Title: Lipid Profile as Early Predictor of Complication in Diabetes Mellitus

Authors: Dr Talat Fatma (MD), Dr Shamim Khurrum Azmi (MS), Dr Ajit Kumar Chaudhary (MD)

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i5.193

Abstract

Aim: To establish that lipid profile is important marker and can be used to predict severity of diabetes mellitus and onset of complications.

Design: Retrospective study done at Darbhanga Medical College, Bihar from December 2004- January 2009.

Materials and Methods: 100 patients with diabetes mellitus having age between 20yrs to 60 yrs age were included in the study. Among these there were 62 %( n=62) male patients and 38% (n=38) female patients with diabetes mellitus.

24 control cases were investigated in similar manner. Among these there were 66% (n=16) males and 33 %( n=8) females.

After taking informed consent, their serum samples were assessed for blood glucose level 2 hours after 50 gm oral glucose, fasting total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL) , high density lipoprotein cholesterol (HDL) and VLDL(very low density lipoproteins)  by using standard biochemical methods.

The values of various parameters of lipid profile were statistically analyzed in diabetic patients and control group.

Results

  1. Lipid profile in control group:
  • Serum triglyceride level ranged from 40-128mg% with mean value of 86.33 ± 24.13 S.D.
  • Serum HDL level ranged from 55-75mg/100ml with mean value of 65 mg/100ml.
  • Serum total cholesterol level ranged from 150-250mg/100ml with mean value 200mg/100ml
  • Serum LDL level ranged from 87-144.4 mg/100ml with mean value of 115.7mg/100ml.
  • Serum VLDL level ranged from 8-37mg/dl with mean value of 22.8mg/100ml.
  • Mean value of serum triglyceride in male (n=16) and that in female (n=8) were 84.34 ± 27.78 S.D. and 91.2 ± 16.95 S.D. respectively.

2 .Lipid profile in diabetes mellitus patients:

  • Serum triglyceride level ranged from 88-226mg% with mean value of 136.50 ± 30.88 S.D.
  • Serum HDL level ranged from 28-48 mg/100ml with mean value of 38 mg/100ml.
  • Serum total cholesterol level ranged from 205.4-294.4 mg/100ml with mean value of 249.9
  • Serum LDL level ranged from 135-225mg/dl with mean value of 180.3mg/100ml
  • Serum VLDL level ranged from 17.6-45.2mg/100ml with mean value of 31.4mg/dl
  • Mean serum total cholesterol, triglyceride; HDL, VLDL AND LDL concentration was 226±23, 40±7, 35±6 and 148±26
  1. Lipid profile level and duration of illness:
  • Serum triglyceride levels are higher in patients with duration of illness more than 4 yrs (138mg% ± 26.75 S.D. and 147.1mg% ± 22.19 S.D. ) as compared to those whose duration of illness was less than 4 years ( 126.3mg% ± 24.66 S.D. and 113.8 ± 14.49 S.D.)
  1. Lipid profile level and severity of illness:

      Severity was decided on basis of ketone bodies in urine and levels of blood sugar.

  • Serum triglyceride, total cholesterol, LDL and VLDL level was significantly raised in diabetics with ketoacidosis (n=14) with mean value of 179.42mg% ± 28.93, 263.1 mg%,199.5 mg% and 54.7 mg%  than that of diabetics without ketoacidosis (n=86) with mean value of 129.86mg% ± 26.65, 249.9mg%, 150.3mg% and 26.6 mg %.

Keywords:  Lipid profile, diabetes mellitus

References

  1. Ruotolo G, Ericsson CG, Tettamanti C, Karpe F, Grip L, Svane B, Nilsson J, de Faire U, Hamsten A: Treatment effects on serum lipoprotein lipids, apolipoproteins and low density lipoprotein particle size and relationships of lipoprotein variables to progression of coronary artery disease in the Bezafibrate Coronary Atherosclerosis Intervention Trial (BECAIT). J Am Coll Cardiol32:1648–1656, 1998
  2. Lipid profile of patients with diabetes mellitus: a cross sectional study G. D. Bhambhani1 , Rutu G. Bhambhani1 , Nilesh Chandradityasinh Thakor2
  3. Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group: Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med339:1349–1357, 1998
  4. Guérin M, Bruckert E, Dolphin PJ, Turpin G, Chapman MJ: Fenofibrate reduces plasma cholesteryl ester transfer from HDL to VLDL and normalizes the atherogenic, dense LDL profile in combined hyperlipidemia. Arterioscler Thromb Vasc Biol16:763–772, 1996
  5. Fredenrich A: Role of apolipoprotein CIII in triglyceride-rich lipoprotein metabol-ism.  Diabetes Metab24:490–495, 1998
  6. Mazzone T. Current concepts and controversies in the pathogenesis, prevention, and treatment of the macrovascular complications of diabetes. J Lab Clin Med 2000;135:437-43. 3
  7. Ginsberg HN, Goldberg LL. Disorders of lipoprotein metabolism. In: Fauci AS, Braunwald E, Isselbacher KJ, Wilson JD, Martin JB, Kasper DL, et al., editors. Harrison’s Principles of Internal Medicine. Vo1. 2. Ch. 344. New York: McGraw Hill Medical Publishing Division; 2001. p. 224.
  8. Krauss RM. Lipids and lipoproteins in patients with type 2 diabetes. Diabetes Care. 2004;27:1496–504.
  9. Witztum JL, Steinberg D. Role of oxidized low density lipoprotein in atherogenesis. J Clin Invest. 1991;88:1785– 92

Corresponding Author

Dr Talat Fatma

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