RELATIONSHIP BETWEEN HBA1C AND HYPERLIPIDAEMIA IN PATIENTS WITH DIABETES MELLITUS
Abstract
Introduction: HbA1c is well now as predictor for hyperglycaemia due to accumulation of sugar on the Hb. The aim of this study is to now the relationship between HbA1c level and hyperlipidaemia. Patient and methods: this study was done in the diabetic and endocrine centre between 2010-2011 in which 187 patients involved, all of them had DM we send them for B.sugar,HbA1c, lipid profile including s.cholestrol, s.triglyceride, HDL, LDL and VLDL, renal function test. We divide them according to their sex, age, residency, work, family history of DM, past medical history of HT, atherosclerosis, IHD, smoking habit, type of drug used, albuminuria and type of DM. we use the chi square and exact test and SPSS 17 for statistics. Results: 187 patients were involved in this study. 79(42%) were male and 108(58%) were female, there age was 3(1%) were less than 15 years, 74(40%) were in between 15-45 years and 110(59%) were more than 45years, HbA1c was divided into three groups the first one was less than 6 20(11%), 7-8 was 26(14%) and more than 8 was 141(75%). Strong relation ship between level of HbA1c and HDL (p=0.001), VLDL (p=0.027), s.cholestrol (p=0.004), s.triglyceride (p=0.05) and LDL (p=0.029). Conclusion: strong correlation was found between HbA1c and all component of lipid profile in patients with DM, there fore HbA1c is a good predictor for hyperlipidaemia in DMReferences
- Kiyoshi Shibata et al. Diagnostic accuracy of glycohaemoglobin A1c (HbA1c) for postprandial hyperglycemia was equivalent to that of fasting blood glucose Journal of Clinical Epidemiology Volume 58, Issue 10 , Pages 1052-1057, October 2005.
- Elizabeth Selvin et al. Glycated haemoglobin, Diabetes, and cardiovascular risk in nondiabetic adults. NEJMVolume 362:800-811. March 4, 2010 Number 9.
- David B. Sacks. Hemoglobin Variants and Hemoglobin A1c Analysis: Problem Solved?. Clinical Chemistry. 2003;49:1245-1247.
- T Lahousen, R E Roller, Silent haemoglobin variants and determination of HbA1c with the HPLC Bio-Rad Variant II. J Clin Pathol. 2002 September; 55(9): 699–703.
- Schnedl WJ, Liebminger A, Roller RE, Lipp RW, Krejs GJ. Hemoglobin variants and determination of glycated hemoglobin (HbA1c). Diabetes Metab Res Rev 2001;17:94-98
- Nakanishi T, Iguchi K, Shimizu H. A method for hemoglobin A1c measurement based on peptide analysis by electrospray ionization mass spectrometry with deuterium-labeled synthetic peptides as internal standards. Clin Chem 2003;49:829-831.
- Bry L, Chen PC, Sacks DB. Effects of hemoglobin variants and chemically modified derivatives on assays for glycohemoglobin [Review]. Clin Chem 2001;47:153-163.
- Little RR, Wiedmeyer HM, England JD, Wilke AL, Rohlfing CL, Wians FH, Jr, et al. Interlaboratory standardization of measurements of glycohemoglobins. Clin Chem 1992;38:2472-2478.
- Christopher D. Saudek, et al. Assessing Glycemia in Diabetes Using Self-monitoring Blood Glucose and Hemoglobin A1c. JAMA. 2006;295(14):1688-1697.
- Philip Barter, e. al. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular Events . NEJM Volume 357:Number 13.September 27. 1301-1310. 2007.
- Al Muhtaseb N et al. Plasma lipoproteins and apolipoproteins in insulin-dependent and young non-insulin-dependent Arab women. Department of Medicine, Faculty of Medicine, Kuwait University.Acta Diabetologica Latina. 28(1):61-9. 1991.
- Futterman LG, Lemberg L artery disease do not have any of the conventional risk factors. Fifty percent of patients with coronary. Am J Crit Care. 1998 May;7(3):240-4
- Castelli WP. Framingham Cardiovascular Institute, Atherosclerosis. 1996 Jul;124 Suppl:S1-9.
- Kay-Tee Khaw, Nicholas, Sheila Bingham Robert et al. Association of Hemoglobin A1c with Cardiovascular Disease and Mortality in Adults : The European Prospective Investigation into Cancer in Norfol. Annals of Internal Medicine, 2004, Vol 141, no 6, 413-420 .
- Lydie N. Pani et. Al. Effect of aging on HbA1c level in individuals without Diabetes:Evidence from the Framingham Offspring study and the NHANES 2001-2004. Diabetes Care 31:1991-1996, 2008.
Haseeb Ahmad Khan. Clinical significance of HbA1c as a marker of circulating lipids
- in male and female type 2 diabetic patients. 23 November 2006 .
- Betteridge DJ. Lipid disorders in diabetes an Mmellitus. In: Pickup J, Willams G. eds. Diabetes, 2nd ed, Blackwell Science, Victoria, 1997; 2: 1-31.
- Murat Sert, Gokhan Morgul, Bekir Tamer. Diabetic dyslipidemia is a well-known issue, but what about lipoprotein a levels in Type 2 diabetics?. Vol.18 No.2 August 2010.
- Onat A, Surdum A, Senocak M, ضrnek E, Gِzükara Y. Plasma lipids and their interrelationship in Turkish adults. J Epidemiol Comm Health 1992; 46: 470-476.
- Mengesha AY. Lipid profile among diabetes patients in Gaborone Botswana. S Afr Med J 2006; 96: 147-148.
- Lawrence JM, Bennett P, Young A, Robinson AM. Primary care screening for diabetes in general practice: cross sectional population study. BMJ 2001; 323: 548-551.
- Seyoum B, Abdulkadir J, Berhanu P, Feleke Y, Mengistu Z, Worku Y, Ayana G. Analysis of serum lipids and lipoproteins in Ethiopian diabetic patients. Ethiop Med J 2003; 41: 1–8.
- 23. Saaddine JB, Engelgau MM, Beckles GL, Gregg EW, Thompson TJ,Narayan KM. A diabetes report card for the United States: quality of care in the 1990s. Ann Intern Med 2002; 136: 565
- Onat A, Surdum A, Senocak M, ضrnek E, Gِzükara Y. Plasma lipids and their interrelationship in Turkish adults. J Epidemiol Comm Health 1992; 46: 470-476.
- Dunn Fredrick L. Hyperlipidemia and Diabetes. Med Clin North Am 1982; 77: 1347-1360.
- Howard BV, Reitman JS, Vasquez B, Zech L. Very low density Lipoprotein Triglyceride Metabolism in Non-insulin-dependent Diabetes Mellitus. Diabetes 1983; 32: 271-276.
- Reaven GM, Greenfield MS. Diabetic hypertriglyceridemia: Evidence for three clinical syndromes. Diabetes 1981; 30: 66-75.
- Lewis GF, Uffelman KD, Szeto LW, Steiner G. Effects of acute hyperinsulinemia on VLDL, triglyceride and VLDL apo B production in normal weight and obese individuals. Diabetes 1993; 42: 833-842.
- Durington P. Is insülin atherogenic? Diabetic Med 1992; 9: 597-600
- Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, and Treatment of High Blood Cholesterol (ATP III). JAMA 2001; 285: 2486-2497.
- Agrawal RP, Sharma P, Pal M, Kochar A, Kochar DK. Magnitude of dyslipedemia and its association with micro and macro vascular complications in type 2 diabetes: a hospital based study from Bikaner (Northwest India). Diabetes Res Clin Pract 2006; 73: 211–214.
- Imperatore G, Rivellese A, Galasso R, Celentano E, İovine C, Ferrara A, Riccardi G, Vaccaro O. Lipoprotein (a) concentrations in NIDDM and borderline hyperglycemia. Metabolism 1995; 44: 1293 -1297.