Lipid profile abnormalities seen in T2DM patients in primary healthcare in Turkey: a cross-sectional study

Lipids in Health and Disease

Aclan Ozder¹ 

[1]Medical Faculty, Department of Family Medicine, Bezmialem Vakif University, Adnan Menderes Boulevard, 34093 Fatih, Istanbul, Turkey

关键词: Lifestyle modification;    Type 2 diabetes;    Insulin resistance;    Glucose intolerance;    Dyslipidemia;   

Others  :  1151657
DOI  :  10.1186/1476-511X-13-183

 received in 2014-08-28, accepted in 2014-11-29,  发布年份 2014

【 摘 要 】

Background

Diabetes is characterized by chronic hyperglycemia and disturbances of carbohydrate, lipid and protein metabolism. We aimed to research association between serum lipid profile and blood glucose, hypothesizing that early detection and treatment of lipid abnormalities can minimize the risk for atherogenic cardiovascular disorder and cerebrovascular accident in patients with type 2 diabetes mellitus.

Methods

Fasting blood glucose (FBG), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), triglyceride (TG) and glycated haemoglobin (HbA1c) levels were evaluated. A hepatic ultrasound was performed for every diabetic to evaluate hepatosteatosis. The study was done from January 2014 to June 2014 among 132 patients with T2DM who were admitted to outpatient clinic of Family Medicine department in a university hospital. The patients whose taking multi-vitamin supplementation or having hepatic, renal or metabolic bone disorders (including parathyroid related problems) were excluded from the study for the reason that those conditions might affect the carbohydrate and lipid metabolism in diabetes. Test of significance was calculated by unpaired student’s t test between cases and controls. Correlation studies (Pearson’s correlation) were performed between the variables of blood glucose and serum lipid profile. Significance was set at p<0.05.

Results

Results of serum lipid profile showed that the mean values for TC, TG, HDL and LDL in female patients were 227.6 ± 57.7 mg/dl, 221.6 ± 101.1 mg/dl, 31.5 ± 6.7 mg/dl and 136.5 ± 43.7 mg/dl, respectively. The mean values for TC, TG, HDL and LDL in male patients were 219.1 ± 34.7 mg/dl, 250.0 ± 100.7 mg/dl, 30.2 ± 7.4 mg/dl and 125.7 ± 21.4 mg/dl, respectively. Significantly higher mean serum levels of TC, TG and LDL and significantly lower mean serum levels of HDL were noted in patients with diabetes (p<0.001). FBG showed significant positive correlation with TC (p<0.05) and TG (p<0.05). Significant correlations were observed between serum levels of TC, TG, LDL and hepatosteatosis and HbA1c (p<0.05).

Conclusions

The study showed widespread lipid abnormalities in the course of diabetes triggered dyslipidemia as hypercholesterolemia, hypertriglyceridemia, elevated LDL and decreased HDL. This study proposes the predominance of hyperlipidemia over increased prevalence of diabetic dyslipidemia.

【 授权许可】

   
2014 Ozder; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Abou-Seif MA, Youssef AA: Evaluation of some biochemical changes in diabetic patients. Clin Chim Acta 2004, 346:161-170.
• [2]Gadi R, Samaha FF: Dyslipidemia in type 2 diabetes mellitus. Curr Diab Rep 2007, 7(3):228-234.
• [3]Khan SR, Ayub N, Nawab S, Shamsi TS: Triglyceride profile in dyslipidaemia of type 2 diabetes mellitus. J Coll Phys Surg Pak 2008, 18(5):270-273.
• [4]Elinasri HA, Ahmed AM: Patterns of lipid changes among type 2 diabetes patients in Sudan. East Mediterr Health J 2008, 14(2):314-324.
• [5]Unalacak M, Kara IH, Baltaci D, Ozgur E, Bucaktepe PGE: Effects of Ramadan fasting on biochemical and hematological parameters and cytokines in healthy and obese individuals. Met Synd Rel Disord 2011, 9(2):157-161.
• [6]Reaven GM: Banting lecture 1988. Role of insulin resistance in human disease. Diabetes 1988, 37:1595-1607.
• [7]Kaplan NM: The deadly quartet. Upper-body obesity, glucose intolerance, hypertriglyceridaemia and hypertension. Arch Intern Med 1989, 149:1514-1520.
• [8]Zimmet P, Alberti G, Shaw J: A new IDF worldwide definition of the metabolic syndrome: the rationale and the results. Diabetes Voice 2005, 50(3):31-33.
• [9]Taskinen MR: Diabetic dyslipidemia. Atheroscler Suppl 2002, 3(1):47-51.
• [10]Folli F, Corradi D, Fanti P, Davalli A, Paez A, Giaccari A, Perego C, Muscogiuri G: The role of oxidative stress in the pathogenesis of type 2 diabetes mellitus micro- and macrovascular complications: avenues for a mechanistic-based therapeutic approach. Curr Diabetes Rev 2011, 7(5):313-324.
• [11]Maritim AC, Sanders RA, Watkins JB: Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol 2003, 17(1):24-38.
• [12]Mahato RV, Gyawali P, Raut PP, Regmi P, Khelanand PS, Dipendra RP, 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):375-380.
• [13]Wexler DJ, Grant RW, Meigs JB, Nathan DM, Cagliero E: Sex disparities in treatment of cardiac risk factors in patients with type 2 diabetes. Diabetes Care 2005, 28(3):514-520.
• [14]Regmi P, Gyawali P, Shrestha R, Sigdel M, Mehta KD, Majhi S: Pattern of dyslipidemia in type-2 diabetic subjects in Eastern Nepal. J Nepal Assoc Med Lab Sci 2009, 10(1):11-13.
• [15]Selvin E, Steffes MW, Zhu H, Matsushita K, Wagenknecht L, Pankow J, Coresh J, Brancati FL: Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. N Engl J Med 2010, 362:800-811.
• [16]Brownlee M: Biochemistry and molecular cell biology of diabetic complications. Nature 2001, 414(6865):813-820.
• [17]Jokl R, Colwell JA: Arterial thrombosis and atherosclerosis in diabetes. Diabetes Metab Rev 1997, 5:1-15.
• [18]Taskinen MR: Diabetic dyslipidaemia: from basic research to clinical practice. Diabetologia 2003, 46(6):733-749.
• [19]Goldberg IJ: Diabetic dyslipidemia: causes and consequences. J Clin Endocr Metab 2001, 8(3):965-971.
• [20]Krauss RM: Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care 2004, 27(6):1496-1504.
• [21]Haffner SM, Mykkanen L, Festa A: Insulin-resistant prediabetic subjects have more atherogenic risk factors than insulin-sensitive prediabetic subjects. Circulation 2000, 101:975-980.
• [22]Mooradian AD: Dyslipidemia in type 2 diabetes mellitus. Nat Clin Pract Endocr Metab 2009, 5:150-159.
• [23]Smith S, Lall AM: A Study on lipid profile levels of diabetics and non-diabetics among Naini region of Allahabad, India. Turk J Biochem 2008, 33(4):138-141.
• [24]Howard BV: Lipoprotein metabolism in diabetes mellitus. J Lipid Res 1987, 28(6):613-628.
• [25]Taskinen MR, Kahri J, Koivisto V, Shepherd J, Packard J: Metabolism of HDL apolipoprotein A-I and A-II in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1992, 35(4):347-356.
• [26]Bitzur R, Cohen H, Kamari Y, Shaish A, Harats D: Triglycerides and HDL Cholesterol: Stars or second leads in diabetes? Diabetes Care 2009, 32(2):373-377.
• [27]Goldbourt U, Yaari S, Medalie JH: Isolated low HDL cholesterol as a risk factor for coronary heart disease mortality: a 21-year follow-up of 8000 mMen. Arterioscler Thromb Vasc Biol 1997, 17:107-113.
• [28]Goldberg IJ: Lipoprotein lipase and lipolysis: central roles in lipoprotein metabolism and atherogenesis. J Lipid Res 1996, 37(4):693-707.
• [29]Andersen GE, Christiansen JS, Mortensen HB, Christiansen KM, Pedersen-Bjergaard L, Kastrup KW, Vestermark S: Serum lipids and lipoproteins in 157 insulin dependent diabetic children and adolescents in relation to metabolic regulation, obesity and genetic hyperlipoprotenimia. Acta Paediatr Scand 1983, 72:361-365.
• [30]Hachem SB, Mooradian AD: Familial dyslipidaemias: an overview of genetics, pathophysiology and management. Drugs 2006, 66:1949-1969.
• [31]He S, Wang S, Chen X, Jiang L, Peng Y, Li L, Wan L, Cui K: Higher ratio of triglyceride to high-density lipoprotein cholesterol may predispose to diabetes mellitus: 15-year prospective study in a general population. Metabolism 2012, 61(1):30-36.
• [32]Zoppini G, Negri C, Stoico V, Casati S, Pichiri I, Bonora E: Triglyceride-highdensity lipoprotein cholesterol is associated with microvascular complications in type 2 diabetes mellitus. Metabolism 2012, 61(1):22-29.
• [33]Giannini C, Santoro N, Caprio S, Kim G, Lartaud D, Shaw M, Pierpont B, Weiss R: The triglyceride-to-HDL cholesterol ratio: association with insulin resistance in obese youths of different ethnic backgrounds. Diabetes Care 2011, 34(8):1869-1874.
• [34]Kim-Dorner SJ, Deuster PA, Zeno SA, Remaley AT, Poth M: Should triglycerides and the triglycerides to high-density lipoprotein cholesterol ratio be used as surrogates for insulin resistance? Metabolism 2010, 59(2):299-304.
• [35]Sattar N, Gill JMR: Type 2 diabetes as a disease of ectopic fat? BMC Med 2014, 12:123.
• [36]Siraj ES, Seyoum B, Saenz C, Abdulkadir J: Lipid and lipoprotein profile in Ethopian patients with diabetes mellitus. Metabolism 2006, 55(6):706-710.
• [37]Al-Habori M, Al-Mamari M, Al-Meeri A: Type II diabetes mellitus and impaired glucose tolerance in Yemen: frequency, associated metabolic changes and risk factors. Diabetes Res Clin Pract 2004, 65:275-281.
• [38]Heshmat R, Tabatabaei-Malazy O, Abbaszadeh-Ahranjani S, Shahbazi S, Khooshehchin G, Bandarian F, Larijani B: Effect of vitamin D on insulin resistance and anthropometric parameters in Type 2 diabetes; a randomized double-blind clinical trial. DARU J Pharm Sci 2012, 20:10. BioMed Central Full Text
• [39]Wu P: Thyroid disease and diabetes. Clin Diab 2000, 18(1):38.
• [40]American Gastroenterological Association: AGA technical review on nonalcoholic fatty liver disease. Gastroenterology 2002, 123:1705-1725.