Assessment of Cardiovascular Disease Risk in Type 2 Diabetic Patients: A Comparison of Risk Indices
American Journal of Clinical and Experimental Medicine
Volume 4, Issue 6, November 2016, Pages: 216-220
Received: Oct. 30, 2016;
Accepted: Nov. 19, 2016;
Published: Dec. 26, 2016
Views 2815 Downloads 58
Brown Holy, Dept. of Medical Laboratory Science, Rivers State University of Science and Technology, Npkolu, Port Harcourt, Nigeria
Obi Doris Chidinma, Dept. of Medical Laboratory Science, Rivers State University of Science and Technology, Npkolu, Port Harcourt, Nigeria
Diabetes mellitus is a major public health problem; it is synchronized with the development of many complications of which cardiovascular disease is the most prevalent and detrimental. This study aimed at comparing the strength of various cardiovascular risk indices among diabetes type 2 patients. The risk indices evaluated were: Apoprotein A1, Apoprotein B1, lipoprotein (a), total cholesterol, (TCHOL), Triglyceride (TG), low density lipoprotein (HDL), TC/HDL, pentad and tetrad. Two hundred and four (204) subjects were studied comprising of 152 diabetes subjects and 52 non-diabetics as control. The result shows significantly higher values in the mean blood pressure of diabetic subjects when compared with the control at (p < 0.05. Mean HbA1C and total cholesterol values for diabetes subjects were significantly higher when compared with the control. However, the HDL-cholesterol of the diabetes subjects was significantly lower when compared to the control subjects. There was no significant difference in triglyceride level of both groups. The mean values of Apo A, Apo B and lipoprotein a, were higher in diabetic subjects compared to the control subjects at (p < 0.05). Comparison of the liporprotein induces in terms of sensitivity, specificity and accuracy, Lpa had a sensitivity of 97.3%, specificity of 100% and accuracy of 95.7%, next was pentad with sensitivity of 91.45%, specificity of 100% and accuracy of 95.73%. Tetrad had a sensitivity of 81.05%, specificity of 100% and accuracy of 90.5%, the TC/HDL ratio and the least accuracy of 75.76%. Based on the overall accuracy Lpa tend to display highest accuracy followed by PENTAD and TETARD.
Obi Doris Chidinma,
Assessment of Cardiovascular Disease Risk in Type 2 Diabetic Patients: A Comparison of Risk Indices, American Journal of Clinical and Experimental Medicine.
Vol. 4, No. 6,
2016, pp. 216-220.
Beck-Nielsen, H., Ferrannini, E., Gabriel, R., Laakso, M., Laville, M., Mari, A., Natali, A. and Tura, A., (2010). Impaired beta cell glucose sensitivity rather than inadequate compensation for insulin resistance is the dominant defect in glucose intolerance. Diabetologia, 53, 749–756.
Tapp, RJ, Dunstan, D. W., Philips, P., Tonkin, A., Zimmet, P. Z., & Shaw, E. S (2006). Association between impaired glucose metabolism and quality of life: Results from the Australian diabetes obesity and lifestyle study. Diabetes Research and Clinical Practice (74)154–161.
Bellamy, L., Casas, J. P., Hingorani, A. D. and Williams, D., (2009). Type 2 diabetes mellitus after gestational diabetes: A systematic review and meta-analysis. Lancet, 373, 1773–1779.
Heianza Y, Arase Y, Fujihara K, Tsuji H, Saito K, Hsieh SD, Kodama S, Shimano H, Yamada N, Hara S (2012). Screening for pre-diabetes to predict future diabetes using various cut-off points for HbA1c and impaired fasting glucose: the Toranomon Hospital Health Management Center Study 4 (TOPICS 4). Diabetic Medicine (29) e279-e285.
Australian Institute of Health and Welfare (2011). Cardiovascular disease: Australian facts 2011. Cardiovascular Disease Series.53.
Begg, S. J., Vos, T., Barker, B., Stanley, L and Alan D (2008) Burden of disease and injury in Australia in the new millennium: measuring health loss from diseases, injuries and risk factors. Medical Journal of Australia; 188 (1), 36-40.
Barter, P., Best, J., Boyden, A., Furler, J., Hossack, K. and Tonkin, A., (2005). National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand: position statement on lipid management. Heart Lung Circulation, 14(4), 275-291.
Kadiri, S. (2005). Tackling cardiovascular diseases in Africa. BioMedical Journal of West Africa, 8,172-173.
Fox, C. S., Coady, S, Sorlie, P. D., Levy, D., Meigs, J. B., Agostino, D., Wilson, P. W. F. & Savage, P. J. (2004). Trends in cardiovascular complications of diabetes. Journal of American Medical Association, 292, 2495-2499.
Laakso, M. (2001). Cardiovascular disease in type 2 diabetes: challenge for treatment and prevention. Journal of Internal Medicine, 249, 225-235.
Liu, J, Sempos, C, Donahue, R. P, Dorn, J, Trevisan, M, & Grundy, S. M. (2005). Joint distribution of Non-HDL and LDL cholesterol and coronary heart disease risk prediction among individuals with and without diabetes. Diabetes care, 28, 1916-1921.
Ejim, E. C., Okafor, C. I., Emehel, A., Mbah, A. U., Onyia, U., Egwuonwu, T. & Akabueze, J. (2011). Prevalence of Cardiovascular Risk Factors in the Middle-Aged and Elderly Population of a Nigerian Rural Community. Journal of Tropical Medicine, 2011, 1-5.
Sowers, J. R., Murray, E., & Edward, D. F. (2001). Diabetes, Hypertension, and Cardiovascular Disease: An Update. American Heart Association, 37, 1053-1059.
Ancheta, I. B., Battie, C. A., Tuason, M. T., Borja-Hart, N. & Ancheta, C. V. (2014). The prevalence of cardiovascular risk factors and diabetes increases with a body mass index of > or = 23 kg/m2 in Filipino American women. Ethnicity and Disease, 24(1), 48-54.
Eeg-Olofsson, K., Cederholm, J., Nilsson, P. M., Zethelius, B., Svensson, A. M., Gudbjörnsdóttir, S. &Eliasson, B. (2010). New aspects of HbA1c as a risk factor for cardiovascular diseases in type 2 diabetes: an observational study from the Swedish National Diabetes Register (NDR).Journal of Internal Medicine, 268, 468-470.
Xu, L., Chan, W. M., Hui, Y. F. & Lam, T. H. (2012). Association between HbA1c and cardiovascular disease mortality in older Hong Kong Chinese with diabetes. Diabetes and Medicine, 29(3), 393-398.
Drew, B. G., Rye, K., Duffy, A., Barter, S. J. & Kingwell, P. B. A. (2012). The emerging role of HDL in glucose metabolism. Nature Reviews Endocrinology, 235, 1-9.
Enas, E. A., Dhawan, J. & Petkar, S. (1997). Coronary artery disease in Asian lndians: Lessons learnt and the role of lipoprotein (a). Indian Heart Journal, 49(1), 25-34.
Das, B., Daga, M. K. & Gupta, S. K. (2007). Lipid Pentad Index: a novel bioindex for evaluation of lipid risk factors for atherosclerosis in young adolescents and children of premature coronary artery disease patients in India. Clinical Biochemistry, 40(2), 18-24.