Endocrine Abstracts

Objective: The objective of this study was to determine level of non-HDL and LDL cholesterol in type 2 diabetic patients with or without coronary artery disease irrespective on lipid lowering therapy and the common factors associated with elevated non-HDL cholesterol.

Study design: cross-sectional study: Place and duration of study: diabetic clinic, Aga Khan University Hospital, Karachi. Data of Type 2 diabetes mellitus patients attended clinics during 2007 and 2011 were reviewed.

Patients and methods: All type 2 diabetic patients of either gender with fasting lipid profile irrespective of on lipid lowering therapy were included. T1DM, gestational diabetes, type 2 diabetes patients with pregnancy and those T2DM patients with incomplete data were excluded. Multivariable regression was done to identify common factors associated with elevated non-HDL cholesterol.

Results: A total of 5000 patients visited diabetes clinics during 2007–2011. Out of these 1352 patients fulfill the eligibility criteria. Among them 169 (13%) had coronary artery disease. Mean age of patients was 48±6.3 years, 57% were males, more than 80% were obese with equal proportion had HBA 1C>6.5. Mean non-HDL cholesterol was 132 mg/dl S.D.±43. Mean LDL cholesterol was103 mg/dl S.D.±37. Both LDL≤100 and non-HDL≤130 was achieved in 645(48%) patients. In total, 728 (61.5%) patients achieved target LDL of ≤100 mg/dl among them 83 (11.4%) have non-HDL cholesterol >130 mg/dl (P<0.05). In patients with CAD, combined goal achievement of LDL≤70 and non-HDL≤100 was seen in 59 (35%). Among patients with LDL≤100 mg/dl, 8 (11.9%) patients have non-HDL>100 mg/dl (P<0.05). Multivariable analysis shows that age ≤60 years and BMI>25 are independently associated with NHDL>130 (Adj. OR 1.5, 95% CI 1–2.2) and (Adj. OR 3.8, 95% CI 1.6–8.6), respectively. Similarly, HBA1C>6.5 was 40% more associated with NHDL>130 (Adj. OR 1.4, 95% CI 0.9–2.3).

Conclusion: T2DM patients need aggressive lipid lowering therapy to achieve non-HDL cholesterol for residual risk reduction.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.