Abstract
BackgroundDyslipidemia is an important modifiable risk factor for cardiovascular disease. It is diagnosed by the presence of an abnormal lipid profile, primarily with elevated levels of plasma cholesterol, triglyceride, or both, or reduced levels of high-density lipoprotein cholesterol. However, some studies have reported increased risk of ischemic stroke with elevated low-density lipoprotein cholesterol (LDL-C) levels and increased risk of cardiovascular mortality independent of LDL-C levels in type 2 diabetes mellitus (T2DM) patients.MethodsIn this cross-sectional study, data were included for Thai adults with diabetes from the Diabetes Mellitus/ Hypertension (DM/HT) study, 2010–2014 (data was collected by the Medical Research Network of the Consortium of Thai Medical Schools). The target population comprised T2DM patients who were treated at a hospital for more than 12 months. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated to determine factors associated with dyslipidemia.ResultsIn total, 140,557 participants (average age, 60 years) were enrolled, with a dyslipidemia prevalence of 88.9% in the cohort. The factors associated with dyslipidemia included female sex (aOR: 1.47, 95% CI: 1.38–1.56); age < 50 years (aOR: 1.16, 95% CI: 1.10–1.22); waist circumference ≥ 90 cm in males and ≥ 80 cm in females (aOR: 1.23, 95% CI: 1.16–1.31); treatment at a primary care unit (aOR: 1.28, 95% CI: 1.23–1.33); and a history of unknown stroke (aOR: 1.10, 95% CI: 1.02–1.19), coronary revascularization (aOR: 0.85, 95% CI: 0.79–0.91), diabetic nephropathy (aOR: 1.06, 95% CI: 1.01–1.12), or renal insufficiency (aOR: 1.08, 95% CI: 1.02–1.13).ConclusionsDyslipidemia is prevalent among Thai T2DMpatients and is associated with gender; age; obesity; central obesity; treatment at a primary care unit; and a history of unknown stroke, coronary revascularization, diabetic nephropathy, and renal insufficiency. Our study results will help increase the awareness of healthcare providers regarding dyslipidemia in diabetic patients. To reduce cardiovascular risk, healthcare professionals should provide regular follow-up and proper advice and ensure primary prevention of vascular complications. Improved education and increased self-awareness regarding the need to change behaviors and regular intake of medication would help decrease dyslipidemia prevalence among diabetic patients.
Highlights
Dyslipidemia is an important modifiable risk factor for cardiovascular disease
Dyslipidemia is a major risk factor for cardiovascular disease, stroke, and type 2 diabetes mellitus (T2DM) [1], but it is modifiable by lifestyle changes and medication [2]
We found associations between dyslipidemia and complications, notably for a history of stroke and coronary revascularization and for patients with diabetic nephropathy and renal insufficiency
Summary
Dyslipidemia is an important modifiable risk factor for cardiovascular disease It is diagnosed by the presence of an abnormal lipid profile, primarily with elevated levels of plasma cholesterol, triglyceride, or both, or reduced levels of high-density lipoprotein cholesterol. Some studies have reported increased risk of ischemic stroke with elevated low-density lipoprotein cholesterol (LDL-C) levels and increased risk of cardiovascular mortality independent of LDL-C levels in type 2 diabetes mellitus (T2DM) patients. Compared with other middle-income Asian countries, unawareness regarding hypercholesterolemia in Thailand was reportedly the highest at 78% in 2004, with low levels of treatment and control [6] This was compounded by the results of a national survey in 2009, which found that dyslipidemia was present in 66.5% of the Thai population [7]. In Thailand, socioeconomic development and lifestyle changes such as consumption of Western-style diets, reduced physical activity, and changes in type of work have contributed to the increased dyslipidemia prevalence among the population
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