Diabetes mellitus is usually associated with dyslipidemia and increases the risk of atherosclerosis and diabetic nephropathy. Log value of TG/HDL, defined as atherogenic index of plasma (AIP), risk ratio (Total cholesterol/HDL) and non-HDL Cholesterol has been used to predict risk for cardiovascular diseases. Glycated hemoglobin (HbA1c) as an index of hyperglycaemia is associated with different types of diabetic complications and the decrease in HbA1c significantly decreases all types of complication and diabetic mortality. Therefore in present study different risk factors for diabetic complications including lipoprotein indices, their ratio and urinary protein was examined in type 2 diabetes patients and the degree of relationship with HbA1c was examined.
Cross-sectional study was done in the department of biochemistry, Kathmandu University Hospital from August 2013 to March 2014 in diabetic patients. Diabetes was defined as per American diabetes association (ADA) guideline and dyslipidemia was defined as per the guideline of National Cholesterol Education Program (NCEP) The variables collected were age, gender, BMI, smoking habits, fasting blood sugar, lipid profile, urinary protein and HbA1c.
Patient with HbA1c > 7.0 had significant higher value of TC, TAG, LDL, AIP and risk ratio as compared to patient with HbA1C <7.0. There was significant positive correlation between HbA1c and AIP. Risk ratio and non-HDL cholesterol also increased along with HbA1c but significant positive correlation was not found. Presence of multiple risk factors in individual patients was also observed and found that 28.12% of patients were having any of the three established risk factor (poor glycaemic, dyslipedemia, high blood pressure, increase BMI, and smoking). Two risk factors were seen in 22.91% and four risk factors were seen in17%. There was significant positive correlation between HbA1c and AIP. Risk ratio and non-HDL cholesterol also increased along with HbA1c but significant positive correlation was not found.
Conclusion, diabetic patients enrolled were in high risk of atherosclerosis and diabetic nephropathy.