CONNECTING THE DOTS: INVESTIGATING THE RELATIONSHIP BETWEEN HBA1C AND LIPID PROFILE

Authors

  • JOSEPH KI Department of General Medicine, KMCHIHSR, Coimbatore, Tamil Nadu, India
  • SIVAGAMI K Department of Community Medicine, KMCHIHSR, Coimbatore, Tamil Nadu, India.
  • MOHAN KUMAR Department of Community Medicine, KMCHIHSR, Coimbatore, Tamil Nadu, India.
  • APARNAVI P Department of Community Medicine, KMCHIHSR, Coimbatore, Tamil Nadu, India.
  • JEEVITHAN S Department of Community Medicine, KMCHIHSR, Coimbatore, Tamil Nadu, India.

DOI:

https://doi.org/10.22159/ajpcr.2024v17i12.50249

Keywords:

Diabetes mellitus, Lipid profile,, Hemoglobin A1c, Tamil Nadu.

Abstract

Objectives: To determine the association between lipd profile and HbA1c. Hemoglobin A1c (HbA1c) is used to monitor blood sugar levels. HbA1c is one among the panel of tests that is done for patients who come for routine master health check-ups. This helps us to identify pre-diabetic and diabetic individuals. Diabetic individuals are at increased risk for dyslipidemia. The aim of this study is to look into the association between lipid profile and HbA1c.

Methodology: This study was done in a multispecialty hospital in the Western part of Tamil Nadu among the patients who came for master health check-ups between 2017 and 2024. Ethical Committee approval was obtained (EC/AP/1100/12/2023). From the laboratory database of 67,000 patients, patients who reported for the 1st time and had their HbA1c and lipid profile levels evaluated were selected. They were categorized into normal, pre-diabetic, and diabetic based on HbA1c values. Data were analyzed using the Statistical Package for Social Sciences 27. Categorical variables were expressed as frequency and percentages whereas continuous variables were expressed as mean and standard deviation. Analysis of variance (ANOVA) was used to find if there was a significant difference in lipid profile among the three groups.

Results: Our study had 23,238 participants. Out of them 7168 (30.84%) had normal HbA1c levels, 8347 (35.91%) were pre-diabetics, and 7955 (34.23%) were diabetic patients. The mean total cholesterol (TC) level (186.8±40.14) and low-density lipoprotein (LDL) cholesterol level (129.74±37.20). It was high for pre-diabetic patients. The median very LDL (VLDL) cholesterol (29.00(21–39) levels were higher for diabetic patients. The mean high-density lipoprotein (HDL) cholesterol levels (39.54±9.40) were less for diabetic patients. One-way ANOVA revealed a significant difference in TC, HDL cholesterol, LDL cholesterol, and VLDL cholesterol levels between the three groups. Pearson correlation coefficient showed a positive correlation between VLDL, LDL, TC, and HbA1c. HbA1c and HDL cholesterol were negatively correlated.

Conclusion: Our study revealed a significant correlation between HbA1c and these changes signify a higher risk of cardiovascular complications in individuals with diabetes mellitus. Understanding these associations underscores the need for vigilant monitoring and proactive management of lipid profiles among pre-diabetics and diabetics to reduce the risk of cardiovascular diseases and enhance their overall health.

Downloads

Download data is not yet available.

References

Uppal V, Vij C, Bedi GK, Vij A, Banerjee BD. Thyroid disorders in patients of type 2 diabetes mellitus. Indian J Clin Biochem. 2013;28(4):336-41. doi: 10.1007/s12291-012-0293-9, PMID 24426234

Ministry of Health and Family Welfare. Update on Treatment of Diabetes. India: Press Information Bureau; 2023. Available from: https://pib.gov.in/pib.gov.in/Pressreleaseshare.aspx?PRID=1944600 [Last accessed on 2024 Jun 04].

Castelli WP, Anderson K, Wilson PW, Levy D. Lipids and risk of coronary heart disease The Framingham Study. Ann Epidemiol. 1992;2(1- 2):23- 8. doi: 10.1016/1047-2797(92)90033-m, PMID 1342260

Lippi G, Targher G. Glycated hemoglobin (HbA1c): Old dogmas, a new perspective? Clin Chem Lab Med. 2010;48(5):609-14. doi: 10.1515/cclm.2010.144, PMID 20464776

Chume FC, Freitas PA, Schiavenin LG, Pimentel AL, Camargo JL. Glycated albumin in diabetes mellitus: A meta-analysis of diagnostic test accuracy. Clin Chem Lab Med. 2022;60(7):961-74. doi: 10.1515/cclm-2022-0105, PMID 35470641

American Diabetes Association. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42 Suppl 1(Suppl 1):S13-28. doi: 10.2337/dc19-S002, PMID 30559228

American Diabetes Association. Understanding Diabetes Diagnosis. VA. Available from: https://diabetes.org/about-diabetes/diagnosis

Kundu D, Saikia M, Paul T. Study of the correlation between total lipid profile and glycosylated hemoglobin among the indigenous population of Guwahati. Int J Life Sci Scienti Res. 2017;3(4):1175-80. doi: 10.21276/ijlssr.2017.3.4.13

Naqvi S, Naveed S, Ali Z, Ahmad SM, Asadullah Khan RA, Raj H, et al. Correlation between glycated hemoglobin and triglyceride level in type 2 diabetes mellitus. Cureus. 2017;9(6):e1347. doi: 10.7759/cureus.1347, PMID 28713663

Hirano T. Pathophysiology of diabetic dyslipidemia. J Atheroscler Thromb. 2018;25(9):771-82. doi: 10.5551/jat.RV17023, PMID 29998913

Kumar S, Kumari B, Kaushik A, Banerjee A, Mahto M, Bansal A. Relation between HbA1c and lipid profile among prediabetics, diabetics, and non-diabetics: A hospital-based cross-sectional analysis. Cureus. 2022;14(12):e32909. doi: 10.7759/cureus.32909, PMID 36699757

Artha IM, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Mahariski PA, et al. High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vasc Health Risk Manag. 2019;15:149-57. doi: 10.2147/ VHRM.S209830, PMID 31239693

Khil J, Kim SM, Chang J, Choi S, Lee G, Son JS, et al. Changes in total cholesterol level and cardiovascular disease risk among type 2 diabetes patients. Sci Rep. 2023;13(1):8342. doi: 10.1038/s41598-023-33743-6, PMID 37221278

Ooi EM, Ng TW, Chan DC, Watts GF. Plasma markers of cholesterol homeostasis in metabolic syndrome subjects with or without type-2 diabetes. Diabetes Res Clin Pract. 2009;85(3):310-6. doi: 10.1016/j. diabres.2009.06.003, PMID 19573945

Simonen PP, Gylling HK, Miettinen TA. Diabetes contributes to cholesterol metabolism regardless of obesity. Diabetes Care. 2002;25(9):1511-5. doi: 10.2337/diacare.25.9.1511, PMID 12196419

Brindisi MC, Guiu B, Duvillard L, Athias A, Rollot F, Bouillet B, et al. Liver fat content is associated with an increase in cholesterol synthesis independent of statin therapy use in patients with type 2 diabetes. Atherosclerosis. 2012;224(2):465-8. doi: 10.1016/j. atherosclerosis.2012.08.016, PMID 22959662

Mahran HN, Saber LM, Alghaithy AA, Elareefy AA. The role of elevated alanine aminotransferase (ALT), FASL and atherogenic dyslipidemia in type II diabetes mellitus. J Taibah Univ Med Sci. 2017;12(1):8-13. doi: 10.1016/j.jtumed.2016.10.002, PMID 31435207

Drew BG, Duffy SJ, Formosa MF, Natoli AK, Henstridge DC, Penfold SA, et al. High-density lipoprotein modulates glucose metabolism in patients with type 2 diabetes mellitus. Circulation. 2009;119(15):2103- 11. doi: 10.1161/CIRCULATIONAHA.108.843219, PMID 19349317

Fryirs MA, Barter PJ, Appavoo M, Tuch BE, Tabet F, Heather AK, et al. Effects of high-density lipoproteins on pancreatic beta-cell insulin secretion. Arterioscler Thromb Vasc Biol. 2010;30(8):1642-8. doi: 10.1161/ATVBAHA.110.207373, PMID 20466975

Barter PJ. The causes and consequences of low levels of high density lipoproteins in patients with diabetes. Diabetes Metab J. 2011;35(2):101- 6. doi: 10.4093/dmj.2011.35.2.101, PMID 21738891

Yu P, Huang L, Wang Z, Meng X, Yu X. The association of serum uric acid with beta-cell function and insulin resistance in nondiabetic individuals: A cross-sectional study. Diabetes Metab Syndr Obes. 2021;14:2673-82. doi: 10.2147/DMSO.S312489, PMID 34163195

Zhu Y, Hu Y, Huang T, Zhang Y, Li Z, Luo C, et al. High uric aciddirectly inhibits insulin signalling and induces insulin resistance. Biochem Biophys Res Commun. 2014;447(4):707-14. doi: 10.1016/j. bbrc.2014.04.080, PMID 24769205

Zhi L, Yuzhang Z, Tianliang H, Hisatome I, Yamamoto T, Jidong C. High uric acid induces insulin resistance in cardiomyocytes in vitro and in vivo. PLoS One. 2016;11(2):e0147737. doi: 10.1371/journal. pone.0147737. PMID 26836389

Baldwin W, McRae S, Marek G, Wymer D, Pannu V, Baylis C, et al. Hyperuricemia as a mediator of the proinflammatory endocrine imbalance in the adipose tissue in a murine model of the metabolic syndrome. Diabetes. 2011;60(4):1258-69. doi: 10.2337/db10-0916, PMID 21346177

Ndrepepa G. Uric acid and cardiovascular disease. Clin Chim Acta. 2018;484:150-63. doi: 10.1016/j.cca.2018.05.046, PMID 29803897

Wei Y, Wu Z, Wang Y, Wang G, Liu J. Interaction of sex and diabetes on the association between hemoglobin glycation index, hemoglobin A1c and serum uric acid. Diabetol Metab Syndr. 2022;14(1):185. doi: 10.1186/s13098-022-00955-1, PMID 36464722

Published

07-12-2024

How to Cite

JOSEPH KI, SIVAGAMI K, MOHAN KUMAR, APARNAVI P, and JEEVITHAN S. “CONNECTING THE DOTS: INVESTIGATING THE RELATIONSHIP BETWEEN HBA1C AND LIPID PROFILE”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 12, Dec. 2024, pp. 151-4, doi:10.22159/ajpcr.2024v17i12.50249.

Issue

Section

Original Article(s)