The pattern of dyslipidemia among Somali type 2 diabetic patients: a cross-sectional study

Abstract

Background: Diabetes mellitus (DM) is a major public health concern. This study aims to determine frequency, pattern, and potential determinants of dyslipidemia among adults with type 2 DM (T2DM) at Somalia's only diabetes outpatient clinic.

Methods: Five hundred twenty-nine consecutive patients with T2DM who applied to our outpatient clinic between January 2020 and June 2020 were included in this cross-sectional hospital-based study. Demographic characteristics of participants, including lipid panel, were extracted from the registry system. Correlation analysis was performed between lipid profile and related parameters. Multivariate binary logistic regression models were used to identify independent determinants of dyslipidemia for further analysis.

Results: The overall population's mean age was 51.9 ± 12.2 years, with 177 (33.5%) males. Total and atherogenic dyslipidemias were found in 92.8% and 24.8%, respectively. The most common isolated pattern of dyslipidemia was high non-high-density lipoprotein cholesterol (non-HDL-C) (82.8%), followed by high low-density lipoprotein cholesterol (LDL-C) (72.6%), high total cholesterol (TC) (54.3%), and low HDL-C (48.3%). Females were found to have a higher prevalence of high TC (63.4% vs. 54.2%, p = 0.043) and lower HDL-C (57.4% vs. 46.3%, p = 0.016). High LDL-C with low HDL-C was the most common pattern among combined type dyslipidemias (18.1%), followed by high LDL-C with high triglyceride (TG) (17.8%), as well as low TG with low HDL-C (3.6%). Females had a higher proportion of high LDL-C with low HDL-C than males (20.3% vs. 13.6%, p = 0.036). Age, gender, body mass index, central obesity, spot urinary proteinuria, fasting blood glucose, poor glycemic control, creatinine, and Hs-CRP were all associated with different dyslipidemia patterns in multivariate logistic regression analyses.

Conclusions: We found that the prevalence of dyslipidemia, especially atherogenic patterns, was extremely high among Somali T2DM patients. An enhanced health policy should, therefore, be established to detect, treat and prevent dyslipidemia.

Keywords: Atherogenic dyslipidemia; Diabetes mellitus; Dyslipidemia; LDL-C; Somalia.

Fig. 1

Venn diagram showing the overlapping of the individual components of atherogenic dyslipidemia criteria. HDL-C high-density lipoprotein, LDL-C low-density lipoprotein, TG triglycerides

Fig. 2

Age- and sex-specific mean values of serum lipid parameters and TC/HDL-C ratio in the study population. One-way ANOVA was used to compare serum levels of a single lipid parameter among six different age groups. In age groups, 1 indicates those between the ages of 24 and 34, 2 35–44, 3 45–54, 4 55–64, 5 65–74, and 6 75 and over. All single lipid parameters have a statistically insignificant distribution among age groups (p > 0.05, for all). The mean reflects serum lipid parameter concentrations (mg/dL) and TC to HDL-C ratio values. TG triglycerides, TC total cholesterol, HDL-C high-density lipoprotein cholesterol, LDL-C low-density lipoprotein cholesterol