North Indian Type Research Articles

Association of Single Nucleotide Polymorphism in OCT1 and OCT3 Genes with the Efficacy of Metformin Response in North Indian Type 2 Diabetes Mellitus Patients

Introduction: Variability in the effectiveness of metformin treatment among individuals with type 2 diabetes mellitus (T2DM) has been linked to various genetic factors. Understanding the genetic mechanisms underlying the action of metformin can greatly aid the personalized management of T2DM. Our investigation aimed to explore the impact of genetic variations in the organic cation transporters (OCT1 and OCT3) genes on the efficacy of metformin therapy in T2DM individuals from North India. Methods: This observational cross-sectional study assessed the influence of OCT1 (rs628031) and OCT3 (rs2292334) polymorphisms on metformin response in T2DM patients. Metformin response was determined based on HbA1c levels, dividing patients (n = 177) into two categories: responders (HbA1C<7%; n = 127) and non-responders (HbA1C≥7%; n = 50). Responders were further classified as T2DM patients receiving either monotherapy (n = 55) or combination therapy (n = 72). Genotyping was conducted using the PCR-RFLP method. Results: No significant association was observed between OCT1 (rs628031) polymorphism and metformin response in T2DM patients. However, a notable association was found between OCT3 (rs2292334) polymorphism and metformin response. Carriers of the AA genotype exhibited enhanced efficacy of metformin in both monotherapy (OR (CI)= 0.29(0.11-0.72), p=0.007) and combination therapy (OR (CI)= 0.41(0.16-1.0), p=0.047). Additionally, the A allele was more prevalent in responders (OR (CI)= 0.48(0.28-0.84), p=0.010), while the G allele was associated with reduced efficacy of metformin in T2DM patients (OR (CI)= 2.07(1.19-3.61), p=0.010). Conclusion: Genotyping of OCT3 (rs2292334) may serve as a valuable tool in predicting the response to metformin in T2DM patients.

Differential HLA Association of GAD65 and IA2 Autoantibodies in North Indian Type 1 Diabetes Patients.

The human leucocyte antigen (HLA) association with type 1 diabetes (T1D) is well known but there are limited studies investigating the association between β-cell autoantibodies and HLA genes. We evaluated the prevalence of GAD65 and IA-2 autoantibodies (GADA and IA2A) in 252 T1D patients from North India and investigated the genetic association of GADA and IA2A with HLA class I and class II genes/haplotypes. GADA and IA2A were detected in 50.79% and 15.87% of T1D patients, respectively, while only 8.73% had both GADA and IA2A. HLA-DRB1∗03 was observed to be significantly higher in GADA+ T1D patients as compared to GADA– (91.41% vs. 66.13%, Bonferroni-corrected P (Pc) = 1.11 × 10−5; OR = 5.45; 95% CI: 2.67-11.08). Similarly, HLA-DQB1∗02 was found to be significantly increased in GADA+ patients (94.53%, Pc = 2.19 × 10−5; OR = 6.27; 95% CI: 2.7-14.49) as compared to GADA– (73.39%). The frequencies of HLA-DRB1∗04 and DQB1∗03 were increased in IA2A+ patients (45.0% and 52.5%, respectively) as compared to that in IA2A– (25.94% and 33.96%, respectively). Further, the frequency of DRB1∗03-DQB1∗02 haplotype was found to be significantly increased in GADA+ T1D patients as compared to GADA- (60.55% vs. 41.94%, P = 3.94 × 10−5; OR = 2.13; 95%CI = 1.49-3.03). Similarly, HLA-DRB1∗04-DQB1∗03 haplotype was found to be significantly increased in IA2A+ T1D patients compared to IA2A– patients (22.5% vs. 12.97%; P = 0.041; OR = 1.95; 95%CI = 1.08-3.52). None of the HLA class I genes (HLA-A, B, and Cw) was found to be associated with GADA or IA2A in people with T1D. Our findings suggest that HLA-DRB1∗03/DQB1∗02 and HLA-DRB1∗04/DQB1∗03 might play an important role in the development of GADA and IA2A, respectively.

Health-related quality of life and sleep quality among North Indian type 2 diabetes mellitus patients: evidence from a cross-sectional study

ObjectiveThe objective of this study is to measure the relationship between sleep quality and health-related quality of life (HRQOL), in Indian population with type 2 diabetes mellitus (T2DM). MethodsA cross-sectional study, included a total of 300 patients with T2DM. All participants were responding to the Pittsburgh Sleep Quality Index (PSQI) and European Quality of Life-5 Dimensions Questionnaire (EQ-5D). A PSQI global score ≥5 was defined as poor sleep quality. EQ-5D visual analogue scale (VAS), determining the overall health status. Logistic regression analysis was used to examine the association between PSQI and EQ-5D. All the study data were analysed using the SPSS software version 20.0. Values of p < 0.05 were considered statistically significant. ResultsThe mean age of included participants were 55.29. Majority of the participants (55.3%) were identified as “poor sleepers” and female (31.3%) contributing higher proportion. Poor sleepers had significantly lower the HRQoL (p < 0.001). After adjustment, poor sleep quality was significantly associated with a lower HRQoL; EQ-5D index (OR = 1.080, 95%, CI: 1.015–1.148, p < 0.05), and EQ-5D VAS (OR = 1.092, 95%, CI: 1.021–1.176, p < 0.01). Overall, the EQ-5D index and EQ-5D VAS were found to be an independent predictors of sleep quality. ConclusionsPoor sleep quality is prevalent in Indian T2DM population, and it imparts negative impact on several dimensions of EQ-5D that characterising the daily activities performance. Therefore, further real-world studies are needed to determine the causal relationship between T2DM patients and measure of objective sleep and their impact on health.

Metabolic syndrome in north Indian type 2 diabetes mellitus patients: A comparison of four different diagnostic criteria of metabolic syndrome

Metabolic syndrome in north Indian type 2 diabetes mellitus patients: A comparison of four different diagnostic criteria of metabolic syndrome

Prevalence of thyroid disorders in North Indian Type 2 diabetic subjects: A cross sectional study

BackgroundType 2 diabetes mellitus (T2DM) is a major health burden worldwide with many patients encountering thyroid dysfunction later in their life. Various studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexists. However, the prevalence of thyroid dysfunction and associated clinical variables in these patients has not been investigated. ObjectivesThe study aimed at determining the incidence and prevalence of thyroid dysfunction in patients with T2DM in relation to age, sex, metabolic syndrome and other co-morbid conditions. Research designs & methodsIn this cross-sectional study, 250 Type 2 DM patients were enrolled aged between 40 and 75 years. All the patients were evaluated for thyroid dysfunction by testing thyroid profile (T3, T4 and TSH. These subjects were also investigated for fasting blood sugar (FBS), post prandial glucose (PPG) glycosylated hemoglobin (HbA1c), serum cholesterol, serum triglycerides, high density lipoprotein (HDL), low density lipoprotein(LDL), very low density lipoprotein(VLDL), blood urea, serum creatinine and presence of other co-morbid conditions. The observations and interpretations were recorded and results obtained were statistically analyzed. ResultsA high prevalence of thyroid dysfunction (28%) was observed in type 2 diabetic patients with subclinical hypothyroidism (18.8%) as the commonest thyroid disorder. Thyroid dysfunction was more prevalent in females, with presence of dyslipidemia, retinopathy, poor glycemic state (HbA1c ≥7) and longer duration of diabetes as significant contributing factors associated. ConclusionsIn addition to glycemic status, screening of thyroid disorder should be routinely done in type 2 diabetic subjects along with other comorbid conditions.

Association of functional SNP-1562C > T in MMP9 promoter with proliferative diabetic retinopathy in north Indian type 2 diabetes mellitus patients

ObjectiveRetinal angiogenesis is a hallmark of diabetic retinopathy. Matrix Metalloproteinases (MMPs) are involved in degradation of extracellular matrix (ECM). Functional SNP-1562C>T in the promoter of the MMP-9 gene results increase in transcriptional activity. The present work was designed to evaluate the contribution of functional SNP-1562C>T of MMP-9 gene to the risk of proliferative diabetic retinopathy (PDR) in type 2 diabetes mellitus (T2DM) patients in north Indian Population. MethodsThis Case control study comprised of a total of 645 individuals in which 320 were T2DM patients out of which 73 had PDR, 98 had non- proliferative diabetic retinopathy (NPDR), 149 T2DM cases without any eye related disease (DM) and 325 non diabetic healthy individuals as controls (non DM controls). Genotyping for SNP-1562C>T of MMP-9 was done by polymerase chain reactions followed by restriction analyses with specific endonucleases (PCR-RFLP). DNA sequencing was used to ascertain PCR-RFLP results. ResultsT allele frequency in PDR patients was 32.1%, 20.4% in NPDR, 15.4% in DM and 13.7% in controls. Statistically significant difference was observed in both allele and genotype distribution between the PDR versus non-DM control group (p<0.0001 by T allele; p=0.002 by TT and p<0.0001 by CT genotype). ConclusionsThe present study suggests that the functional SNP-1562C>T in the promoter of the MMP-9 gene could be regarded as a major risk factor for PDR as increased MMP-9 production from high expressing T allele may promote retinal angiogenesis.

Study of IL4-590C/T and IL6-174G/C Gene Polymorphisms in Type 2 Diabetic Patients With Chronic Kidney Disease in North Indian Population.

To explore the associations between potential functional promoter polymorphisms in pro-inflammatory and anti-inflammatory (IL-4(-590C/T) and IL-6(-174G/C) cytokine genes, and kidney dysfunction in North Indian type 2 diabetic subjects with chronic kidney disease. A total of 150 subjects aged 25-75 year were included in this study. The glomerular filtration rate (GFR) and serum creatinine were estimated. PCR was performed to analyse genotype distribution in IL-4 (-590T/C) and IL-6 (-174G/C) among healthy, type 2 diabetic patients with or without CKD. The genotype distributions were determined by Hardy-Weinberg equilibrium. CKD patients showed lower GFR (59.36 ± 1.33 ml/min/1.73 m2 ) and higher serum creatinine (1.93 ± 0.99% mg) level in comparison to diabetic patients without CKD and healthy subjects. Genotypic distribution of the different genotypes among the study groups in IL-4 gene was genotype CC = 30, TC = 12, and TT = 8 in CKD patients. In type 2 diabetic patients without CKD, genotype distribution was CC = 38, TC = 10, and TT = 2. In healthy subjects, distribution of genotype was CC = 35, TC = 14, and TT = 1. The distribution of different genotype among the study groups for IL-6 gene was GG = 27, GC = 20, and CC = 3 in healthy subjects; GG = 28, GC = 19, and CC = 3 in diabetic patients without CKD and GG = 38, GC = 11, and CC = 1 in diabetic patients with CKD. There was no significant difference in the distribution of genotype frequencies between healthy subjects and diabetic patients without CKD but a significant difference was found in diabetic patients with CKD. The functional promoter polymorphisms IL4-590C/T and IL6-174G/C, which affect the IL-4 and IL-6 levels in north Indian subjects, were associated with kidney dysfunction and CKD. J. Cell. Biochem. 118: 1803-1809, 2017. © 2016 Wiley Periodicals, Inc.

Distribution of Genetic Polymorphisms in Drug Metabolizing Gene Cytochrome P450 (CYP2C8*3 and CYP2C9*2) in a North Indian Type 2 Diabetes Population

Diabetes is growing as an epidemic, with around 250 million diabetics estimated globally and which is expected to rise up to 380 million in the next 15 years. Differences in the efficacy and toxicity of various antidiabetic drugs have been linked to polymorphisms in various drug metabolizing enzymes. In this study we have investigated the frequency of occurrence of two single nucleotide polymorphisms in the CYP gene (CYP2C8*3 and CYP2C9*2) in type 2 diabetes mellitus (T2DM) patients from North India.

De novo assembly and characterization of root transcriptome in two distinct morphotypes of vetiver, Chrysopogon zizaniodes (L.) Roberty.

Vetiver, a perennial C4 grass, has long been known for its multifarious uses in perfumery, medicine and environmental protection. Two distinct vetiver morphotypes have been identified in India, i.e., A. North Indian type characterized by thick and smooth fast growing roots that produce superior quality of laevorotatory oil; and B. South Indian type with more number of thin and hairy roots that produce inferior quality of dextrorotatory oil. The two morphotypes were targeted for transcriptome analysis to understand the contribution of genetic background on oil quality and root morphology. Sample A showed enhanced activity of flavonoid and terpenoid biosynthesis related genes, i.e. ERF, MYB, bHLH, bZIP and WRKY. Interestingly, expression analysis revealed that the genes involved in sesquiterpene biosynthesis pathway were up regulated in Sample A. Moreover, some of the genes involved in mevalonate pathway of sesquiterpene biosynthesis were unique to Sample A. Our results also demonstrated several transcripts involved in root development and hormonal regulation being up regulated in Sample A. To validate gene expression results of RNA-seq data, 20 transcripts were validated by qRT-PCR experiment. The present study provided an important start point for further discovery of genes related to root oil quality in different ecotypes of vetiver.

Correlation of body fat percentage to various metabolic and cardiovascular risk markers in North Indian type II diabetic patients

Correlation of body fat percentage to various metabolic and cardiovascular risk markers in North Indian type II diabetic patients

A study of asymptomatic bacteriuria in North Indian type 2 diabetic patients

The prevalence of asymptomatic bacteriuria (ASB) in diabetic patients varies from 9 to 27 % in various studies which is certainly higher as compared to healthy individuals. The risk factors which lead to increased prevalence of asymptomatic bacteriuria in diabetic patients are immune system dysregulation, development of bladder dysfunction and prostatism. Studies have reported that ASB has a higher prevalence in diabetic individuals as compared to nondiabetics. Patients having type 2 diabetes mellitus along with age- and sex-matched controls who were hemodynamically stable were enrolled. A prospective case-control study was done. A total of 200 patients were enrolled, and they were divided into two groups, i.e. those with diabetes and nondiabetic patients (age- and sex-matched controls) without symptoms of UTI. Urine examination and biochemical investigations of the patients were done. In our study, the prevalence of ASB among the diabetic patients was significantly higher 28.2 % as compared to 7.5 % in the controls (p = 0.001). The main risk factors for asymptomatic bacteriuria in our study were female sex (p = 0.003), increased age (p = 0.007), longer duration of diabetes mellitus (p = 0.003), poor glycemic control (p < 0.001) and recent urinary tract infection (p = 0.02). There were no significant differences in the serum creatinine levels in the patients with asymptomatic bacteriuria among diabetics as compared to the culture-negative patients. The presence of ASB may be considered a marker of poorly controlled and long-standing diabetes.

A Study of Asymptomatic Bacteriuria in North Indian Type 2 Diabetic Patients

A Study of Asymptomatic Bacteriuria in North Indian Type 2 Diabetic Patients

Correlation of body fat percentage to various metabolic and cardiovascular risk markers in North Indian type II diabetic patients

Correlation of body fat percentage to various metabolic and cardiovascular risk markers in North Indian type II diabetic patients

Prevalence and risk factors of development of peripheral diabetic neuropathy in type2 diabetes mellitus in a tertiary care setting.

Aims/IntroductionThe study was carried out to assess the prevalence of diabetic peripheral neuropathy (DPN), compare the prevalence between known diabetes mellitus (KDM) and newly detected diabetes mellitus (NDDM), identify risk factors associated, its prevalence pattern and to assess if any sex-specific differences are present.Materials and MethodsA cross-sectional study was carried out in a tertiary care hospital. Patients with duration of diabetes ≤6 months were considered to be NDDM. DPN was diagnosed by the combination of more than one abnormal result of 10-g monofilament, pinprick sensations and ankle reflexes, and categorized according to the severity level using vibration perception threshold. The study included 1,637 KDM and 369 NDDM patients.ResultsA total of 586 participants were found to have DPN, accounting for 29.2% (95% confidence interval [CI] 27.2–31.2) prevalence. The higher prevalence was observed in KDM compared with NDDM 33.7% (95% CI 31.42–36.01) vs 9.2% (95% CI 6.3–12.2; P < 0.001). Prevalence of mild, moderate, and severe neuropathies was 8.06, 14.55 and 6.63%, respectively. Regression analysis showed age (P < 0.001), duration of diabetes (P < 0.001), dyslipidemia (P = 0.03), glycated hemoglobin (P < 0.001), the presence of other microvascular complications (P < 0.001), macrovascular complications (P = 0.003) and alcoholic status (P < 0.033) to be associated. No sex-specific differences were observed in the mean age at diagnosis of diabetes, mean age at the diagnosis of neuropathy, and duration taken for the DPN development among females and males.ConclusionsThe study showed a high prevalence (29.2%) of DPN among north Indian type 2 diabetes mellitus patients. Thus, timely screening with earlier detection and intervention would be useful in preventing the progression of neuropathy.

The Design of the Spire from Temple 45 at Sanchi

This article investigates the original design of the ruined spire from Temple 45 at Sanchi in Madhya Pradesh through the detailed analysis of hundreds of fallen architectural fragments that are stacked near the monument. These remains indicate that Temple 45 was a ninth-century Latina temple, a north Indian temple type distinguished by its curved spire, and that it shows anomaly and ingenuity in many aspects of its design and context. The question of how early Indian architects achieved the characteristic curves of Latina superstructures has not yet been answered by contemporary scholarship in a way that would allow the fragments to be virtually reassembled into an authentically shaped spire: the proposals are either unconvincing, or they do not contain enough information to complete the task. This paper critiques these accounts, and examines verses pertaining to Latina spires from a particular Vastuśāstra called the Dīpārṇava, turning them into diagrams of temple spires, analysing their proportions and outlines, and comparing them to the measurements taken from Temple 45. It then builds on this information, and proposes a new and more detailed account of Latina spire design than has previously been offered. Finally, this methodology is used to reconstruct an elevation of the spire from Temple 45.

Association of Variant rs7903146 (C/T) Single Nucleotide Polymorphism of TCF7L2 Gene With Impairment in Wound Healing Among North Indian Type 2 Diabetes Population

The variants of transcription factor 7-like 2 (TCF7L2) gene have been shown to be associated with type 2 diabetes mellitus (T2DM) and its several secondary complications. Here, we aimed to examine the possible role of one of the common variant of this gene, rs7903146 (C/T), with impairment of wound healing in cases with T2DM. A total of 750 individuals, including 322 patients with T2DM and 120 patients with diabetic foot ulcers (DFUs) and 308 controls, were analyzed for rs7903146 variant of the TCF7L2 gene. Genotyping was done by polymerase chain reaction-restriction fragment length polymorphism. For rs7903146 variant, TT genotype frequency in patients with DFU was 10.8% and in controls was 5.2%. Risk genotype (TT) frequencies showed statistically significant difference between the DFU patients versus non-DM control group (odds ratio = 2.44, P = .037, 95% confidence interval = 1.05-5.64) compared with nonrisk genotype (CC + CT). In the present study, a positive significant association between DFU and the TT genotype of rs7903146 (C/T) variant of TCF7L2 gene was found.

Prevalence and Severity of Erectile Dysfunction as Assessed by IIEF-5 in North Indian Type 2 Diabetic Males and Its Correlation with Variables

The aim of this study was to assess the severity of the erectile (ED) dysfunction among type 2 diabetic men. For subjective information patients were asked to fill up the IIEF questionnaire. This study was also done to correlate ED with other variables like age, obesity, duration of diabetes, degree of diabetic control and complications of diabetes. Neuropathy was assessed objectively by using the Vibration Perception Threshold (VPT). This study was conducted on 348 patients. Age range of these subjects was 25 years to 75 years. All patients underwent routine clinical examinations which included recording of duration of diabetes, type of diabetes, Body Mass Index, previous HbA1c tests and VPT measurement. In the present study, it was observed that there was a significant association of ED with age, duration of diabetes, glycemic control and BMI. In fact, VPT emerged as a strong predictor of ED. We conclude that adding objectivity of VPT measurement improves the subjective predictive value of IIEF-5.

Angiotensin-converting enzyme gene variants interact with the renin-angiotensin system pathway to confer risk and protection against type 2 diabetic retinopathy.

The angiotensin‐converting enzyme (ACE) gene has been found to be associated with pathogenesis and progression of diabetic retinopathy (DR). A recent meta‐analysis comprising 2,224 Chinese patients showed moderate evidence of a relationship between the ACE insertion/deletion (I/D) polymorphism and proliferative diabetic retinopathy (PDR)1; however, the role of other renin–angiotensin system (RAS) polymorphisms and their possible interactions with ACE I/D genotypes are less clearly defined. Thus, we investigated the association and interaction between RAS gene polymorphisms and the development and progression of DR in 1,446 north Indian type 2 diabetic patients. DR patients were divided into two groups, non‐proliferative diabetic retinopathy (NPDR) and PDR. DR was diagnosed by dilating the pupils with mydriatics and then carefully examining the retina. Retinal photography or fluorescein angiography tests were also carried out. A total of 1,720 type 2 diabetic patients were screened for the presence of DR, of which, 1,446 patients were finally included for the present study. Patients receiving antihypertensive drug treatment, with any retinopathy other than DR, cataracts and cataract surgery, and age‐related macular degeneration were excluded from the study. All the participants in both the cohorts were age (≥35 years), sex and ethnicity matched. Significant deviation from the Hardy–Weinberg equilibrium of genotype distribution in the present population in ACE I/D and angiotensinogen (AGT) variant rs5050 might be a result of the moderate population size or the rare allele, which can cause a random change in allele frequencies. Furthermore, we excluded the possibility of a typing error (logarithmic odds ratio score >0). The present sample size had the power of 90% at a small effect size (0.1) and alpha level (0.05). In both the cohorts, we observed a consistently higher prevalence and increased risk of PDR in patients with the DD genotype of ACE I/D, TT genotype of AGTrs699 and the CC genotype of angiotensin II receptor type 1 A1166C (Table 1). Table 1 Genotype frequencies of the renin–angiotensin system variants in type 2 diabetes patients (diabetes mellitus vs non‐proliferative diabetic retinopathy vs proliferative diabetic retinopathy) The biological mechanism through which the ACE I/D polymorphism might be related to an increased risk of PDR is unclear. Serum ACE concentrations are significantly higher in those carrying the DD genotype2. Also, the final component of RAS, which is converted by ACE, has a vasoconstrictive effect, promotes the accumulation of extracellular matrix and induces plasminogen activator inhibitor‐1 production in endothelial cells3. Furthermore, DR is associated with impaired balance of retinal RAS. Increased expression of ACE/AGT overcomes this imbalance and confers protection against DR4. The present results suggest RAS polymorphism as a significant risk factor for DR in Asian Indians.

Endothelial nitric oxide synthase gene polymorphisms and renal responsiveness to RAS inhibition therapy in type 2 diabetic Asian Indians

AimTo investigate the association of functional single nucleotide polymorphisms (SNPs) of the endothelial nitric oxide synthase gene (eNOS) gene (T-786C, G894T) and one variable number tandem repeat polymorphism (aa 27VNTR bb) with reno-protective response to angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) therapy in North Indian type 2 diabetic mellitus (T2DM) subjects with cases having diabetic nephropathy (DN) and controls without DN. MethodWe genotyped three polymorphisms of eNOS (two SNPs: T-786C, G894T and one 27 VNTR) in T2DM patients with overt nephropathy (cases: n=320) and T2DM patients without overt nephropathy (controls: n=490), using validated PCR-RFLP assays. These 810 North Indian T2DM patients treated with ACEI or ARB after diagnosis were followed up for 3 years. Percent changes in eGFR, urinary albumin excretion (UAE), serum creatinine at the end of 3 years of treatment were taken as end points of renoprotective response. ResultWe observed that in normoalbuminuric patients, eNOS -786 CC genotype and haplotypes C-b-G and C-b-T were associated with lesser renoprotective response to ACEI. While, in macroalbuminurics, eNOS -786 CC genotype, haplotypes C-b-G and C-b-T and 27VNTR aa were associated with better renoprotective response to ACEI/ARB. ConclusionOur results showed that eNOS T-786C CC genotype and 27VNTR individually and in interaction with other eNOS SNPs modulate renoprotective efficacy of ACEI and ARB in T2DM patients, depending on the status of proteinuria.

Inter-relationship between low-density lipoprotein phenotype and carotid intima-media thickness in North Indian type 2 diabetic subjects

Aims Diabetic dyslipidemia is characterized by a preponderance of small dense LDL which is highly atherogenic. The aim of this study was to examine the interrelationship between LDL Phenotype and atherosclerosis; to determine the factors determining LDL phenotype; and evaluate LDLc:apo-B ratio as a surrogate for the assessment of LDL phenotype in a group of North Indian Type 2 diabetic subjects. Methods 285 diabetic subjects attending the outpatient Endocrine Clinic were subjected to detailed anthropometry and fasting serum lipid and apo-B was measured. The carotid intima-media thickness (IMT) was determined using a high resolution B-mode Ultrasonography. LDLc:apo-B ratio was taken as a surrogate index for LDL size. Results 29.5% patients with normal triglyceride levels and 52.1% patients with normal LDLc levels showed the presence of small dense LDL or Phenotype B as estimated by the LDL cholesterol/apo-B ratio. The mean IMT in Phenotype B group was higher (0.88 mm vs. 0.68 mm). Triglycerides was the most important predictor variable predicting carotid IMT ( R 2 = 0.15, β = 0.376) as well as LDL phenotype B ( R 2 = 0.28, β = 0.561). Conclusions Triglycerides and HDLc contribute independently to the variability in LDL particle size, and LDL particle size was associated with preclinical atherosclerosis as determined by carotid IMT in North Indian Type 2 diabetic subjects. LDL cholesterol/apo-B ratio serves as an easy clinical tool to determine the elevated small dense LDL.