Abstract
BackgroundDiabetes mellitus (DM) is a disorder that is often associated with cardiovascular events and underlying lipid abnormalities. Cardiovascular complications are common causes of DM deaths in Nigeria yet dyslipidaemia is one aspect of DM that is underdiagnosed and undertreated in our patients. This report seeks to determine the prevalence and pattern of lipid abnormalities in Nigerians with types I and 2 DM.MethodsA total of 600 patients with DM aged between 22 – 79 years were evaluated for lipid abnormalities. The anthropometric indices, glycosylated haemoglobin, pattern of DM treatment and co-morbidities were noted. Total cholesterol (TCHOL), triglyceride (TG), high density lipoproteins (HDL-C), low density lipoproteins cholesterol (LDL-C) levels and the atherogenic indices levels were documented. Test statistic used included student's t test and χ2.ResultsWell over half (89%) of the study subjects had lipid abnormalities and there was no statistically significant difference in the proportions of subjects with type 1 and 2 DM with lipid abnormalities. Elevated LDL-C, TCHOL, TG and reduced HDL-C were noted in 74%, 42%, 13%, and 53% respectively of the study subjects. The commonly noted combined lipid abnormalities were elevated TG and reduced HDL-C. Hypertension, significant histories of smoking and alcohol ingestion were found to be potential determinants of the occurrence of dyslipidaemia. Age, sex, type of DM and anthropometric indices were found to be determinants of the the pattern of dyslipidaemia. Only a small proportion – (8%)-of the subjects with dyslipidaemia were on treatment for it.ConclusionHaving defined the scope of dyslipidaemia in our patients and also highlighting its gross undertreatment, we hope that our data will help sensitize health care practitioners on screening for and treating dyslipidaemia. Elevated LDL-C and reduced HDL-C should be the primary targets of treatment in our patients with dyslipidaemia.
Highlights
Diabetes mellitus (DM) is a disorder that is often associated with cardiovascular events and underlying lipid abnormalities
The high burden of DM in Nigeria is largely attributable to cardiovascular diseases which account for 15% of all DM deaths [1,2]
The development of cardiovascular disease in DM is often predicted by several factors which include central obesity, hypertriglyceridemia, elevated low highdensity lipoprotein (HDL-C) levels, and hypertension [3]
Summary
Diabetes mellitus (DM) is a disorder that is often associated with cardiovascular events and underlying lipid abnormalities. The development of cardiovascular disease in DM is often predicted by several factors which include central obesity, hypertriglyceridemia, elevated low highdensity lipoprotein (HDL-C) levels, and hypertension [3]. Elevated low density lipoprotein (LDL-C) has been found to be an independent risk factor for the development of cardiovascular disease and is often reported to be the commonest lipid abnormality found in patients with DM [4,5,6]. The role of LDL-C in the development of CVD cannot be overemphasized as there is documented evidence that high levels of LDL-C cause atherosclerosis but pharmacological interventions that reduce LDL-C cholesterol are associated with stabilization and regression of atherosclerosis in proportion to the cholesterol lowering achieved[8]. The triglycerides have been found to be univariate predictors of CVD in many studies, no clinical trial data has established that lowering triglycerides in individuals with or without diabetes independently leads to lower CVD event rates after changes in HDL cholesterol are adjusted for
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