Evaluation of type-2 diabetes mellitus patients for dyslipidemia in a tertiary care centre
DOI:
https://doi.org/10.18203/2349-3933.ijam20201078Keywords:
Coronary heart disease, Dyslipidemia, HbA1c, High density lipoproteinAbstract
Background: Diabetes mellitus (DM) is a syndrome consisting of metabolic, vascular and neuropathic components that are interrelated. Diabetes mellitus is associated with a considerably increased risk of premature atherosclerosis, particularly coronary heart disease (CHD) and peripheral arterial disease. Dyslipidemia is a common feature of diabetes. There is an association between atherosclerotic cardiovascular disease and serum cholesterol and triglyceride levels in both type 1 and type 2 diabetes.
Methods: The study was done on 50 adult diabetes mellitus (T2) patients from IPD of General Medicine wards at SMS Hospital, Ahmedabad, Gujarat. 50 healthy age and sex matched healthy volunteers were taken as control. They were evaluated for lipid profile i.e., Total Cholesterol (TC),Triglyceride (TG), Low-density lipoprotein (LDL), High density lipoprotein (HDL), Very low density lipoprotein (VLDL) and glycemic status i.e., Fasting blood glucose (FBS), Postprandial 2 hours blood glucose (PP2BS) & Glycosylated haemoglobin(HbA1C).
Results: Diabetic cases had statistically highly significant (p<0.001) elevated levels of total Cholesterol, Triglycerides and VLDL as compared to controls. Serum TG, serum TC, LDL-C and VLDL-C had positive correlation with the postprandial plasma glucose, fasting plasma glucose and HbA1c.
Conclusions: Significant correlations between HbA1c levels and lipid levels point towards the usefulness of HbA1c for screening high-risk diabetic patients. High TC, TG, LDL-C and HbA1c with normal or low HDL-C is seen in almost all diabetic patients either alone or in combinations.
References
Imani SF, Hashemipour M, Kelishadi R. lipid profile of children with type in diabetes compared to controls. ARYA J. 2006;2(1):36-8.
King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diab Care. 1998 Sep 1;21(9):1414-31.
Fall CH. Non-industrialised countries and affluence: relationship with type 2 diabetes. Brit Med Bull. 2001 Nov 1;60(1):33-50.
Bjork S, Kapur A, King H, Nair J, Ramachandran A. Global policy: aspects of diabetes in India. Health policy. 2003 Oct 1;66(1):61-72.
Rao CR, Kamath VG, Shetty A, Kamath A. A study on the prevalence of type 2 diabetes in coastal Karnataka. Int J Diabetes Dev Ctries. 2010;30(2):80-5.
Adler AI, Neil HA, Stratton IM, Holman RR. Ethnicity and cardiovascular disease: The incidence of myocardinal infarction in white, South Asian, and Afro-Caribbean patients with type 2 diabetes (UK Prospective Diabetes Study 32). Diab Care. 1998 Aug 1;21(8):1271-7.
Kudchodkar BJ, Lee MJ, Lee SM, DiMarco NM, Lacko AG. Effect of dietary protein on cholesterol homeostasis in diabetic rats. J Lipid Res. 1988 Oct 1;29(10):1272-87.
Mitka M. Aggressive lipid, hypertension targeting yields no benefit for some with diabetes. JAMA. 2010 May 5;303(17):1681-3.
Bamba V, Rader DJ. Obesity and atherogenic dyslipidemia. Gastroenterol. 2007 May 1;132(6):2181-90.
Smith DG. Epidemiology of dyslipidemia and economic burden on the healthcare system. Am J Managed Care. 2007 Jun;13:S68-71.
Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med. 1998 Jun 4;338(23):1650-6.
Joshi SR, Anjana RM, Deepa M, Pradeepa R, Bhansali A, Dhandania VK, et al. Prevalence of dyslipidemia in urban and rural India: the ICMR–INDIAB study. PloS One. 2014;9(5).
Washington RL. Interventions to reduce cardiovascular risk factors in children and adolescents. Am Fam Phys. 1999 Apr 15;59(8):2211-8.
Grundy S. Third Report of the National Cholesterol Education Program (NCEP), National Heart, Lung, and Blood Institute. NIH Publication; 2001:3670.
Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine. Longo DL, editor. New York: Mcgraw-hill; 2012.
Rye KA, Bursill CA, Lambert G, Tabet F, Barter PJ. The metabolism and anti-atherogenic properties of HDL. J Lipid Res. 2009 Apr 1;50(Supplement):S195-200.
Tagoe DN, Amo-Kodieh P. Type 2 diabetes mellitus influences lipid profile of diabetic patients. Ann Biol Res. 2013;4(6):88-92.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diab Med. 1998 Jul;15(7):539-53.
VinodMahato R, Gyawali P, Raut PP, Regmi P, Singh KP, Pandeya DR, Gyawali P. Association between glycaemic control and serum lipid profile in type 2 diabetic patients: Glycated haemoglobin as a dual biomarker. Biomed Res. 2011;22(3):375-80.
Masum N, Nasrin F, Neaz S, Tamanna N, Islam KS, Chowdhury MR, et al. Association of Uric acid with type II diabetes. IRJALS. 2012;1(4):32- 7.
Huang KC, Chen CC, Su YC, Lin JS, Chang CT, Wang TY, et al. The relationship between stasis-stagnation constitution and peripheral arterial disease in patients with type 2 diabetes. Evidence-Based Complement Alternat Med. 2014;2014.
Gustafsson I, Brendorp B, Seibæk M, Burchardt H, Hildebrandt P, Køber L, et al. Influence of diabetes and diabetes-gender interaction on the risk of death in patients hospitalized with congestive heart failure. J Am Coll Cardiol. 2004 Mar 3;43(5):771-7.
Agrawal Y, Goyal V, Chugh K, Shanker V, Singh AA. Types of dyslipidemia in type 2 diabetic patients of Haryana region. Sch J App Med Sci. 2014;2(4):1385-92.
Yang X, So W, Ko GT, Ma RC, Kong AP, Chow CC, et al. Independent associations between low-density lipoprotein cholesterol and cancer among patients with type 2 diabetes mellitus. CMAJ. 2008 Aug 26;179(5):427-37.
Jee SH, Ohrr H, Sull JW, Yun JE, Ji M, Samet JM. Fasting serum glucose level and cancer risk in Korean men and women. JAMA. 2005;293(2):194-202.
Lipscombe L, Goodwin P, Zinman B, McLaughlin JR, Hux JE. Diabetes mellitus and breast cancer:a retrospective population-based cohort study. Breast Cancer Res Treat. 2006;98(3):349-56.
Rodriguez C, Patel AV, Mondul AM, Jacobs EJ, Thun MJ, Calle EE. Diabetes and risk of prostate cancer in a prospective cohort of US men. Am J Epidemiol. 2005;161(2):147-52.
Singh D, Singh A, Kumar R, Khan I. Dyslipidemia in Type 2 Diabetes Mellitus Patients of Udaipur Population. Scholars J Appl Med Sci. 2015;3(2D):813-5.
Bhatt RD, Lochan K. Types of Dyslipidemia in Type 2 DM Patients of Bhubaneswar region. Ann Clini Chem Lab Med. 2015 Mar 19;1(1):33-6.
Alam R, Aleem M, Khan S, Waseem SM. Assessment of Lipid profile and Glycated Hemoglobin in Newly Diagnosed type 2 Diabetes Mellitus in Rural Population of Indore, MP, India. Sch J App Med Sci. 2015;3(2E):916-8.
Lodha R, Lal R, Biyani S. HbA1c as screening biomarker of dyslipidemia in type 2 diabetes mellitus patients. Scholar J Appl Med Sci. 2016;4:1600-2.
Bali K, Vij AS. Pattern of dyslipidemia in Type 2 Diabetes Mellitus in Punjab. Int J Res Med Sci. 2016;4(3):809-12.
Rohlfing CL, Wiedmeyer HM, Little RR, England JD, Tennill A, Goldstein DE. Defining the relationship between plasma glucose and HbA1c: analysis of glucose profiles and HbA1c in the Diabetes Control and Complications Trial. Diab Care. 2002 Feb 1;25(2):275-8.
El-Hazmy MAF, Warsy A S. Lipid profile in Saudi NIDDM patients. Int Diabetes Digest. 1994;5:21-4.
Hague S. The role of ACE inhibitors in diabetic nephropathy. Int Diabetes Digest. 1994;5:21-4.
Naway LM. Lipid Profile in Sudanese Diabetic Patients. 2011:48-54.