The Effect of Nutritional Status on the Prevalence of Cardiovascular Diseases among Diabetic Patients

Diabetes mellitus is associated with increased incidence of cardiovascular disease (CVD). Poor nutritional status such as under- and over-nutrition accelerates the development of complications and reduces the longevity of life of diabetes patients. The study aimed to assess nutritional status, using anthropometric, biochemical, dietary indicators as well as unhealthy lifestyle factors and finding their association with cardiovascular diseases; mainly stroke, hypertension and heart failure. A cross sectional descriptive study was conducted among 145 diabetes patients selected from three hospitals in the Ashanti Region of Ghana. Nutritional status and lifestyle assessments were done using anthropometric, biochemical and dietary indicators of participants. Out of the participants, 76.6% were females. The mean age of respondents was 55.88 ± 12.75 S.D years. There was a significant association of age with cardiovascular diseases (p<0.05). The prevalence rates of cardiovascular diseases; hypertension, stroke and heart failure among the diabetic patients were 66.2%, 8.28% and 3.45%, respectively. The prevalence of overweight and obesity, assessed by BMI were 42.8% and 22.8%, respectively but there was no significant association of BMI with cardiovascular diseases (p>0.05). The prevalence of abdominal obesity, measured by waist circumference and waist to hip ratio were 61.38% and 65.5%, respectively and were significantly associated with cardiovascular diseases (p<0.05). Dyslipidemia among diabetes patients showed prevalence of hypercholesterolemia (47.58%), hypertriglyceridemia (55.9%), low HDL-C (35.2%) and high LDL-C levels (36.8%). Lipid profile showed that total cholesterol was not significantly associated with cardiovascular diseases, but TG, HDL-C and LDL-C levels were significantly associated with cardiovascular diseases. The study showed that 18.6% had high creatinine levels, but there was no significant association of creatinine levels with cardiovascular diseases (p>0.05). The study showed inadequate intake of fruits and vegetables and there was no significant association of fruit and vegetable intake with cardiovascular diseases (p>0.05). Majority of the respondents, 56.6% reported low salt intake, whilst 9.0% reported high salt intake. Salt intake showed significant association with cardiovascular diseases (p<0.05). The patients lifestyles showed low levels of physical activity, as 61.4% did not exercise, 91.0% diabetics had never smoked, 9.0% were ex-smokers, 33.8% were ex-drinkers, whilst 11.7% were current alcohol drinkers. The lack of exercise and smoking status had significant association with cardiovascular diseases (p<0.05) but alcohol consumption had no significant association with cardiovascular diseases (p>0.05). The study showed independent risk factors significantly associated with cardiovascular diseases incidence among diabetes patients included family history of hypertension with (odds ratio of 6.8), exercise (0.1), salt intake (0.1) and HDL-C level (0.2) with p-values < 0.05. In conclusion, the study has shown that family history of hypertension, moderate exercise, low salt intake and HDL-C level are significantly associated with cardiovascular diseases incidence.

Source: KNUST