Glycated Hemoglobin: Predictor Of Dyslipidemia And Atherogenicity In Diabetes Mellitus

Objective: Cardiovascular disease (CVD) is the major cause of morbidity/mortality in diabetes. Patient with type 2 diabetes have an increased prevalence of lipid abnormalities contributing to their high risk of CVD. Dyslipidemia resulting from uncontrolled hyperglycemia has been implemented in cardiovascular complications in diabetes patients. Individual with coexisting diabetes and dyslipidemia are often soft targets for CVD and deaths. A timely intervention to normalize circulating lipids has shown to reduce cardiovascular events and mortality. Glycated hemoglobin (HbA1c) is routinely used as a marker to indicate long-term glycemic control. The Atherogenic index of plasma (AIP), Risk ratio(RR) and Non–HDL cholesterol(NHC) have recently been proposed as a predictive marker for plasma atherogenicity. Recent studies have shown positive correlation with CVD risks and events. Thus this study intends to evaluate the diagnostic value of HbA1c in predicting Diabetes dyslipidemia and atherogenicity. Design and Method: A total of 3125 diagnosed type II diabetes patients, who attended Tribhuvan University Teaching Hospital and Dhulikhel Hospital, Nepal between January 2013 and January 2016 were recruited in the study. Fasting blood samples were collected for the analysis of HbA1c, fasting Blood sugar (FPG) and Lipid Profile panel test [Total cholesterol (TC), High density Lipoprotein (HDL), Triacylglycerol (TAG), Low Density Lipoprotein (LDL)]. AIP [log(TAG/HDL)], RR(TC/HDL) and NHC (TC minus HDL) was calculated. Results: HbA1c showed direct correlation with FPG, TC, TAG, LDL and AIP while inverse correlation with HDL. Statically significant ‘p’ values were obtained for FPG, TC, TG and LDL while for the HDL was not significant. RR and NHC and AIP positively correlated significantly. HbA1c showed direct and significant correlation with RR, NHC and AIP. Conclusions: These findings indicate that the HbA1c can provide valuable supplementary information about the cardiac risk besides its primary role in monitoring long-term glycemic control. Thus, Hba1c can be used as a predictor of cardiovascular risk in diabetes.