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Glycated Haemoglobin Actsas an Indicator of Dislipidemia in Patients with Type Ii Diabetes Mellitus

Sumaia Sahrin
Department of Human Nutrition and Dietetics, Patuakhali Science and Technology University, Dumki, Patuakhali-8602

Dilruba Easmin Jharna
Department of Human Nutrition and Dietetics, Patuakhali Science and Technology University, Dumki, Patuakhali-8602

M. Shafiqul Islam Khan
Department of Food Microbiology, Patuakhali Science and Technology University, Dumki, Patuakhali-8602

Jayati Debnath
Department of Human Nutrition and Dietetics, Patuakhali Science and Technology University, Dumki, Patuakhali-8602

SumanTalukder
Department of Community Health and Hygiene, Patuakhali Science and Technology University, Dumki, Patuakhali-8602, Bangladesh

Abstract/ Executive Summary:

Diabetic patients with associated dyslipidemia are easy targets for cardiovascular diseases (CVD). Glycated hemoglobin predicts the risk for the development of diabetic complications. This study was an attempt to determine lipid abnormalities associated with Type-2 Diabetes Mellitus and association between glycated hemoglobin (HbA1c) levels and serum lipid profile to assess the importance of HbA1c as an indicator of dyslipidemia and future risk of cardiovascular disease in Bhola District, Barisal. In this cross-sectional study, 200 known patients of Type-2 Diabetes Mellitus within 35-85 years of age were randomly selected. They were investigated for HbA1c and lipid profile. The data were evaluated by Statistical Package for Social Sciences (SPSS) 16.0 version software. Independent samples t-test (2-tailed) was used to compare means of anthropometric, clinical and laboratory parameters and the effect of the glycemic control on their lipid profile was determined using correlation coefficient. Amongst the study group, 65% patients showed poor glycemic control, 35% with good glycemic control and 59.60% patient’s haddyslipidemia.HbA1c was found to have significant positive correlation with total cholesterol (TCHO), low density lipoprotein (LDL-C) and triglycerides (TG) and significant negative correlation with high density lipoprotein (HDL-C). The mean value of TC, LDL-C and TG was found to be lower in patients with good glycemic control than those with poor glycemic control. These differences were significant at the level of P<0.05. These findings conclude that the glycemic control of the patient has got a strong impact on the serum lipid level and dyslipidemia is frequently encountered in those who have got poor glycemic control.

Keywords: Glycemic control, HbA1c, Serum lipid profile, Type 2 diabetes

Location: Diabetic Hospital, Bhola, Bangladesh

Start Date: 00-09-2017

End Date: 00-03-2018

Program Area: Animal Health and Management

Commodity: Organic products, Becteriocides

Objectives:

To investigate the relationship between glycemic control and serum lipid profile and

To investigate whether Glycated haemoglobin is a risk factor for cardiovascular disease.

Methodology:

A hospital-based cross-sectional study was conducted from September 2017 to March 2018. The study populations were selected from the Diabetic Hospital, Bhola. A total of 200 T2DM patients (89 males and 111 females) with confirmed T2DM diabetes were selected. Confirmed T2DM diabetes patients aged 35 to 85 years and regularly attended clinic were included in the study. Patients who qualified but not willing to participate in the study were not included in the study. The study was approved by the Department of Human Nutrition and Dietetics, Patuakhali Science and Technology University. Further written permission was obtained from the Medical Superintendent of the Diabetic Hospital, Bhola where samples were collected. Informed consent was obtained from study participants before the commencement of each interview, and no personal identification was registered. There was no any financial compensation or provision for the study participants. Venous blood samples were collected from all the subjects after at least 8 hours fasting. Blood specimens were collected for HbA1c in Serum Separator Tube for fasting glucose (FBG) and lipid profile measurement. All the biochemical analyses were performed in the Laboratory of Bhola Diabetic Hospital, Bangladesh. Serum was used for analyzing lipid profile, which includes total cholesterol (TC), HDL-cholesterol (HDLC), triglycerides (TAG) and LDL-cholesterol (LDL-C) was calculated. The patients were classified into two groups depending on their glycated hemoglobin (HbA1c); Good Glycemic Control (GGC) group having HbA1c < 7.0% and Poor Glycemic Control (PGC) group having HbA1c>7.0%. For serum lipid reference level, National Cholesterol Education Programme (NCEP) Adult Treatment Panel III (ATP III) guideline was referred (http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm). According to NCEP-ATPIII guideline, hypercholesterolemia is defined as TC>5.2 mmol/l, high LDL-C when value >2.6 mmol/l, hypertriglyceridemia as TG >3.8 mmol/l and low HDL-C when value <1.0 mmol/l. Dyslipidemia was defined by presence of one or more than one abnormal serum lipid concentration (Ram et al., 2011). Finally, Statistical analysis was carried out by using student’s‘t’ test using SPSS 16 version. Pearson’s correlation coefficient was also calculated to find the correlation between HbA1c and lipid parameters. Value of HbA1c was given as percentage of total haemoglobin and values of all other parameters were given in mmol/l. All Values are expressed as mean ± SD. The results were considered non-significant when P > 0.05.

Source of Information: Res. Agric. Livest. Fish. Vol. 5, No. 2, August 2018 : 185-192.

Article Link (Online Journal):

Funding Source:

Total Budget (Tk.) :

Achievement/Findings:

There were affirmative correlations of HbA1C with TC, TG, LDL and negative correlations between HbA1c and HDL levels. It was concluded that HbA1c can be utilized as an indicator of dyslipidemia in T2DM and could be additionally used as glycemic control parameter. Hence, early diagnosis of dyslipidemia can be used as a pre-emptive measure for the development of cardiovascular disease (CVD) in T2DM.

Knowledge Management: Journal