To Determine the Patterns of Dyslipidaemia Amongst the Macrovascular Complications of Type – II Diabetes Mellitus

Abstract

Objective: To assess the characteristics of dyslipidaemia amongst the type 2 diabetic patient with macrovascular compli-cations like ischaemic heart disease, cerebrovascular and peripheral vascular disease and to compare the variables of dyslipidemia in male and female subjects under study.
Design: A prospective observational analytic study.
Setting and place of Study: Study was conducted in medical unit-III of Bahawal Victoria Hospital Bahawalpur, over a period of 6 months from 1st July, 2008 to 31st December, 2008.
Procedure: A total of hundred patients of type 2 diabetes were randomly selected for study. Those who had hyperlipidaemia due to secondary causes e.x. nephrotic syndrome, drugs, hypothyroidism etc. were excluded. Blood samples were taken for serum sugar fasting and random and fasting lipid profile. For statistical analysis student t.test at 5% level of significance was used. All mean values were presented as mean ± SD (Standard Deviation).
Results: Majority of patients presented in middle and old age category, and they had poor glycemic control. The female patients had uncontrolled hyperglycemic and hypertensive (BP = 145 ± 25.72 / 85.6 ± 76 mm/Hg) than males and their mean random serum sugar was 246.64 ± 105 mg% High percentage of complications were observed in patients of middle age group with great frequency of cardiovascular complications like coronary heart diseases and hypertension (52%) followed by cerebrovascular complications (30%) and peripheral vascular disease (18%). The lipid profile was in high risk range in pati-ents with cardiovascular and cerebrovascular complications. In patients with CHD, the mean +SD concentration of choles-terol was 207.08 ± 27.94 mg/dl, HDL – C was 34.8 ± 6.27 mg/dl and TC : HDLC ratio > 6, (normally TC:HDLC ratio should be < 5 and HDL – C > 40 mg/dl). In patients with CVA, HDL – C was 35.09 ± 6 mg/dl and triglycerides was 146.9 ± 50.70 mg/dl and these variables meet the definition of isolated low HDL – C (defined as TG < 150 mg% and HDL – C < 35 mg% = isolated low HDL – C) and that was considered as independent risk factor. LDL – C concentration was high normal (188 ± 23.4 mg/dl) in these cases. Collectively the mean concentration of LDL-C was raised and statistically very highly significant in all these macrovascular complications. In female patients, the mean concentration of LDL – C, triglycerides and HDL – C was 191 ± 31.6 mg/dl, 179 ± 93 mg/dl and 32 ± 2.4 mg/dl respectively, all in high risk range.
Conclusion: Poor glycemic control is associated with higher incidence of dyslipidaemia in type 2 diabetes. Current study confirms the association of hypercholesterolemia, low HDL-C and increased TC HDL-C ratio (all in high risk range) in patients with coronary heart disease, hypertension and CVA. Lipid profile was found to be significantly higher among females.
Key Words: Diabetic dyslipidaemia HDL – C. LDL – C. Triglycerides. Macrovascular complications.