Endocrine Abstracts

Introduction: Screening and preventing the onset of degenerative complications of type 2 diabetes is the cornerstone of patients follow up. Recently, new emerging indicators have been suggested to be more sensitive for the early detection of the onset of micro and macroangiopathies. These indicators emerge from the involvement of metabolic syndrome, dyslipidemia and glycemic imbalance in endothelial dysfunction. Among these indicators, we cite the atherogenic index (TC-(HDL-C))/HDL-C), the atherogenic plasma index (LDL-C/HDL-C) and the HbA1C/HDLc ratio. The objective of our study was to evaluate the association between these indicators correlated with atherosclerosis and degenerative complications of diabetes.

Methods: It was a cross-sectional study that included 100 type 2 diabetic patients followed at the Tunis Military Hospital for a period of 3 months. An assay of the various biological parameters dating back for less than six months as well as an evaluation of micro and macroangiopathies were carried out.

Results: In our population, patients had an average HbA1C of 10.51% ± 2.44% and 88% of patients had dyslipidemia. Regarding the impact of diabetes, the distribution of degenerative complications was 50% for diabetic retinopathy, 61% for diabetic neuropathy, 43% for diabetic nephropathy, 7% for stroke, 32% for coronary heart disease and 9% for peripheral arterial disease. Diabetic nephropathy was significantly associated with the atherogenic plasma index (P=0.041) and the HbA1C/HDLc ratio (P=0.003). As for microalbumiuria, it was associated with the atherogenic index (P=0.024) and atherogenic plasma index (P=0.007). However, no association between these different indicators and the other degenerative complications of diabetes has been found.

Conclusions: Positive associations suggest that the atherogenic index, the atherogenic plasma index and the HbA1C/HDLc ratio may be good indicators of the occurrence of diabetic nephropathy in the Tunisian population. However, larger multicenter studies are needed to determine their exact place as an indicator of the occurrence of degenerative complications of diabetes.