Prevalence and pattern of dyslipidemia in Nepalese individuals with type 2 diabetes

Prevalence of dyslipidemia among persons with type 2 diabetes in Africa: a systematic review and meta-analysis

Background

Dyslipidemia is an established cardiovascular risk factor in persons with type 2 diabetes (T2D), yet the extent to which these conditions co-occur in Africa is unknown. This systematic review and meta-analysis aimed to determine the prevalence of dyslipidemia among persons with T2D in Africa.

Methods

Medline, Embase, Global Health, Scopus, and Web of Science were searched on 5 December 2023. This review adhered to the PRISMA guidelines and was prospectively registered on PROSPERO. The prevalence data for dyslipidemia was pooled through a random-effects meta-analysis. The authors assessed heterogeneity and publication bias using I 2 statistics and Egger's test, respectively.

Results

Our search identified 8035 records, of which 60 articles involving 20 034 individuals with T2D were included in this review. The pooled prevalence of dyslipidemia recorded 38.6% (95% CI: 34.1-43.4) for high TC (≥ 5.2 mmol/l), 52.7% (95% CI: 44.2-61.1) for high low-density lipoprotein cholesterol (LDL-C) (≥ 2.6 mmol/l), 43.5% (95% CI: 37.1-50.0) for low high-density lipoprotein cholesterol (HDL-C) (< 1.0 mmol/l in men and less than 1.3 mmol/l in women), and 37.4% (95% CI: 32.2-42.9) for high triglycerides (TG) (≥ 1.7 mmol/l). Subgroup analysis based on gender indicated a notably higher prevalence of dyslipidemia among females compared to males.

Conclusion

Dyslipidemia is prevalent among persons with T2D in Africa. This highlights the need for early screening, diagnosis, and management of dyslipidemia to mitigate the risk of cardiovascular complications in this population.

Patterns of dyslipidemia and its associated factors among prediabetic subjects. A cross-sectional study at a primary care clinic

Introduction

Diabetes is closely linked to cardiovascular diseases, with diabetic dyslipidaemia serving as an established marker of the acceleration of complications, contributing to an increased cardiovascular risk among patients. Timely detection and early characterization of lipid abnormalities can help clinicians in implementing effective preventive measures. This study aimed to determine the patterns and associated factors of dyslipidaemia among Malaysian subjects with borderline diabetes.

Methods

A retrospective study was conducted among subjects with borderline diabetes aged ≥18 years who visited a primary healthcare centre at Universiti Sains Malaysia from January 2017 to December 2018. Sociodemographic, clinical and laboratory data were obtained from electronic medical records. Data were analysed using SPSS version 25.

Results

A total of 250 participants with borderline diabetes were included in the analysis. Of them, 93.6% (n=234) had lipid abnormalities. Isolated dyslipidaemia characterised by a high low-density lipoprotein cholesterol (LDL-C) level (38.8%, n=97) was the most common pattern found, followed by combined dyslipidaemia of high LDL-C and triglyceride (TG) levels (22.8%, n=57). The male sex was found to be significantly associated with hypertriglyceridemia (adjusted odds ratio [AOR] = 1.86, 95% confidence interval [CI] =1.09-3.1)(P=0.02). Diastolic blood pressure ≥90mmHg was significantly associated with a low HDL-C level (A0R=2.09, 95% CI=1.0-4.1) (P=0.03).

Conclusion

The majority of subjects with borderline diabetes have lipid abnormalities. Specifically, isolated dyslipidaemia characterised by a high LDL-C level is alarmingly prevalent. Further large-scale robust studies are needed to confirm the present findings.

Social determinants of health and cardiometabolic risk factors in Nepal: A scoping review

AIMS

Cardiometabolic risk factors are modifiable contributors to cardiometabolic disease and adverse outcomes. Cardiometabolic risk factors are emerging health concerns among adults in low and middle-income countries. The role of social determinants of health on cardiometa gaps.

DATA SYNTHESIS

A comprehensive search was conducted in multiple databases: PubMed (MEDLINE), Web of Science (Clarivate), and CINAHL (EBSCO). Joanna Briggs Institute's (JBI) Scoping Review methodology and PRISMA extension for scoping reviews-SCRA guided this review. Forty-four cross-sectional studies published between 2010 and 2022 were eligible for this review. Men were more likely to have hypertension, while women were more likely to have obesity and abdominal obesity. Participants from marginalized caste/ethnicity, urban regions, and those with lower education, and greater wealth index had a greater likelihood of hypertension, dyslipidemia, and hyperglycemia; however, differences across these sociodemographic subgroups are narrowing. Smoking, harmful alcohol use, high salt intake, low fruit and vegetable intake, and sedentary lifestyles were associated with one or more cardiometabolic risk factors. Finally, one cardiometabolic risk factor increased the risk of others.

CONCLUSIONS

Findings reflect that Nepal is at the intersection of rapid urbanization, nutritional transition, and socioeconomic shift. Future studies should take a multilevel approach to investigate the role of social determinants in increasing the cardiometabolic risk burden in Nepal.

Correlation of HbA1c Level with Lipid Profile in Type 2 Diabetes Mellitus Patients Visiting a Primary Healthcare Center in Jeddah City, Saudi Arabia: A Retrospective Cross-Sectional Study

INTRODUCTION

Type 2 diabetes mellitus (T2DM) patients are at high risk of dyslipidemia, which in turn is associated with macrovascular diseases, such as heart diseases and stroke, and microvascular diseases, such as neuropathy and nephropathy. There are contradictory findings in the literature regarding the relationship between glycated hemoglobin (HbA1c) and the lipid profile among T2DM patients. This study was performed to investigate the association between HbA1c level and the lipid profile in elderly T2DM patients at a primary care hospital in Jeddah City, Saudi Arabia.

METHODS

This study is a retrospective cross-sectional study conducted at the Prince Abdul Majeed Healthcare Center (PAMHC) in Jeddah, Saudi Arabia. The sociodemographic and clinical data of the T2DM patients who had visited the PAMHC from 1 January 2020 to 31 December 2021, were collected from the data registry of the PAMHC and analyzed for publication.

RESULTS

The study included a total of 988 T2DM patients (53.3% male). Of the participants, 42.9% were aged between 55 and 64 years. Dyslipidemia parameters were presented as high LDL-c (in 60.3% cases), low HDL-c (in 39.8% cases), high triglycerides (in 34.9% cases), and high total cholesterol (in 34.8% cases). The correlation of HbA1c with total cholesterol (TC) and triglycerides (TGs) was positively significant, thereby highlighting the important link between glycemic control and dyslipidemia. A mean increase of 4.88 mg/dL and 3.33 mmHg in TG level and diastolic blood pressure, respectively, was associated with the male gender, in comparison to the female gender. However, the male gender was significantly associated with the reduction in the mean cholesterol level, BMI, HbA1c, HDL-c, and LDL-c by 11.49 mg/dL, 1.39 kg/m2, 0.31%, 7.47 mg/dL, and 5.6 mg/dL, respectively, in comparison to the female gender.

CONCLUSIONS

The results of this study show that HbA1c was significantly associated with cholesterol and triglyceride levels in the T2DM patients included in the study. Our findings highlight the important relationship between glycemic control and dyslipidemia.

Dyslipidemia among Patients with Type 2 Diabetes Mellitus Visiting a Tertiary Care Centre

Introduction

A triad of lipid and lipoprotein metabolism is known as dyslipidemia. Dyslipidemia is one of the major risk factors for cardiovascular diseases in diabetes mellitus which is a leading cause of morbidity and mortality worldwide. The aim of the study was to find out the prevalence of dyslipidemia among patients with type 2 diabetes mellitus visiting a tertiary care centre.

Methods

A descriptive cross-sectional study was conducted in a tertiary care centre among patients with type 2 diabetes mellitus from 18 February 2020 to 18 August 2020 after obtaining ethical clearance from the Institutional Review Committee. Demographic and blood samples were analysed and recorded using validated and calibrated tools. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval.

Results

Out of 390 patients with type 2 diabetes mellitus, 343 (87.95%) (84.72-91.18, 95% Confidence Interval) had dyslipidemia. The most prevalent dyslipidemia was high low-density lipoprotein cholesterol at 85 (24.78%) followed by mixed dyslipidemia at 305 (88.92%).

Conclusions

The prevalence of dyslipidemia among patients with type 2 diabetes mellitus was found to be higher than studies conducted in similar settings. We recommend regular testing of blood glucose and blood lipid levels for early detection of dyslipidemia and putting them under medical supervision to reduce the unwanted complications of cardiovascular diseases.

Keywords

cardiovascular disease; dyslipidemia; prevalence; type 2 diabetes mellitus.

Association of urinary albumin-to-creatinine ratio with lipid abnormalities and glycemic control in patients with type 2 diabetes mellitus

Introduction

While proteinuria aggravates dyslipidemia in diabetic patients, dyslipidemia further worsens proteinuria via inflammatory cytokines-mediated glomerular damage. Urinary albumin creatinine ratio (ACR) is an easy and reliable method of detecting proteinuria. This study aims to determine the association of ACR with lipid abnormalities and glycemic control in the Nepalese population.

Methods

This was a cross-sectional study conducted among 201 diabetes patients visiting the outpatient department of internal medicine. Based on ACR values, patients were categorized as nonalbuminuric (less than 300 μg/mg) or albuminuric (more than 300 μg/mg). An unpaired t-test was used to compare the mean of various lipoproteins in these two categories. Binary logistic regression was used to check the association of ACR with sociodemographic factors (age, sex, and education), hypertension, and glycated hemoglobin.

Results

Albuminuric patients had higher mean cholesterol (192.8±53.5 vs. 184.2± 37.6; P=0.209), triglyceride (194.9±97.8 vs. 164.4±73.7; P=0.017) and low-density lipoprotein (99.9±38.4 vs. 90.0±27.4; P=0.034) but lower high-density lipoprotein (53.9±18.5 vs. 61.3±19.9; P=0.008) compared to nonalbuminuric patients. There was a significant difference in mean HbA1c values across albuminuria and nonalbuminuria groups (7.1±1.1 vs. 6.7±0.8; OR: 1.4, 95% CI=1.1-1.9, P=0.030).

Conclusions

Urine ACR of more than 30 mg/gram was associated with higher triglyceride and low-density lipoprotein levels and lower high-density lipoprotein levels. The HbA1c level strongly correlates with the development of albuminuria.

Prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus patients in rural and urban areas: A multicenter cross-sectional study

Background and Aims

Dyslipidemia in diabetes mellitus has been linked to unhealthy lifestyle and bad eating habits. However, this association has not been well studied among rural and urban Ghanaian populations. In this study, we determined the prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus (T2DM) patients in rural and urban areas.

Methods

This comparative multicentre-cross-sectional study recruited 228 T2DM outpatients attending the St. Michael Hospital, Pramso (rural) and Kumasi South Regional Hospital (urban), Ghana for routine check-ups. Self-structured questionnaire was used to collect sociodemographic, knowledge, and lifestyle characteristics. Fasting blood samples were taken to measure lipid profiles. Dyslipidemia was defined per the American Diabetes Association criteria. All p < 0.05 were considered statistically significant.

Results

The overall prevalence of dyslipidemia was 79/228 (34.7%). Dyslipidemia was more prevalent among urban participants 43 (18.9%) than rural participants 36 (15.8%). Twenty-seven (11.7%) had adequate knowledge about the risk factors, complications, and management of diabetes. Eating supper after 7 p.m. [adjusted odds ratio = 3.77, 95% confidence interval (1.70-8.37), p = 0.001] significantly increased one's risk of having dyslipidemia by 3.8-fold compared to eating supper earlier (before 5 p.m.).

Conclusion

Dyslipidemia is increasing among T2DM patients in both urban and rural areas and it's independently influenced by eating supper after 7 p.m. Most participants were ignorant of the risk factors, complications, and management of diabetes. Adjusting eating habits and increasing diabetes awareness programs to sensitize the general public can mitigate the increasing prevalence of dyslipidemia in both urban and rural areas.

Patterns of Dyslipidemia Among Acute Coronary Syndrome (ACS) Patients at a Tertiary Care Hospital in Lahore, Pakistan

INTRODUCTION

Dyslipidemia refers to the presence of abnormalities in lipid parameters. It has become a global issue with a high risk of cardiovascular diseases (CVDs). The aim of the investigation was to find out the pattern and prevalence of dyslipidemia among patients with the acute coronary syndrome (ACS).

METHODOLOGY

A cross-sectional study design was used. Data were collected using convenient sampling from 101 patients presenting with ACS, admitted at the critical care unit (CCU) / Rasheeda Begum Cardiac Centre (RBCC) of Shalamar Hospital, during a 12-month period from January 2020 to December 2021. Dyslipidemia is diagnosed by testing the lipid profile when there are one or more abnormal readings of the lipid profile.

RESULTS

Nearly 43 (42.6%) had ST-segment elevation myocardial infarction (STEMI), 27 (26.7%) had non-ST segment elevation myocardial infarction (NSTEMI), and 31 (30.7%) were categorized as unstable angina (USA). Overall dyslipidemia was present in 84 (83.2%) patients. The prevalence of dyslipidemia was 55 (65%) in male patients and 29 (34.5%) in female patients. Dyslipidemia was present in 39 (90.7%) patients with STEMI, 25 (80.6%) in the USA, and 20 (74.1%) with NSTEMI.

CONCLUSION

The prevalence of dyslipidemia was quite high among ACS patients. The proportion of obese patients was also high in our study. However, dyslipidemia was more frequent in overweight patients.

Prevalence and Pattern of Dyslipidemia and Its Associated Factors Among Patients with Type 2 Diabetes Mellitus in Jordan: A Cross-Sectional Study

Background

Dyslipidemia and type 2 diabetes mellitus (T2DM) are growing health problems, particularly in developing countries. This study aimed to determine the prevalence and pattern of dyslipidemia and its associated factors among patients with T2DM.

Methods

A cross-sectional study was conducted among patients with T2DM attending Family Medicine Clinics in Jordan between August 2017 and March 2019. The socio-demographics, clinical features, medications, and laboratory findings were collected. These laboratory findings included high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TGs).

Results

A total of 870 patients with T2DM were included. The prevalence of dyslipidemia among patients with T2DM was 91.4%. The most common patterns of dyslipidemia were low HDL-C (66.2%), high LDL-C (62.1%), and hypertriglyceridemia (58.2%). Female gender, obesity, and hypertension were associated with diabetic dyslipidemia patterns. T2DM duration and poor glycemic control were associated with high LDL-C and hypercholesterolemia. Hypertriglyceridemia was associated with poor glycemic control and smoking.

Conclusion

Dyslipidemia is highly prevalent among patients with T2DM. Evidence -based interventions are needed to prevent and control dyslipidemia among patients with T2DM in Jordan.

The pattern of dyslipidaemia and factors associated with elevated levels of non-HDL-cholesterol among patients with type 2 diabetes mellitus in the Ho municipality: A cross sectional study

Background

Dyslipidaemia is a key comorbid condition of type 2 diabetes mellitus that increases the risk of cardiovascular disease. This study describes the pattern of dyslipidaemia and factors associated with elevated levels of non-high density lipoprotein cholesterol (HDL-C) among patients with type 2 diabetes mellitus in Ho.

Methods

This hospital-based cross-sectional study enrolled 210 patients with type 2 diabetes mellitus from Ho municipality. A semi-structured questionnaire was used to obtain demographic and other relevant parameters. Anthropometric, haemodynamic, and biochemical variables were obtained using standard methods. Dyslipidaemia was defined according to the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) criteria while elevated levels of non-HDL-C was defined as non-HDL-C level ≥3.37 mmol/L. A Chi-square test and multivariate logistic regression analyses were performed to determine factors associated with elevated non-HDL-C levels.

Results

Overall, dyslipidaemia and elevated levels of non-HDL-C prevalence was 67.1% and 64.3%, respectively. The frequency of atherogenic, isolated, and mixed dyslipidaemias were 10.5%, 58.09% and 53.33 %, respectively. Females were four times more likely to develop elevated levels of non-HDL-C after adjustment for age (AOR: 4.07; CI: 2.20-7.51; p < 0.0001). Likewise, overweight (AOR: 3.1; CI: 1.45-6.61; p = 0.0035), grade 1 obesity (AOR: 2.8; CI: 1.20-6.49; p = 0.0168), and truncal obesity (AOR: 3.09; CI: 1.54-6.19; p < 0.0001) were three times each more likely to develop elevated levels of non HDL-C after adjustment for age and gender. However, alcohol intake was 66% unlikely to develop elevated levels of non-HDL-C (COR: 0.34; CI: 0.16-0.73; p = 0.006).

Conclusion

Dyslipidaemia and elevated levels of non-HDL-C were common in our study participants. Hypercholesterolaemia and co-occurrence of high TG and high LDL-C levels were the most prevalent isolated and mixed dyslipidaemias, respectively. The female gender, overweight, grade 1 obesity and truncal obesity, as well as alcohol intake were significant predictors of elevated levels of non-HDL-C.

Poor glycemic control, cardiovascular disease risk factors and their clustering among patients with type 2 diabetes mellitus: A cross-sectional study from Nepal

Background

Cardiovascular disease (CVD) is the most common complication of diabetes mellitus (DM). To prevent morbidity and mortality among patients with type 2 diabetes mellitus (T2DM), optimization of glycemic status and minimizing CVD risk factors is essential. As Nepal has limited data on these CVD risk parameters, we assessed the prevalence of poor glycemic control, CVD risk factors, and their clustering among patients with T2DM.

Methods

Using a cross-sectional study design, we collected data of 366 patients with T2DM. We applied a multistage cluster sampling technique and used the WHO STEPS tools. Binary logistic and Poisson regression was applied to calculate odds and prevalence ratio of clustering of risk factors, considering P< 0.05 statistically significant.

Results

The mean age of participants was 54.5±10.7 years and 208 (57%) were male. The prevalence of poor glycemic control was 66.4% (95% C.I: 61.5–71.2). The prevalence of smoking, alcohol users, inadequate fruit and vegetables intake and physical inactivity were 18% (95% C.I:14 to 21.9), 14.8% (95% C.I:11.1 to 18.4), 98.1% (95% C.I: 96.7–99.4), and 9.8% (95% C.I:6.7–12.8), respectively. Overall, 47.3% (95% C.I: 42.1–52.4) were overweight and obese, 59% (95% C.I: 52.9–63) were hypertensive, and 68% (95% C.I: 63.2–72.7) had dyslipidemia. Clustering of two, three, four, five and more than five risk factors was 12.6%, 30%, 30%,19%, and 8.7%, respectively. Four or more risk factors clustering was significantly associated with gender, age, level of education, T2DM duration, and use of medication. Risk factors clustering was significantly higher among males and users of anti-diabetic medications with prevalence ratio of 1.14 (95% C.I:1.05–1.23) and 1.09 (95% C.I: 1.09–1.18)], respectively.

Conclusions

The majority of the patients with T2DM had poor glycemic control and CVD risk factors. Policies and programs focused on the prevention and better management of T2DM and CVD risk factors should be implemented to reduce mortality in Nepal.

Dyslipidemia and its associated factors among adult diabetes outpatients in West Shewa zone public hospitals, Ethiopia

Purpose

Dyslipidemia is a major risk factor for cardiovascular disease (CVD) in diabetic patients and early detection and treatment can reduce its morbidity and mortality. There is little information on the lipid profile of diabetic patients at West Shewa Public Hospitals, Ethiopia. Therefore, this study aimed to investigate the prevalence and related factors of dyslipidemia among adult diabetes on their follow up at West Shewa Public Hospitals, Ethiopia.

Methods

A facility-based cross-sectional study was conducted from June 1 to September 30, 2020. Data were collected using pre-tested interviewer-administered structured questionnaire. The participants were recruited using a systematic random sampling method. Bivariable and multivariable binary logistic regression were employed to identify the factors associated with dependent variable. Adjusted odds ratios (AOR) were calculated at 95% confidence interval (CI) and p value of < 0.05 was considered as statistically significant.

Results

A total number of 390 participants with a mean age of 46.45 (± 15.6) years participated in the study. The overall prevalence of dyslipidemia was 81.5% [95% CI 77.4, 85.4] and the most common lipid abnormality was elevated triglycerides (63.3%). According to multivariate analysis being female gender (AOR = 2.93; 95% CI 1.65, 5.23), age above 50 years (AOR = 3.24; 95% CI 1.54, 6.80) and alcohol consumption (AOR = 2.68; 95% CI 1.33, 5.411) were significantly associated with dyslipidemia.

Conclusion

The majority of study participants had dyslipidemia. Gender, alcohol intake, and age over 50 years were significantly associated with it. Therefore, the results of this study should be taken into account in order to implement appropriate interventions for the identified risk factors.

Dyslipidemia and associated cardiovascular risk factors in HIV-positive and HIV-negative patients visiting ambulatory clinics: A hospital-based study

Background

Dyslipidemia is a well-known risk factor for cardiovascular disease (CVD), accounting for more than half of all instances of coronary artery disease globally (CAD).

Purpose

The purpose of this study was to determine lipid-related cardiovascular risks in HIV-positive and HIV-negative individuals by evaluating lipid profiles, ratios, and other related parameters.

Methods

A hospital-based study was carried out from January 2019 to February 2021 in both HIV + and HIV- ambulatory patients.

Results

High TG (p = .003), high TC (p = .025), and low HDL (p < .001) were all associated with a two-fold increased risk of CVD in people aged 45 and up. Due to higher TG (p < .001) and lower HDL (p < .001), males were found to have a higher risk of atherogenic dyslipidemia. A twofold increase in the likelihood of higher TG levels has been associated with smoking (p = .032) and alcohol intake (p = .022). A twofold increase in a high TC/HDL ratio and an elevated TG/HDL ratio was observed with an increase in waist-to-height ratio (p = .030) and a high level of FBS (126 mg/dl) and/or validated diabetes (p = .017), respectively. In HIV + participants, central obesity (p < .001), diabetes (p < .001), and high blood pressure (p < .001) were all less common than in HIV- participants.

Conclusions

Dyslipidemia is linked to advanced age, male gender, diabetes, smoking, alcohol consumption, and increased waist circumference, all of which could lead to an increased risk of CVD, according to the study. The study also revealed that the risks are less common in HIV + people than in HIV-negative ambulatory patients.

The Aliment to Bodily Condition knowledgebase (ABCkb): a database connecting plants and human health

OBJECTIVE

Overconsumption of processed foods has led to an increase in chronic diet-related diseases such obesity and type 2 diabetes. Although diets high in fresh fruits and vegetables are linked with healthier outcomes, the specific mechanisms for these relationships are poorly understood. Experiments examining plant phytochemical production and breeding programs, or separately on the health effects of nutritional supplements have yielded results that are sparse, siloed, and difficult to integrate between the domains of human health and agriculture. To connect plant products to health outcomes through their molecular mechanism an integrated computational resource is necessary.

RESULTS

We created the Aliment to Bodily Condition Knowledgebase (ABCkb) to connect plants to human health by creating a stepwise path from plant [Formula: see text] plant product [Formula: see text] human gene [Formula: see text] pathways [Formula: see text] indication. ABCkb integrates 11 curated sources as well as relationships mined from Medline abstracts by loading into a graph database which is deployed via a Docker container. This new resource, provided in a queryable container with a user-friendly interface connects plant products with human health outcomes for generating nutritive hypotheses. All scripts used are available on github ( https://github.com/atrautm1/ABCkb ) along with basic directions for building the knowledgebase and a browsable interface is available ( https://abckb.charlotte.edu ).

Predictors of Lipid Profile Abnormalities Among Patients with Metabolic Syndrome in Southwest Ethiopia: A Cross-Sectional Study

BACKGROUND

Lipid profile abnormalities are an integral part of metabolic syndrome (MetS) and major underlying causes of cardiovascular disease (CVD) and type-2 diabetes mellitus (T2DM). Lipid profile abnormalities in a patient with MetS are resulted due to the presence of central obesity and insulin resistance. In Ethiopia, the burden and predictors of lipid profile abnormalities in a patient with MetS are not well known. Thus, this study aimed to determine the prevalence of lipid profile abnormalities and predictors among patients with MetS in southwest Ethiopia.

METHODS AND MATERIALS

A cross-sectional study was conducted among 381 patients with MetS from September to December 2019 with a response rate of 100%. A structured questionnaire was used to collect data on socio-demographic and behavioral factors. Waist circumference, height, weight, and blood pressures were measured. The venous blood sample was collected for glucose and lipid profile determination. Data were entered and analyzed by using SPSS version 21. Binary logistic regression and Pearson's correlation analyses were performed. A p-value was set at a <0.05 for statistical significance.

RESULTS

In this study, about 58% of participants were at least one or more lipid profile abnormalities with the 95% CI (52.8-62.7). About 67.2%, 44.6%,18.4%, and 14.2% of study participants were low HDL, high TG, LDL, and TC, respectively. Central obesity (adjusted odds ratio (AOR): 1.89, 95% CI: 1.14-3.14), increasing age (AOR: 2.08, 95% CI: 1.27-3.4), higher BMI (AOR: 2.06, 95% CI: 1.23-3.4), being hypertensive (AOR: 3.48, 95% CI: 2.12-5.7) and increasing blood glucose level (AOR: 2.34, 95% CI: 1.36-4.03) were independent predictors of lipid profile abnormalities (dyslipidemia).

CONCLUSION

In this study area, a high (58%) prevalence of dyslipidemia was observed in study participants, and increasing age, higher BMI, central obesity, hypertension, and high blood glucose level were identified as independent predictors of dyslipidemia among patients with MetS. Prevention and control of dyslipidemia and its predictors among patients with MetS were recommended.

Dyslipidemia in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Centre: A Descriptive Cross-sectional Study

INTRODUCTION

Dyslipidemia is highly prevalent among type 2 diabetic patients. It increases the risk of atherosclerosis and consequent mortality in diabetic patients. The aim of this study was to find out the prevalence of dyslipidemia among type 2 diabetic patients.

METHODS

This was a descriptive cross-sectional study in 355 type 2 diabetic patients at tertiary care hospital from 15th May, 2020 to 15th November, 2020 after taking ethical clearence from Institutional Review Committee (Reference no. IRC-PA-052/2077-78). Convenience sampling was done. Demographic and lipid profile variables were recorded based on the structured questionnaires. Data were analyzed by Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data.

RESULTS

Out of total 355 cases of type 2 Diabetes mellitus, prevalence of dyslipidemia was 224 (63.1%). It was more prevalent in male 145 (69.4%) than female 79 (54.1%). Increased Low density Lipoprotein (94.2%) was the most prevalent type followed by mixed dyslipidemia (91.1%).

CONCLUSIONS

Dyslipidemia was common among type 2 diabetic patients and was higher in male gender, older age, obesity and longer duration of diabetes. Hence type 2 diabetic patient should undergo the routine monitoring of blood sugar and lipid profile so that any abnormalities can be identified and preventive measures along with interventions can be initiated at the earliest.

Prevalence of plasma lipid disorders with an emphasis on LDL cholesterol in selected countries in the Asia-Pacific region

Cardiovascular disease (CVD) is a major cause of mortality and morbidity within the Asia-Pacific region, with the prevalence of CVD risk factors such as plasma lipid disorders increasing in many Asian countries. As members of the Cardiovascular RISk Prevention (CRISP) in Asia network, the authors have focused on plasma lipid disorders in the six countries within which they have clinical experience: Indonesia, Malaysia, Philippines, Thailand, Vietnam, and Australia. Based on country-specific national surveys, the prevalence of abnormal levels of total cholesterol, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), and triglycerides (TG) are reported. An important caveat is that countries have used different thresholds to define plasma lipid disorders, making direct comparisons difficult. The prevalence of abnormal lipid levels was as follows: high total cholesterol (30.2-47.7%, thresholds: 190-213 mg/dL); high LDL-C (33.2-47.5%; thresholds: 130-135 mg/dL); low/abnormal HDL-C (22.9-72.0%; thresholds: 39-50 mg/dL); and high/abnormal TG (13.9-38.7%; thresholds: 150-177 mg/dL). Similarities and differences between country-specific guidelines for the management of plasma lipid disorders are highlighted. Based on the authors' clinical experience, some of the possible reasons for suboptimal management of plasma lipid disorders in each country are described. Issues common to several countries include physician reluctance to prescribe high-dose and/or high-intensity statins and poor understanding of disease, treatments, and side effects among patients. Treatment costs and geographical constraints have also hampered disease management in Indonesia and the Philippines. Understanding the factors governing the prevalence of plasma lipid disorders helps enhance strategies to reduce the burden of CVD in the Asia-Pacific region.

Dyslipidemia and Its Associated Risk Factors Among Adult Type-2 Diabetic Patients at Jimma University Medical Center, Jimma, Southwest Ethiopia

BACKGROUND

Dyslipidemia is one of the major modifiable risk factors for cardiovascular diseases (CVD) in a type-2 diabetic (T2DM) patient. Dyslipidemia in T2DM patients is attributed due to increased free fatty acid flux secondary to insulin resistance. Despite its high prevalence and related complication of dyslipidemia in T2DM patients, there is a paucity of data on the prevalence of dyslipidemia in T2DM patients in Ethiopia.

OBJECTIVE

To determine the prevalence of dyslipidemia and its associated risk factors among T2DM patients at Jimma medical center (JUMC) Jimma, Ethiopia.

METHODS AND MATERIALS

An institution-based- cross-sectional study was conducted from June 1 to August 4, 2019. A convenience sampling technique was used to recruit 248 T2DM patients in the study. Data on socio-demographic characteristics, behavioral, and clinical factors were collected using a structured questionnaire through face to face interviews. Five milliliters of the fasting venous blood sample was collected for serum glucose and lipid profile analysis. Blood pressure, weight, and height were measured. Data were analyzed by SPSS version 21. Bivariate and multivariate logistic regression analyses were performed and p-value <0.05 was considered as statistically significant.

RESULTS

The overall prevalence of dyslipidemia among study participants was 68.1%. Isolated lipid profile abnormality of hypertriglyceridemia was found in 48%, hypercholesterolemia in 13.7%, high level of low-density lipoprotein (LDL-C) in 28.6%, and low level of high-density lipoprotein (HDL-C) in 50.8% study participants. Being in an age group ≥30 years, physical inactivity, being obese, hypertension, and high blood glucose value were significantly associated factors with dyslipidemia.

CONCLUSION

High prevalence of dyslipidemia was found among T2DM in the study area. The findings of this study should be taken into account to conduct appropriate intervention measures on the identified risk factor, and implement routine screening, treatments, and prevention of dyslipidemia.

The cut-off value of impaired fasting glucose should be lower: Based on the associations of fasting blood glucose with blood lipids

OBJECTIVE

The previous study served impaired fasting glucose (IFG), a pre-diabetic state which was much greater than that of diabetic patients, have reached no consensus on its cut-off value. In this study, we aimed to explore the cut-off value of IFG via the associations of blood lipids with fasting plasma glucose (FPG).

DESIGN

A cross-sectional study in Jilin province, China, 2012.

SAMPLE

13,093 participants aged 18-79 years in Jilin province were involved in the study. The Lamba-Mu-Sigma (LMS) method and generalized additive model (GAM) were used to explore the associations of different levels of FPG and blood lipids.

RESULTS

The distributions of FPG, triglyceride (TG) and high-density lipoprotein cholesterol (HDL-c) were significantly different by gender (p<0.01). In general, both LMS and GAM results showed that the TG and HDL-c curves had a steeper tendency when the FPG was greater than 6.0mmol/L.

CONCLUSION

FPG was positively associated with TG while negatively associated with HDL-c, and the associations were stronger in females. The cut-off value of IFG was suggested to be 6.0mmol/L.

Case reports of metabolic disorders from Nepal

BACKGROUND

The prevalence of metabolic disease in Nepal is largely unknown. Some consideration has been given by the nepalese government for high prevalence of congenital disorders in some populations, but disorders due to enzymatic deficiencies have not been considered as a class of diseases where timely diagnosis and intervention might be possible. No case for these disorders has been made so far, however, findings of many rare metabolic diseases have been reported in literature by the nepalese medical fraternity.

METHODS

A search for case reports on metabolic disorders listed according to International Classification of Diseases -11 was performed using the google search engine.

RESULTS

A total of 443 cases have been discovered presented in the literature. This does not include disorders that might be due to lifestyle and behaviour. Most of the reported cases have been identified based on clinical acumen, radiological and histopathological findings.

CONCLUSIONS

Glucose 6 phosphate dehydrogenase deficiency, Wilson's disease and lysosomal disorders should be considered for early diagnosis through newborn screening along with the acknowledged disorders hypothyroidism and hemoglobinopathies in Nepal. Early intervention in these disorders can significantly reduce morbidity and mortality in infancy.

Prevalence and pattern of dyslipidemia in patients with type 2 diabetes mellitus in Zaria, Northwestern Nigeria

INTRODUCTION

Dyslipidemia confers excess atherosclerotic cardiovascular risk in type 2 diabetes mellitus (DM) patients, and this requires prompt identification and management to reduce morbidity and mortality. This study assessed the prevalence and pattern of dyslipidemia in type 2 DM patients in Zaria, Northwestern Nigeria.

METHODS

This was a cross-sectional study of newly diagnosed type 2 DM patients at Ahmadu Bello University Teaching Hospital (ABUTH), Zaria. Demographic, clinical and laboratory data were extracted from the case notes of eligible patients and analyzed using STATA version 14. Continuous variables were presented as mean ± standard deviation (SD), or median and interquartile range (IQR) while categorical variables were as frequencies and percentages. Student t and chi-square tests were used to test for association at p < 0.05.

RESULTS

A total of 322 subjects (161 male, 161 female) with a mean age of 53.5 ± 10.8 years partook in the study. The prevalence of dyslipidemia was 69.3%. Mixed dyslipidemia of high triglyceride (TG) and high low-density lipoprotein cholesterol (LDL-C) was present in 41.0%; high TG and low high-density lipoprotein cholesterol (HDL-C) in 2.8%; and high LDL and low HDL in 2.5%. Atherogenic dyslipidemia, isolated hypercholesterolemia and isolated low HDL-cholesterol were present in 3.4%, 2.5% and 23.6% respectively. Dyslipidemia status was not associated with age, sex, duration of DM or hypertension, obesity, and mean fasting blood sugar (FBS) and 2-hour postprandial glucose.

CONCLUSION

The prevalence of dyslipidemia is high in the newly diagnosed type 2 DM patients and therefore, initial management should incorporate measures to control dyslipidemia.