Objective: To study the correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol in patients with Type 2 diabetes mellitus and the proportion of patients achieving Adult Treatment Panel III recommended goals. Methods: The cross sectional study was conducted at the Diabetic Clinic, Aga Khan University Hospital, Karachi. Data of Type 2 diabetes mellitus patients who attended the clinic bewteen 2007 and 2011 was reviewed. All Type 2 diabetic patients of either gender with fasting lipid profile irrespective of taking lipid lowering therapy were included. Type-1 DM, gestational diabetes, type 2 diabetes patients with pregnancy and those with incomplete data were excluded. Correlation between the low-density lipoprotein and Non- high-density lipoprotein was assessed by applying Cramer V and phi. Proportion of patients achieving Adult Treatment Panel III recommended goals was checked. Multivariable regression was done to identify common factors associated with elevated Non- high-density lipoprotein cholesterol. Results: A total of 1352 patients fulfilling the eligibility criteria were included in the study. Mean age of the patients was 54.5±11.3 years; 797 (59%) were males; 1122 (83%) had Body Mass Index above 25; and 1016 (75%) had HbA1c >7%. Mean Non-high-density lipoprotein cholesterol was 129±42mg/dl. Mean low-density lipoprotein cholesterol was 100±37mg/dl. Both low-density lipoprotein <100 and Non-HDL <130 mg/dl was achieved in 645 (48%) patients. It is important to note that although 728 (53.8%) patients achieved target LDL cholesterol of <100mg/dl, among them 83 (11.4%) had Non-high-density lipoprotein cholesterol still above the target >130mg/dl (p<0.05). Out of 752 patients with Non-high-density lipoprotein cholesterol <130mg/dl, 645(86%) had low-density lipoprotein cholesterol below 100mg/dl. Cramer V and Phi showed that correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol was 0.71 (pvalue<0.01). After adjusting for other covariates, low-density lipoprotein cholesterol >100mg/dl was independently associated with having Non-high-density lipoprotein cholesterol >130mg/dl (Adjusted Odds Ratio 38.6; 95% Confidance Interval = 28.1-53.1). Similarly, age <60 years was 60% more likely to have Non-high-density lipoprotein cholesterol> 130 mg/dl (Adjusted Odds Ratio 1.6; 95% Confidance Interval = 1.01 -2.3). Whereas having obesity Body Mass Index >25 was 3.6 times more associated to have Non-high-density lipoprotein >130mg/dl (Adjusted Odds Ratio 3.6; 95% Confidance Interval = 1.6-7.7). In patients with coronary artery disease, combined goal achievement of low-density lipoprotein <70mg/dl and Non-high-density lipoprotein cholesterol <100mg/dl was seen in 59(35%). Among patients with high-density lipoprotein <70mg/dl, 8(10%) had Non-high-density lipoprotein >100mg/dl (p <0.05). Conclusion: The study showed a correlation between Non-high-density lipoprotein and low-density lipoprotein cholesterol. As measuring Non-high-density lipoprotein cholesterol in Type 2 DM patients is simple, cost-effective and convenient because it does not require 12-hour fasting which may be a risk for hypoglycaemia in these patients, clinicians may choose Non-high-density lipoprotein as a routine measure in everyday practice.
|Journal||Journal of the Pakistan Medical Association|
|Publication status||Published - Feb 2014|
- Coronary artery disease
- Low-density lipoprotein (LDL) cholesterol
- Non-high-density lipoprotein (Non-HDL) cholesterol
- Type 2 diabetes mellitus