Variability in calculating non-HDL atherogenic lipoprotein in reference to atherogenic index in type 2 diabetes

  • Maysoon Tahir Al-Haideri Department of Clinical Analysis, College of Pharmacy, Hawler Medical University, Erbil, Iraq
Keywords: type 2 diabetes, atherogenic index

Abstract

Background and objective: Diabetes mellitus is a disorder that is often associated with cardiovascular diseases and underlying lipid abnormalities. The aim of this study was to calculate the serum level of LDL indirectly, using different equations in type 2 diabetes patients in an attempt to focus on the variation of estimating level which reflected on the decision to prescribe lipid lowering agents.

Methods: A total of 70 patients with type 2 diabetes using oral hypoglycemic agents alone and/or once- or twice-daily insulin, their non-HDL atherogenic lipoprotein in reference to atherogenic index were conducted in Martyr Layla Qasm Center for Diabetes Mellitus in Erbil, Iraq, during the period from June, 2011 to January, 2013.

Results: Age of type 2 diabetes patients ranged from 29 to 82 years with a mean age of 56.6 years with duration of disease ranged between 1.2-39 years. Results revealed that the mean fasting serum glucose and glycosylated hemoglobin were 181.9 mg/dl and 8.428%, respectively. The mean value of serum triglycerides was 171.5 mg/dl which is higher than the cut-off normal value of 150 mg/dl. Results showed significant correlation between atherogenic index and calculated atherogenic lipoprotein and significant correlation between atherogenic index and waist circumference as an indicator of central obesity.

Conclusion: The mean body mass index value indicated that the patients were obese and the mean value of waist circumference did not reach the cut-off level of central obesity. The mean value of atherogenic index indicated that the patients were at increased risk of cardiovascular events. Estimation of LDL value from the direct measurement of lipid profile in type 2 diabetes with high serum triglyceride level is not a reliable method.

References

Ginsberg HN, Illingworth DR. Postprandial dyslipidemia: an atherogenic disorder common in patients with diabetes mellitus. Am J Cardiol 2001; 88(6A):9H-15H

Nesto RW. Beyond low-density lipoprotein: addressing the atherogenic lipid triad in type 2 diabetes mellitus and the metabolic syndrome. Am J Cardiovasc Drugs 2005; 5(6):379-87.

Singh N, Singh N, Kumar Singh S, Kumar Singh A, Kafle D, Agrawal N. Reduced Antioxidant Potential of LDL Is Associated With Increased Susceptibility to LDL Peroxidation in Type II Diabetic Patients. Int J Endocrino l Metab 2012; 10(4):582-6.

Hirano T, Ito Y, Yoshino G, Measurement of small dense low-density lipoprotein particles. J Atheroscler Thromb 2005; 12(2):67-72.

Masana L, Ibarretxe D, Heras M, Cabrȇ A, Ferrȇ R, Merino J, et al. Substituting non-HDL cholesterol with LDL as a guide for lipid-lowering therapy increases the number of patients with indication for therapy Atherosclerosis 2013; 226(2):471-5.

Sugiuchi H, Manabe M, Irie T, Nagata S, Ando Y, Okabe H. Pitfalls in homogeneous assays for HDL-c and LDL-c in serum Rinsho Byori 2005; 53(2):138-43.

Holme I, Aastveit AH, Junger I, Walldius G. Relationships between lipoprotein components and risk of myocardial infarction: age, gender and short versus longer follow-up periods in the Apolipoprotein MOrtality RISk study (AMORIS). J Intern Med 2008; 264:30-8.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge Clin Chem 1972; 18:499-502.

Rungtanapirom S, Ongphiphanakul B, Kiatbamrungpunt T, Bhakdilku J, archavanuntakun S, Taerakul C, et al. Comparative study of direct - measured and calculated LDL in clinical use. J Med Assoc Thai 2008; 91(7):989-94.

Ito K, Yoshida H, Yanai H, Kurosawa H, Sato R, Mannita D, et al. Relevance of intermediate-density lipoprotein cholesterol to Framingham risk score of coronary heart disease in middle-aged men with increased non-HDL cholesterol Int J Cardiol 2013; 168(4):3853-8.

van Deventer HE, Miller WG, Myers GL, Sakurabayashi I, Bachmann LM, Caudill SP, et al. Non-HDL cholesterol shows improved accuracy for cardiovascular risk score classification compared to direct or calculated LDL cholesterol in a dyslipidemic population Clin Chem 2011; 57(3):490-501.

Murguía-Romero M, Jiménez-Flores JR, Sigrist-Flores SC, Espinoza-Camacho MA, Jiménez-Morales M, Piña E, et al. Plasma triglyceride/high-density lipoprotein cholesterol ratio, insulin resistance, and cardio-metabolic risk in young men and women. J Lipid Res 2013;54(10):2795-9.

Yamashita S,Kawase R, Nakaoka H, Nakatani K, Inagaki M, Yuasa-kawase M, et al. Differential reactivities of four homogeneous assays for LDL-cholesterol in serum to intermediate-density lipoproteins and small dense LDL: comparisons with the Friedewald equation Clin Chim Acta 2009; 410 (1-2):31-8.

Evans SR, Fichtenbaum CJ, Aberg JA. A5087 Study Team, Comparison of direct and indirect measurement of LDL-C in HIV-infected individuals: ACTG 5087 HIV. Clin Trials 2007; 8(1):45-52.

Karim MN, Ahmed KR, Bukht MS, Akter J, Chowdhury HA, Hossain S, et.al. Pattern and predictors of dyslipidemia in patients with type 2 diabetes mellitus Diabetes Metab Syndr 2013; 7(2):95-100.

Published
2018-09-25
How to Cite
Al-Haideri, M. (2018). Variability in calculating non-HDL atherogenic lipoprotein in reference to atherogenic index in type 2 diabetes. Zanco Journal of Medical Sciences (Zanco J Med Sci), 18(3), 805-810. https://doi.org/10.15218/zjms.2014.0037
Section
Original Articles