Selvin E, Marinopoulos S, Berkenblit G, Rami T, Brancati FL, Powe NR, Golden SH. Meta-analysis: glycosylated hemoglobin and cardiovascular disease in diabetes mellitus. Ann Intern Med. 2004;141(6):421-31.

Windler E. What is the consequence of an abnormal lipid profile in patients with type 2 diabetes or the metabolic syndrome?. Atherosclero Supp. 2005;6(3):11-4.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.

Arora M, Koley S, Gupta S, Sandhu JS. A study on lipid profile and body fat in patients with diabetes mellitus. Anthropol. 2007;9(4):295-8.

Taylor KG, John WG, Matthews KA, Wright AD. A prospective study of the effect of 12 months treatment on serum lipids and apolipoproteins AI and B in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1982;23(6):507-10.

Huang ES, Meigs JB, Singer DE. The effect of interventions to prevent cardiovascular diseases in patients with type-2 diabetes mellitus. Am J Med. 2001;111(8):633-42.

Witztum JL, Mahoney EM, Branks MJ, Fisher M, Elam R, Steinberg D. Nonenzymatic glucosylation of low-density lipoprotein alters its biologic activity. Diabetes. 1982;31(4):283-91.