Association of HbA1c, Serum Uric Acid and Non-HDL Cholesterol in Type 2 Diabetes Patients

Abstract

Introduction: Diabetes mellitus (DM) is a metabolic disease resulting from either insulin deficiency or/and insulin resistance. Incidence of cardiovascular events is increased among diabetic with non-diabetic. However, not all patients with cardiovascular risk have elevated LDL-C. There is recognition that non high density lipoprotein cholesterol (Non-HDL-C) is strongly related to cardiovascular risk. NCEP ATP III has recommended using non-HDL cholesterol in assessing CVD risk in patients with diabetes. HbA1c and serum uric acid concentrations are also the independent risk factors and predictors of CVD. Aims and Objective: To find the association of HbA1c, serum uric acid and Non-HDL-C along with the pattern of dyslipidemia in type 2 DM and correlate HbA1c with fasting blood glucose. Materials And Methods: The descriptive and observational study was conducted in Bir hospital, NAMS, Nepal. Patients with diagnosis of diabetes for 3 years or more duration were selected for the study. The data including the duration of diabetes, and HbA1c and Lipid profile were collected using preformed proforma. The data was analysed by computer programme, statistical package for social sciences (SPSS). Mean values of plasma glucose, lipid profile and HbA1c standard deviations were calculated with various variables such as HbA1c and Non HDLc. Results: This study included 125 patients between 34 to 81 years. The mean duration of diabetes was 6.44± 3.42 years. The mean of FBS, PPBS and HbA1c was 181.84±59.08 mg/dl, 269.48±78.24 mg/dl and 9.68±1.95 %. The mean serum uric acid was 5.68±0.87 mg/dl. 21.53% and 10% of male and female had uric acid level more than 6.5mg/dl. In this study, very high cholesterol was 20.8%. Similarly LDL level and near optimal, borderline and high risk was 45.6%,16% and 5.6% and 36% of patients had decreased HDLc level and TG was elevate in 68.8%. Among the Cardiac risk ratio, Non-HDL cholesterol was deranged in 80%, Derangements in total cholesterol were seen in 58.3% of females and 55.4 % of males. Dyslipidemia in LDL groups were more in males as compared to females (73.3% and 63.2 % respectively). Non HDLc were elevated in both male and female in this study. There was positive correlation of total cholesterol and fasting blood sugar with HbA1c (p value<0.001). However, there is no association of HbA1c with uric acid level. There is the strong correlation of Non HDLc with TC/HDLc and LDLc /HDLc (p-value <0.001). Conclusion: In this study there is the correlation with FBS, HbA1c and NON HDLc cholesterol. Hence Non-HDL cholesterol proves to be more sensitive and a better predictor of cardiovascular risks than LDL cholesterol. HbA1c and serum uric acid concentrations are also the independent risk factors and predictors of CVD in diabetes patients which were not correlated in this study.