Association between glycaemic control and lipid profile among type 2 diabetes patients: glycated haemoglobin as a dual marker

Apart from classical risk factors like dyslipidemia, elevated Glycated Haemoglobin has now been regarded as an independent risk factor for cardiovascular disease in people with or without diabetes. Glycated hemoglobin (HbA1c) is a routinely used marker for long-term glycemic control. In accordance with its function as an indicator for the mean blood glucose level, HbA1c predicts the risk for the development of diabetic complications in diabetes patients. The study was aimed at investigating the relationship between glycemic control and serum lipid profile and to evaluate the role of Glycated Haemoglobin as an independent risk factor for cardiovascular diseases in patients with type-2 diabetes. In all 200 diabetic patients who were under treatment were randomly sampled for the study. Socio- demographic data were collected using predesigned questionnaires. Glycated haemoglobin levels, lipid profile, fasting blood sugar, haemoglobin and red blood cell count were estimated using standard procedures. Anthropometric variables such body mass index (BMI), visceral adiposity index (VAI) and body adiposity index (BAI) were measured. Systolic and diastolic blood pressures were also taken. Dyslipidemia was defined as per the National Cholesterol Education Programme (NCEP) Adult Treatment Panel (ATP) III guidelines. Diabetes was defined as per American diabetes association (ADA) criteria. The Statistical analysis was done by SPSS statistical package version 20.0. The patients were divided into two groups (HBA1C ≤7.0% and >7.0%). Duration of type 2 diabetes had a positive correlation with glycated haemoglobin. Females had significantly higher BMI (p= 0.0002), BAI (p= 0.0008), hip circumference (p= 0.0002), and waist circumference (p= 0.0008) measurements than their male counterparts. Participants with higher HBA1C (> 7.0%) levels also had significantly higher measurements in BMI and BAI as compared with those of desirable HBA1C (≤7.0%) levels. The levels of HbA1c and FBG did not differ significantly between male and female. Although there were no significant difference in TC (p=0.2287), LDL-C (p=0.3821) and HDL-C (p=0.5248) levels between male and female, the levels of TG were significantly higher (p=0.0059) in female as compared to male type 2 diabetic patients. This study reveals high prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-C and low HDL-C levels which are well known risk factors for cardiovascular diseases. Significant correlations were observed between HbA1c and TC, LDL-C and TG. Significant correlation between HbA1c and various circulating lipid parameters and significant difference of lipid parameters in two groups (≤7.0% and >7.0%) of glycated hemoglobin indicates that HbA1c can be used as a potential biomarker for predicting dyslipidemia in type 2 diabetic patients in addition to glycemic control. Hence early diagnosis can be accomplished through relatively inexpensive blood testing and may be utilized for screening high-risk diabetic patients for timely intervention with lipid lowering drugs.

Source: KNUST