Association of Male Gender and Younger Age at Diagnosis of Type 2 Diabetes with more Atherogenic Lipid Profile

Authors

  • Weerarathna TP Department of Medicine, Faculty of Medicine, PO Box 70, Galle, SriLanka
  • Liyanage PLGC
  • Herath HMM

DOI:

https://doi.org/10.3823/1775

Keywords:

Type 2 diabetes, Cardiovascular risk factors, Atherogenic lipid profile

Abstract

Background – Recognition of cardiovascular (CVD) risk profile and its patterns at the time of diagnosis of diabetes would enable adoption of most appropriate primary prevention strategies to reduce morbidity and mortality from vascular disease. We aimed to study the prevalence and pattern of modifiable CVD risk factors in patients at the time of diagnosis of type 2 diabetes. 

Methods- In this  single center, cross sectional study,  412 newly diagnosed patients with type 2 diabetes were studied on prevalence of low density lipoproteins (LDL), triglycerides (TG), high density lipoproteins (HDL) and systolic and diastolic blood pressure (SBP and DBP) . Prevalence of each risk factor was determined according to the American diabetes association criteria. Associations of each risk factor (dependent variable) with gender, age at onset of diabetes, waist circumference (WC) and body mass index (BMI) (independent variables) were studied using logistic regression.

Results – Males accounted for 71% of sample and Mean (SD) age 49(11) years. The most prevalent lipid abnormality was LDL > 100 mg (81%) and low HDL and raised TG were detected in 17.1%, 18.5%. SBP> 140 mm Hg and DBP > 90 mm Hg were prevalent in 15% and 12%. Male gender (OR 7.98 – 95% CI 4.39 -14-49) and younger age at onset of diabetes (OR 0.95 95% CI 0.93 -0.98) were significantly associated with lower HDL. The younger age was significantly associated with adverse TG levels (OR 0.95, 95% CI 0.93-0.95) . Significant associations were detected with SBP and DBP with age (OR 1.09, 95% CI 1.05 - 1.13) and OR 1.062 95% CI 1.006 - 1.121).

Discussion – Adverse LDL levels are present in 8 out of 10 patients at the time of diagnosis of diabetes. Modifiable CVD risk factors vary according to the age at onset of diabetes with more atherogenic dyslipidemia prevalent in younger and elevated blood pressure in older patients. 

Author Biography

Weerarathna TP, Department of Medicine, Faculty of Medicine, PO Box 70, Galle, SriLanka

Professor, Deaprtment of Medicine, Faculty of Medicine, Galle, Sri Lanka

References

References

Candido R, Srivastava P, Cooper ME, Burrell LM. Diabetes mellitus: a cardiovascular disease. Current opinion in investigational drugs (London, England : 2000). 2003;4(9):1088-1094.

Baldwin MD. Assessing cardiovascular risk factors and selecting agents to successfully treat patients with type 2 diabetes mellitus. The Journal of the American Osteopathic Association. 2011;111(7 Suppl 5):S2-12.

Toth PP, Simko RJ, Palli SR, Koselleck D, Quimbo RA, Cziraky MJ. The impact of serum lipids on risk for microangiopathy in patients with type 2 diabetes mellitus. Cardiovascular diabetology. 2012;11:109.

Long GH, Cooper AJ, Wareham NJ, Griffin SJ, Simmons RK. Healthy Behavior Change and Cardiovascular Outcomes in Newly Diagnosed Type 2 Diabetic Patients: A Cohort Analysis of the ADDITION-Cambridge Study. Diabetes care. 2014;37(6):1712-1720.

Wang Y, Katzmarzyk PT, Horswell R, Zhao W, Li W, Johnson J, Ryan DH, Hu G. Racial disparities in cardiovascular risk factor control in an underinsured population with Type 2 diabetes. Diabet Med. 2014;31(10):1230-1236.

Haidinger T, Zweimuller M, Stutz L, Demir D, Kaider A, Strametz-Juranek J. Effect of gender on awareness of cardiovascular risk factors, preventive action taken, and barriers to cardiovascular health in a group of Austrian subjects. Gend Med. 2012;9(2):94-102.

Bellary S, O'Hare JP, Raymond NT, Mughal S, Hanif WM, Jones A, Kumar S, Barnett AH. Premature cardiovascular events and mortality in south Asians with type 2 diabetes in the United Kingdom Asian Diabetes Study - effect of ethnicity on risk. Curr Med Res Opin. 2010;26(8):1873-1879.

Executive summary: Standards of medical care in diabetes--2014. Diabetes Care. 2014;37 Suppl 1:S5-13.

Davis TM, Cull CA, Holman RR. Relationship between ethnicity and glycemic control, lipid profiles, and blood pressure during the first 9 years of type 2 diabetes: U.K. Prospective Diabetes Study (UKPDS 55). Diabetes Care. 2001;24(7):1167-1174.

Zhang L, Qiao Q, Tuomilehto J, Janus ED, Lam TH, Ramachandran A, Mohan V, Stehouwer CD, Dong Y, Nakagami T, Onat A, Soderberg S. Distinct ethnic differences in lipid profiles across glucose categories. J Clin Endocrinol Metab. 2010;95(4):1793-1801.

Hughes K, Yeo PP, Lun KC, Thai AC, Sothy SP, Wang KW, Cheah JS, Phoon WO, Lim P. Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. II. Differences in risk factor levels. Journal of epidemiology and community health. 1990;44(1):29-35.

Weerasuriya N, Siribaddana S, Dissanayake A, Subasinghe Z, Wariyapola D, Fernando DJ. Long-term complications in newly diagnosed Sri Lankan patients with type 2 diabetes mellitus. QJM : monthly journal of the Association of Physicians. 1998;91(6):439-443.

U.K. Prospective Diabetes Study 27. Plasma lipids and lipoproteins at diagnosis of NIDDM by age and sex. Diabetes Care. 1997;20(11):1683-1687.

Eeg-Olofsson K, Gudbjornsdottir S, Eliasson B, Zethelius B, Cederholm J, on behalf of the NDR. The triglycerides-to-HDL-cholesterol ratio and cardiovascular disease risk in obese patients with type 2 diabetes: An observational study from the Swedish National Diabetes Register (NDR). Diabetes research and clinical practice. 2014.

Li X, Deng YP, Yang M, Wu YW, Sun SX, Sun JZ. Triglyceride to high-density lipoprotein cholesterol ratio and carotid intima-medial thickness in Chinese adolescents with newly diagnosed type 2 diabetes mellitus. Pediatr Diabetes. 2015.

Zhu XW, Deng FY, Lei SF. Meta-analysis of Atherogenic Index of Plasma and other lipid parameters in relation to risk of type 2 diabetes mellitus. Primary care diabetes. 2014.

Katulanda P, Ranasinghe P, Jayawardena R, Constantine GR, Rezvi Sheriff MH, Matthews DR. The prevalence, predictors and associations of hypertension in Sri Lanka: a cross-sectional population based national survey. Clinical and experimental hypertension. 2014;36(7):484-491.

Downloads

Published

2015-07-27

Issue

Section

Endocrinology