English

Abstract

BACKGROUND: Diabetes is a chronic metabolic disorder and a well-known risk factor for atherosclerotic diseases. Atherosclerosis is mainly due to alterations in lipoprotein profile. HbA1C is a marker of long term exposure to chronic hyperglycemia. HbA1C and dyslipidemia are independent risk factors for atherosclerotic diseases. AIM: To evaluate the correlation between HbA1C and dyslipidemia in type 2 diabetic patients and to find out whether HbA1C can predict dyslipidemia. MATERIALS AND METHODS: We conducted a cross-sectional study of 103 type 2 diabetic patients attending diabetic outpatient clinic at Mahatma Gandhi Memorial Govt. Hospital, Tiruchirappalli. Venous blood samples were collected from all the subjects after at least 8-10 hours of fasting. Fasting and post-prandial Blood Glucose, Lipid Profile and HbA1c were estimated by standard methods. NCEP-ATP III guideline was referred to define dyslipidemia. The data were analyzed using SPSS version 21 software. RESULTS: In our study, the mean values of HbA1C, TGL, VLDL and TGL/HDL were found to be significantly higher (p < 0.05) in women. 98% of the subjects under study were dyslipidemic. 45% of the subjects had four abnormal lipid parameters, 29%-three, 7%-two and 14%-one abnormal parameter. The prevalence of inadequate glycemic control (HbA1C ≥ 7) in the study population was 66%. The mean values of all the lipid parameters and atherogenic risk ratios were found to be higher in the HbA1C ≥ 7 group and were statistically highly significant. Pearson’s correlation test, showed that HbA1C was positively correlated with TC(p < 0.05), TGL(p < 0.001), LDL(p < 0.05), VLDL(p < 0.001), TC/HDL(p < 0.001), TGL/HDL(p < 0.001), LDL/HDL(p < 0.001) and negatively correlated with HDL(p < 0.001). By linear regression analysis, it was also found that HbA1C could predict hypercholesterolemia (p=0.024; R2 = 0.049), hypertriglyceridemia (p=0.000; R2 = 0.254), high LDL (p=0.045; R2 = 0.039), high VLDL (p=0.000; R2 = 0.116), low HDL (p=0.000; R2 = 0.316) and the atherogenic ratios TC/HDL (p=0.000; R2 = 0.196), TGL/HDL (p=0.000; R2 = 0.399) and LDL/HDL (p=0.000; R2 = 0.141). CONCLUSION: We therefore conclude that HbA1C is not only a marker of chronic exposure of hyperglycemia but can also predict dyslipidemia. Lifestyle modifications and earlier intervention by lipid lowering therapy can reduce the cardiovascular mortality of this risk group. However for intervention by lipid lowering therapy, more prospective studies with large sample sizes are essential.