Lipoprotein (a) and atherogenic indices in Sudanese patients with type 2 diabetes

Abstract

Background & aims: Type 2 diabetes is associated with significant cardiac morbidity and mortality with a more than threefold increased risk of coronary artery disease (CAD). We aimed to assess the serum concentrations of lipoprotein (a) and lipid profile indexes as predictors for CAD in Sudanese type 2 diabetics compared to healthy subjects.

Materials & methods: This case-control study was conducted at Jabir Abu-Aliz Specialized Center, Khartoum State, Sudan. After overnight fasting, 4 ml blood samples were collected in plain vials through venous puncture from each subject. Lipid profile parameters were estimated by standard laboratory procedures. Serum lipoprotein (a) was measured by immunoturbidimetric method. Statistical analyses were performed using SPSS software (version 17).

Results: Compared to healthy controls, type 2 diabetics showed significantly higher serum lipids and lipoprotein fractions. The mean values of lipoprotein (a), TC: HDL-C (5.55±.8 vs. 3.89±.6) and LDL-C: HDL-C (3.80±0.7 vs. 2.32±0.5) were significantly increased in patients. Lipoprotein (a) was significantly correlated with TG (p=.025), HDL-C (inversely, p<.001), VLDL-C (p= .025), and TC: HDL-C ratio (p= 016). Moreover, LDL-C: HDL-C ratio and TC were the most common risk factors distributed among the study patients (80% and 71.4% respectively).

Conclusion: Diabetic patients characterized by higher ratios of TC: HDL -C and LDL: HDL and Lipoprotein (a) compared to healthy controls. The evaluation of these lipid indices in diabetics, beside the routine lipid profile analysis, may be a crucial helpful step in the prevention of coronary artery disease since these atherogenic factors can be reduced by lifestyle modifications.

Keywords: LDL-C: HDL-C ratio; Sudan; TC: HDL-C ratio; coronary artery disease; lipoprotein (a); type 2 diabetes.

Fig (1)

frequencies of cardio-metabolic risk factors among Sudanese patients with type 2 diabetes (data represented as %) Cut-off values for the cardiometabolic risk factors as the following: BMI≥ 30 kg/m², systolic BP≥140 mmHg, diastolic BP≥90 mmHg, TC≥200mg/dl, TG≥150mg/dl, HDL-C ≤40mg/dl, LDL-C≥100mg/dl, VLDL-C≥32mg/dl, TC: HDL-C>3.5, LDL-C: HDL-C>6, Lp (a) >6 Abbreviations: BMI, body mass index; BP, blood pressure; FBG, fasting blood glucose; TC, total cholesterol; TG, triglyceride; HD-CL, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; VLDL-C, very low density lipoprotein cholesterol; Lp (a), lipoprotein (a)