IJCRR - 6(6), March, 2014
Pages: 20-25
ASSOCIATION OF HbA1c WITH SERUM LIPID PROFILE AND LIPOPROTEIN (a) IN TYPE 2 DIABETES MELLITUS
Author: Mahantesh Patil, Nirmal Kumar, Aliya Nusrath, Shubha Jayaram, Rajeshwari A.
Category: Healthcare
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Abstract:
Background: Diabetes mellitus (DM) is a group of metabolic disorders of carbohydrate metabolism. Also it is proposed thatunderutilization of glucose is associated with changes in lipid profile. Lipoprotein (a) [Lp (a)] is regarded as an independent indicator of risk development of vascular disease which is also a diabetic complication. Changes in lipid profile are also well related with severity of DM as adjudged by glycated Hb (HbA1c). Objectives: The study intends to find the association between Lipid profile, Lp (a) and HbA1c levels in type 2 diabetic patients. Methods: A case-control study was conducted in Adichunchanagiri Institute of Medical Sciences, B.G.Nagara, Karnataka from 1st Jan to 15th June 2012. Study involved 80 participants of which 40 were patients admitted with diagnosis of DM and other 40 were healthy controls. Blood samples were collected in fasting state and analyzed for FBS, PPBS, HbA1c, TAG, VLDL, HDL, LDL and Lp(a) and values were tabulated for statistical evaluation. Results: In DM patientssignificant changes in the following parameters were observedcompared to controls. FBS, PPBS, HbA1c &Lp (a) levels increased significantly (P<0.001), HbA1c/HDL, HbA1c/LDL & HbA1c/Chol ratios also increased significantly (P<0.001). Also the levels of TAG, VLDL &Chol/HDL were significantly increased with P<0.008, P<0.011 & P<0.003 respectively. The levels of HDL were significantly reduced in patients with DM compared to controls with P<0.002. There is no significant change observed in Cholesterol, LDL & HbA1c/Lp (a) levels. Conclusions: Along with lipid profile and Chol/HDL ratio, study of HbA1c/HDL, HbA1c/LDL & HbA1c/Chol ratios may be helpful in risk assessment of coronary heart disease in DM and association between Lp (a) and HbA1c needs to be further evaluated.
Keywords: Diabetes Mellitus, Glycated hemoglobin (HbA1c), Lp (a)
Citation:
Mahantesh Patil, Nirmal Kumar, Aliya Nusrath, Shubha Jayaram, Rajeshwari A.. ASSOCIATION OF HbA1c WITH SERUM LIPID PROFILE AND LIPOPROTEIN (a) IN TYPE 2 DIABETES MELLITUS International Journal of Current Research and Review. 6(6), March, 20-25
References:
REFERENCES
1. Fauci AS, Kasper DL, Braunwald E, Hauser SL, Longo DL, Jameson JL Et al. Harrison’s Principles of Internal Medicine. 17th Ed. United States of America: McGraw-Hill Medical publishing division; 2008. Chapter 338,Diabetes Mellitus: p. 2275-304.
2. Hilary King, Ronald Aubert E, William Herman H. Global Burden of Diabetes, 1995- 2025: Prevalence, numerical estimates, and projections.Diabetes Care 1998;21:1414–31.
3. Ramachandran A, Snehelatha C, Latha E, Vijay V, Viswanathan M. Rising prevalence of NIDDM in an urban population in India. Diabetologia 1997;40:232–37.
4. Lt Gen SR Mehta, VSM, Col AS Kashyap, Lt Col S Das. Diabetes Mellitus in India: The Modern Scourge. MJAFI 2009;65:50-4.
5. Surekha Rani. H, Madhavi G, RamachandraRao V,Sahay B.K, Jyothy A. Risk Factors for Coronary Heart Disease in Type II DM. Indian Journal of Clinical Biochemistry 2005;20(2):75-80.
6. Zachary T,Bloomgarden. Cardiovascular Disease, Neuropathy and Retinopathy.Diabetes care 2009;32: e64- e 68.
7. Chambless LE, Heiss G, Folsom AR, Rosamond W,Szklo M, Sharrett AR, Clegg LX. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987– 1993. Am J Epidemiol 1997;146:483–94.
8. Burtis Carl A, Ashwood Edward R, Bruns David E.Tietz Textbook of clinical chemistry and molecular diagnostics. 4th Ed. New dehli: Elsevier publishers; 2008. Chapter 26,Lipids, lipopropteins, apolipoproteins and other cardiovascular risk factors: p. 903-83.
9. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 2000;23(Suppl 1):S32–42.
10. Berg K. A new serum in man. The Lp system. ActaPatholMicrobiolScand 1963; 59:369-82.
11. Fijino A, Watanabe T. Kunii H, Yamaguchi N, Yoshinara K, Watanabe Y et al. Lipoprotein(a) is a potential coronary risk factor. JpnCirc J 2000;64(1):51-6.
12. Rath M, Ncendorf A, Reblin T, Dietel M, Knebber HJ. Detection and quantification of lipoprotein(a) in the arterial wall of 107 coronary bypass patients. Atherosclerosis 1989; 9:579-92.
13. KhareKC, Raman PG, Bhatnagar AD, ReemaBhavsar. Serum Lp(a) levels in patients of diabetes mellitus. Int. J. Diab. Dev. Countries 2000;20:79 – 83.
14. Clodi M, Oberbauer R, Bodlay G, Hoffman J, Maurer G, Kostner K. Urinary excretion of apolipoprotein (a) fragments in type I diabetes mellitus patients. Metabolism 1999; 48(3):369-72.
15. Trinder P. Determination of Glucose in Blood Using Glucose Oxidase with an. Alternative Oxygen Acceptor. Ann. Clin. Biochem 1969;6:24.
16. Product data sheet, triglyceride-G code no.997-69801,WAKO Pure Chemical Industries Ltd., Dallas,TX.
17. Allain CC, Poon LS, Chan CS, Richmond W. and Fu P., Clin.Chem 1974;20(4):470-5.
18. Burstein M, Scholnic H.R., Morfin RJ.Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. J Lipid Res 1970;11(6):583-95.
19. Poulik, MD, Weiss ML. in F.W. Putman, Editor,"The Plasma Proteins", second Edition, Academic Press, New York, vol2;52-108.
20. Trivelli, LA, Ranney PH, Lai HT. Haemoglobin components in patients with diabetes mellitus. N Engl J Med 1971;284:355–8.
21. Gonen B, Rubenstein AH. Determination of glycohemoglobin.Diabetologia. 1978;15:1–5.
22. Robert McCarter J, James Hempe M, Ricardo Gomez, Stuart Chalew A. Biological Variation in HbA1c Predicts Risk of Retinopathy and Nephropathy in Type 1 Diabetes. Diabetes Care 2004;27:1259–64.
23. Christian Wilde (2003). Hidden Causes of Heart Attack and Stroke: Inflammation,Cardiology's New Frontier.Abigon Press. pp. 182–183. ISBN 0- 9724959-0-8.
24. Elizabeth Selvin, Josef Coresh, Sherita Golden H, Lori L. Boland,Frederick Brancati L, Michael Steffes W. Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals with Diabetes. Diabetes Care. 2005;28(8):1965–73.
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