ASSESSMENT OF CARDIOVASCULAR RISK INDICES IN TYPE 2 DIABETES MELLITUS (original) (raw)
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Introduction: The reduction of cardiovascular risk by lowering low-density lipoprotein cholesterol (LDL-C) is well documented, and LDL-C remains the main target of lipid lowering therapy. However, not all patients with cardiovascular risk have elevated LDL-C. There is growing recognition that non-high density lipoprotein cholesterol (Non-HDL-C) is strongly related to cardiovascular risk. Aim: This study was done to evaluate the importance of Non-HDL C in predicting cardiovascular risk in type 2 Diabetes Mellitus. Methods: 100 type 2 diabetic patients were taken as subjects. Fasting and post meal blood sugar, lipid profile, and Non-HDL C was analysed in these patients. The patients were divided in two groups depending on their Non-HDL C level; ≤ 130 mg/dl and > 130mg/dl. Result and discussion: In this study it was seen that, age <60 years, being female, BMI >25 kg/m 2 and LDL cholesterol >100mg/dl were associated with having Non-HDL cholesterol >130mg/dl. Conclusion: The results showed positive correlation between Non-HDL and LDL cholesterol. It also showed significant non achievement of Non-HDL cholesterol targets of ≤ 130mg/dl even if LDL cholesterol targets were achieved i.e. <100mg/dl suggesting the importance of measuring Non –HDL Cholesterol to predict the risk of cardiovascular disease in type 2 diabetes.
IOSR Journals , 2019
Dyslipidemia has been identified as one of the most important risk factor associated with cardiovascular diseases (CVD). Absence of abnormal conventional lipid profile may not eliminate the risk of CVD in diabetics. Novel lipid ratios such as atherogenic index of plasma, atherogenic coefficient, castelli risk index I & II and non HDL-C have been found to indicate the level of atherogenicity and hence are suggested to be a better predictor of CVD in diabetes. This cross-sectional study was conducted for 2 months involving 50 diabetic and 50 healthy individuals. Lipid profile and plasma glucose levels were estimated. Using the lipid profile values atherogenic indices such as atherogenic index of plasma (AIP), atherogenic coefficient (AC), castelli risk index I & II (CRI-I, CRI-II) and non HDL-C were calculated. Continuous variables were expressed as mean and SD. Student's t test was used to compare the means of two groups. Pearson's linear correlation was used for evaluating the relationship of plasma glucose levels with traditional lipid parameters and atherogenic lipid indices in T2DM patients. Results were taken to be statistically significant at P ≤0.05. All the lipid profile values in diabetics were higher but only triglycerides (TG) and very low density lipoprotein (VLDL-C) showed statistical significance (p=0.0015 & p= 0.0012 respectively). Similarly, atherogenic indices were higher in diabetic group but only AIP showed statistical significance (p=0.0011). Fasting glucose level showed positive and significant correlation with TG (r=0.2879, p=0.042), VLDL (r= 0.2884, p=0.042) and AIP (r= 0.2961, p=0.036). Total cholesterol (TC) showed a positive and significant correlation with CRI-I (r=0.722, p<0.00001), CRI-II (r=0.718, p<0.00001), AIP (r=0.365, p<0.009), AC (r=0.722, p<0.00001) and non HDL-C (r=0.985, p<0.00001). TG showed positive correlation with all lipid indices except CRI-II. Similarly, Low density lipoprotein (LDL-C) showed statistically significant positive correlation with all the indices except AIP. Additionally, high density lipoprotein (HDL-C) showed negative correlation with all the indices but statistical significance was found only with CRI-I and AC.The study showed derangements in lipid profile among diabetic patients along with abnormally high values of atherogenic index of plasma, indicating its potential use in identifying diabetic patients who are at risk for cardiovascular disease.
Indian Journal of Clinical Cardiology, 2021
One-third of all deaths globally are caused by cardiovascular disease (CVD), and this percentage is predicted to climb as CVD risk factors become more widespread. Primary prevention of risk factors is the most fundamental duty in dealing with the CVD epidemic. The link between atherogenic index of plasma (AIP) and other CVD risks among university workers was investigated among study participants in order to demonstrate that AIP, not lipid profile, is a better predictor of CVDs. They discovered a link between AIP and CVD risk variables (body mass index, visceral fat, body fat, total cholesterol, low density lipoprotein cholesterol, triglyceride, glucose, and high density lipoprotein cholesterol) in people with type 2 diabetes. This comparative study was carried out in Cardiology Department, Zagazig University Hospitals. This study included 140 type 2 diabetes mellitus patients. They were classified into 2 main groups: Group 1: 70 patients with type 2 diabetes who had coronary artery ...
Journal of Advanced Biotechnology and Experimental Therapeutics, 2021
ABSTRACT: The low percentage of high-density lipoprotein-cholesterol (HDL-C) is strongly accompanied with cardiovascular diseases (CVD) where female are at higher risk than male and are the most dangerous reason of a disease called type 2 diabetes mellitus (T2DM). Although the relationship between gender-specific HDL-C / LDL-C level and T2DM is difficult to understand, however, it is suspected to be linked. To determine the HDL-C and LDL-C ratios among males and females with T2DM subjects, a study was conducted in the
Lipids in Health and Disease, 2010
Background Diabetes is a strong risk factor for cardiovascular disease (CVD).The relative role of various lipid measures in determining CVD risk in diabetic patients is still a subject of debate. We aimed to compare performance of different lipid measures as predictors of CVD using discrimination and fitting characteristics in individuals with and without diabetes mellitus from a Middle East Caucasian population. Methods The study population consisted of 1021 diabetic (men = 413, women = 608) and 5310 non-diabetic (men = 2317, women = 2993) subjects, aged ≥ 30 years, free of CVD at baseline. The adjusted hazard ratios (HRs) for CVD were calculated for a 1 standard deviation (SD) change in total cholesterol (TC), log-transformed triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), non-HDL-C, TC/HDL-C and log-transformed TG/HDL-C using Cox proportional regression analysis. Incident CVD was ascertained over a median of 8.6 years of follow-up. Results A total of 189 (men = 91, women = 98) and 263(men = 169, women = 94) CVD events occurred, in diabetic and non-diabetic population, respectively. The risk factor adjusted HRs to predict CVD, except for HDL-C, TG and TG/HDL-C, were significant for all lipid measures in diabetic males and were 1.39, 1.45, 1.36 and 1.16 for TC, LDL-C, non- HDL-C and TC/HDL-C respectively. In diabetic women, using multivariate analysis, only TC/HDL-C had significant risk [adjusted HR1.31(1.10-1.57)].Among non-diabetic men, all lipid measures, except for TG, were independent predictors for CVD however; a 1 SD increase in HDL-C significantly decreased the risk of CVD [adjusted HR 0.83(0.70-0.97)].In non-diabetic women, TC, LDL-C, non-HDL-C and TG were independent predictors. There was no difference in the discriminatory power of different lipid measures to predict incident CVD in the risk factor adjusted models, in either sex of diabetic and non-diabetic population. Conclusion Our data according to important test performance characteristics provided evidence based support for WHO recommendation that along with other CVD risk factors serum TC vs. LDL-C, non-HDL-C and TC/HDL-C is a reasonable lipid measure to predict incident CVD among diabetic men. Importantly, HDL-C did not have a protective effect for incident CVD among diabetic population; given that the HDL-C had a protective effect only among non- diabetic men.
Journal of Laboratory Physicians
Background Uttarakhand is a small state in northern India that comprises mixed population with people dwelling in both hilly and plain areas. Globally, diabetes mellitus (DM) has already been considered to be a pandemic. Furthermore, cardiovascular diseases (CVD) significantly increase mortality and morbidity in patients suffering from DM. Additionally, dyslipidemia has been identified as an important marker in the development of atherosclerosis and ultimately CVD in patients of prediabetes and diabetes. Thus, the identification of subjects with dyslipidemia in prediabetes might be fruitful in lowering their progression to diabetes and ultimately in decreasing incidences of CVD. Hence, this study was undertaken to assess dyslipidemia via the calculation of atherogenic indices (AI) and lipid ratios in prediabetic and diabetic groups attending tertiary care hospital in Uttarakhand. Materials and Methods This study reviewed retrospective biochemical data of 500 study subjects from e-ho...
Lipid profile of patients with diabetes mellitus: a cross sectional study
Background: Dyslipidemia is one of the common disorders which is seen in most of the diabetic patients, which causes cardio vascular disorders. Objective: To detect the lipid abnormality in diabetic patients. Methods: The study was carried out in Medicine Department, at a tertiary care hospital, Visakhapatnam from March 2017 to June 2017. The lipid profiles and the blood sugar values of 60 diabetic patients and 60 healthy subjects were studied after taking informed consent. Their serum samples were assessed for fasting blood glucose (FBG), post prandial blood glucose(PPBS), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL) and high density lipoprotein cholesterol (HDL) by using standard biochemical methods. The data was collected by predesigned, pretested proforma and analyzed using SPSS 17.0 (Trial version). Results: Maximum number of patients (36.6%) were from age group of 40-49 years. Mean age in DM group was 42.13 ± 9.29 years. Among males with diabetes 43.3% were in the 50-59yrs age group. Among females with diabetes 46% were in the 30-39yrs age group. Among Diabetic patients only 26.6% had fasting blood glucose less than 140mg/dl and 23.3% showed more than 200 mg/dl level of Post Prandial Blood Sugar (PPBS). All the subjects with diabetes mellitus showed high serum cholesterol level (>240mg/dl). Among Diabetic patients showed normal (<150 mg/dl) serum triglyceride level, whereas all the control group subjects showed normal level. Serum LDL level was high (>160 mg/dl) in 98.3% of Diabetic patients. In diabetic patients group 41.6% of them showed low (<40 mg/dl) serum HDL value whereas in the control group all the participants had normal serum HDL level(>40mg/dl). In DM patients, the mean values of S. Cholesterol and S. LDL were high whereas S. triglyceride and S. HDL level were in normal limit in both the sexes. Males have shown slightly higher mean level of S. cholesterol, S. triglyceride, S. LDL and S. HDL level as compared to females. Conclusions: The frequencies of the high cholesterol, high TG and high LDL levels were higher in the diabetic group, thus indicating that diabetic patients were more prone for dyslipidemia, which could cause cardiovascular disorders.
Journal of Applied Pharmaceutical Science
Objective: Atherosclerotic cardiovascular diseases were the major culprit in diabetic patients with high mortality rate in non-communicable disease worldwide. Present study was conducted to assess cardiovascular risk among type-2 diabetic patients without the history of cardiovascular disease. Methods: The present study was conducted on type-2 diabetes patients without history of cardiovascular disease (CVD) and the number of samples was 118 (65 male and 53 female) aged between 36 and 74 years in a teaching hospital of southern part of India. The individual patient risk factors were determined. Framingham cardiovascular risk prediction model was used to calculate the 10-year risk for CVD. The relationship between Framingham cardiovascular risk score and individual risk factors was determined using chi-square test. Key findings: Framingham risk score for cardiovascular disease (FRS-CVD) risk assessment model shows 11.01% were at high risk, 33.05% were at intermediate risk, and 55.93% were at low risk for developing CVD in the next 10 years. Visceral adiposity index (VAI), waist circumference, waist height ratio, smoking, systolic blood pressure, diastolic blood pressure contributed significantly to high degree of cardiovascular risk. Conclusion: The results of our study concluded that, in this population of patient with type-2 diabetes mellitus, the estimated cardiovascular risk in relationship with the central obesity, but not with glycemic control parameters. The use of CVD assessment tools like Framingham risk score, VAI, and ankle braquial index can prevent the diabetic patient from CVD.
Dyslipidemia in Type II Diabetes Mellitus - An assessment of the main lipoprotein abnormalities
Bangladesh Journal of Medical Science, 2016
Background: Diabetes is associated with a high risk of cardiovascular diseases and underlying lipid abnormalities. Dyslipidemia, a modifiable risk factor is often underdiagnosed and undertreated in our patients. Its early identification can make aggressive cardiovascular preventive management possible. This report seeks to determine the prevelance and pattern of lipid abnormalities in type II diabetes mellitus. Methods: The lipid profiles and fasting blood sugar values of 100 known diabetics were studied. Their serum samples were assessed for fasting blood glucose [FBG], total cholesterol[TC], triacylglycerol [TG], low density lipoprotein cholesterol [LDL-C] and high density lipoprotein cholesterol [HDL-C] by using standard biochemical methods. Results: 83% of study subjects had lipid abnormalities. The mean TC, TG, LDL-C, and FBG levels were highly significant in the diabetics as compared to those in controls. It was found that 28% had hypercholesterolemia and 44% had hypertriglyceridemia. The mean HDL-C concentration was significantly high in female diabetics as compared to that in male diabetics. The correlation studies showed a nonsignificant negative correlation of FBG with TC, TG and LDL-C. Conclusion: In the diabetics higher frequencies of high TC, high TG and high LDL-C levels are noted indicating diabetic patients were more prone for dyslipidemia which could cause cardiovascular disorders.
Nigerian journal of clinical practice, 2009
To determine the usefulness of total cholesterol/high-density lipoprotein cholesterol and/or high-density lipoprotein cholesterol/total cholesterol ratios in the interpretation of lipid profile result in clinical practice. This is a prospective case-control study involving 109 diabetics, 98 diabetic hypertensives, 102 hypertensives and 120 control subjects. Serum lipid profile and plasma glucose were determined using appropriate methods. The mean ages of the different study groups were similar. Body mass indices of diabetics with or without hypertension were significantly higher than that of the controls. The difference in the mean total cholesterol of each group was not statistically significant when compared with the controls. A significant difference existed in the mean LDL when the different study groups were compared with the controls. There was a significant difference in the mean TG of DM and DM/hypertension patients compared with that of controls. However, the mean TG of hyp...