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Lipid/Lipoprotein Abnormalities Among Adult Type 1 Diabetics in Nigeria

Received: 25 August 2020    Accepted: 10 September 2020    Published: 24 September 2020
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Abstract

Background: Dyslipidemia abounds among diabetics. However, these are poorly characterized among patients with type 1 diabetes (T1DM). The current study determined the pattern of dyslipidemia and their relationship with glycemic status among adult T1DM subjects. Methods: This survey was conducted retrospectively among 346 newly-diagnosed/treatment-naïve T1DM adults attending outpatient units of a third-level hospital in Nigeria. Patients’ fasting plasma glucose and lipid parameters at the time of T1DM diagnosis were abstracted from their medical files. Lipid parameters included triglyceride (Tg), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Abstracted parameters were analyzed using descriptive and comparative statistics. Results: Of the 346 studied, 46.8% (n=162) were dyslipidemic (aged: 32.69±6.29) with female predominance (59.3%; p=0.018). Categorically, females predominated among isolated dyslipidemics while males predominated among the combined/mixed dyslipidemics. High plasma Tg concentration (n=142;87.7%) was the most common isolated dyslipidemia without male/female difference (p>0.05); seconded by low HDL-C (n=80;49.4%) with the females predominating (p<0.05). The most combined and mixed dyslipidemia was high plasma Tg/low HDL-C (total n=28, 17.3%; males n=16, 24.2% vs. females n=12, 12.5%; p=0.011) and high plasma Tg/high LDL-C/low-HDL-C (total n=30, 18.5%; males n=18, 27.3% vs. females n=12, 12.5%; p=0.001) concentrations, respectively with male predominance. The female dyslipidemics were younger with lower BMI, higher systolic blood pressure, glycemia, and mean plasma Tg levels (p<0.05). The overall dyslipidemics had poor glycemic status and their risk of dyslipidemia increases with worsening glycemia. Conclusion: Dyslipidemia was common and associated with poor glycemic status among the studied cohorts. This finding informs the need for more rigorous monitoring of dyslipidemia among T1DM subjects to reduce the risk of its complications.

Published in Science Journal of Clinical Medicine (Volume 9, Issue 3)
DOI 10.11648/j.sjcm.20200903.16
Page(s) 74-81
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetes, Type 1 Diabetes, Lipid/Lipoprotein Abnormalities

References
[1] Athyros VG, Doumas M, Imprialos KP, Stavropoulos K, Georgianou E, Katsimardou A, et al. Diabetes and lipid metabolism. Hormones 2018; 17: 61-7.
[2] Eid S, Sas KM, Abcouwer SF, Feldman EL, Gardner TW, Pennathur S, et al. New insights into the mechanisms of diabetic complications: role of lipids and lipid metabolism. Diabetologia 2019; 62: 1539-49.
[3] Poznyak A, Grechko AV, Poggio P, Myasoedova VA, Alfieri V, Orekhov AN. The Diabetes Mellitus–Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation. Int J Mol Sci. 2020; 21: 1835. DOI: 10.3390/ijms21051835.
[4] Filippatos T, Tsimihodimos V, Pappa E, Elisaf M. Pathophysiology of Diabetic Dyslipidaemia. Curr Vasc Pharmacol 2017; 15: 566-75.
[5] Soran H, Schofield JD, Adam S, Durrington PN. Diabetic dyslipidaemia. Curr Opin Lipidol 2016; 27: 313-22.
[6] Parhofer KG. Interaction between glucose and lipid metabolism: more than diabetic dyslipidemia. Diabetes Metab J 2015; 39: 353-62.
[7] Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.
[8] Hwang Y-C, Ahn H-Y, Lee WJ, Park C-Y, Park SW. An equation to estimate the concentration of serum apolipoprotein B. PLoS One 2012; 7: e51607.
[9] Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995; 854: 1-452.
[10] Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003; 289: 2560–72.
[11] World Health Organization. Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia: Report of a WHO/IDF Consultation. Geneva: World Health Organization; 2006.
[12] Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults Adult treatment panel III. JAMA 2001; 285: 2486–97.
[13] Wadwa RP, Kinney GL, Maahs DM, et al. Awareness and treatment of dyslipidemia in young adults with type 1 diabetes. Diabetes Care 2005; 28: 1051-6.
[14] González Virla B, Mercado Atri M, Molina Ayala M. Prevalence of metabolic syndrome in patients with type 1 diabetes. Gac Med Mex 2012; 148: 137-43.
[15] Homma TK, Endo CM, Saruhashi T, Mori AP, Noronha RM, Monte O, Calliari LE. Dyslipidemia in young patients with type 1 diabetes mellitus. Arch Endocrinol Metab 2015; 59: 215-9.
[16] Luo SH, Yang DZ, Wei XY, Ai HY, Lin QY, Liu ZY, et al. Association of insulin resistance with dyslipidemia in adults with type 1 diabetes. Zhonghua Yi Xue Za Zhi 2019; 99: 2665-9.
[17] Abed E, LaBarbera B, Dvorak J, Zhang Y, Beck J, Talsania M. Prevalence of dyslipidemia and factors affecting dyslipidemia in young adults with type 1 diabetes: evaluation of statin prescribing. J Pediatr Endocrinol Metab 2019; 32: 327-34.
[18] Stankute I, Dobrovolskiene R, Danyte E, Razanskaite-Virbickiene D, Jasinskiene E, Mockeviciene G, et al. Factors Affecting Cardiovascular Risk in Children, Adolescents and Young Adults with Type 1 Diabetes. J Diabetes Res 2019; 2019: 9134280. DOI: 10.1155/2019/9134280.
[19] Noubiap JJ, Bigna JJ, Nansseu JR, Nyaga UF, Balti EV, Echouffo-Tcheugui JB, et al. Prevalence of dyslipidaemia among adults in Africa: a systematic review and meta-analysis. Lancet Glob Health 2018; 6: e998-e1007.
[20] Jaja TC, Yarhere IE. Dyslipidaemia in Nigerian Children and Adolescents with Diabetes Mellitus: Prevalence and Associated Risk Factors. Int J Diabetes Metab 2019; 25: 45-51.
[21] Verges B. Lipid disorders in type 1 diabetes. Diabetes Metab 2009; 35: 353-60.
[22] Kim SH, Jung IA, Jeon YJ, Cho WK, Cho KS, Park SH, et al. Serum lipid profiles and glycemic control in adolescents and young adults with type 1 diabetes mellitus. Ann Pediatr Endocrinol Metab 2014; 19: 191–6.
[23] Millstein RJ, Pyle LL, Bergman BC, Eckel RH, Maahs DM, Rewers MJ, et al. Sex-specific differences in insulin resistance in type 1 diabetes: The CACTI cohort. J diabetes Complications. 2018; 32: 418-23.
[24] Huxley RR, Peters SA, Mishra GD, Woodward M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015; 3: 198–206.
[25] Shamir R, Kassis H, Kaplan M, Naveh T, Shehadeh N. Glycemic control in adolescents with type 1 diabetes mellitus improves lipid serum levels and oxidative stress. Pediatr Diabetes 2008; 9: 104–9.
[26] Baptiste-Roberts K, Gary TL, Beckles GL, Gregg EW, Owens M, Porterfield D, Engelgau MM. Family history of diabetes, awareness of risk factors, and health behaviors among African Americans. Am J Public Health 2007; 97: 907-12.
Cite This Article
  • APA Style

    Collins Amadi, Olufisayo Gabriel Ayoade, Fabian Aniekpon Unyime, Sarah Ifreke Essien, Blessing Thomas Moses, et al. (2020). Lipid/Lipoprotein Abnormalities Among Adult Type 1 Diabetics in Nigeria. Science Journal of Clinical Medicine, 9(3), 74-81. https://doi.org/10.11648/j.sjcm.20200903.16

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    ACS Style

    Collins Amadi; Olufisayo Gabriel Ayoade; Fabian Aniekpon Unyime; Sarah Ifreke Essien; Blessing Thomas Moses, et al. Lipid/Lipoprotein Abnormalities Among Adult Type 1 Diabetics in Nigeria. Sci. J. Clin. Med. 2020, 9(3), 74-81. doi: 10.11648/j.sjcm.20200903.16

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    AMA Style

    Collins Amadi, Olufisayo Gabriel Ayoade, Fabian Aniekpon Unyime, Sarah Ifreke Essien, Blessing Thomas Moses, et al. Lipid/Lipoprotein Abnormalities Among Adult Type 1 Diabetics in Nigeria. Sci J Clin Med. 2020;9(3):74-81. doi: 10.11648/j.sjcm.20200903.16

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  • @article{10.11648/j.sjcm.20200903.16,
      author = {Collins Amadi and Olufisayo Gabriel Ayoade and Fabian Aniekpon Unyime and Sarah Ifreke Essien and Blessing Thomas Moses and Mfonobong Eni Enyong},
      title = {Lipid/Lipoprotein Abnormalities Among Adult Type 1 Diabetics in Nigeria},
      journal = {Science Journal of Clinical Medicine},
      volume = {9},
      number = {3},
      pages = {74-81},
      doi = {10.11648/j.sjcm.20200903.16},
      url = {https://doi.org/10.11648/j.sjcm.20200903.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20200903.16},
      abstract = {Background: Dyslipidemia abounds among diabetics. However, these are poorly characterized among patients with type 1 diabetes (T1DM). The current study determined the pattern of dyslipidemia and their relationship with glycemic status among adult T1DM subjects. Methods: This survey was conducted retrospectively among 346 newly-diagnosed/treatment-naïve T1DM adults attending outpatient units of a third-level hospital in Nigeria. Patients’ fasting plasma glucose and lipid parameters at the time of T1DM diagnosis were abstracted from their medical files. Lipid parameters included triglyceride (Tg), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Abstracted parameters were analyzed using descriptive and comparative statistics. Results: Of the 346 studied, 46.8% (n=162) were dyslipidemic (aged: 32.69±6.29) with female predominance (59.3%; p=0.018). Categorically, females predominated among isolated dyslipidemics while males predominated among the combined/mixed dyslipidemics. High plasma Tg concentration (n=142;87.7%) was the most common isolated dyslipidemia without male/female difference (p>0.05); seconded by low HDL-C (n=80;49.4%) with the females predominating (p<0.05). The most combined and mixed dyslipidemia was high plasma Tg/low HDL-C (total n=28, 17.3%; males n=16, 24.2% vs. females n=12, 12.5%; p=0.011) and high plasma Tg/high LDL-C/low-HDL-C (total n=30, 18.5%; males n=18, 27.3% vs. females n=12, 12.5%; p=0.001) concentrations, respectively with male predominance. The female dyslipidemics were younger with lower BMI, higher systolic blood pressure, glycemia, and mean plasma Tg levels (p<0.05). The overall dyslipidemics had poor glycemic status and their risk of dyslipidemia increases with worsening glycemia. Conclusion: Dyslipidemia was common and associated with poor glycemic status among the studied cohorts. This finding informs the need for more rigorous monitoring of dyslipidemia among T1DM subjects to reduce the risk of its complications.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Lipid/Lipoprotein Abnormalities Among Adult Type 1 Diabetics in Nigeria
    AU  - Collins Amadi
    AU  - Olufisayo Gabriel Ayoade
    AU  - Fabian Aniekpon Unyime
    AU  - Sarah Ifreke Essien
    AU  - Blessing Thomas Moses
    AU  - Mfonobong Eni Enyong
    Y1  - 2020/09/24
    PY  - 2020
    N1  - https://doi.org/10.11648/j.sjcm.20200903.16
    DO  - 10.11648/j.sjcm.20200903.16
    T2  - Science Journal of Clinical Medicine
    JF  - Science Journal of Clinical Medicine
    JO  - Science Journal of Clinical Medicine
    SP  - 74
    EP  - 81
    PB  - Science Publishing Group
    SN  - 2327-2732
    UR  - https://doi.org/10.11648/j.sjcm.20200903.16
    AB  - Background: Dyslipidemia abounds among diabetics. However, these are poorly characterized among patients with type 1 diabetes (T1DM). The current study determined the pattern of dyslipidemia and their relationship with glycemic status among adult T1DM subjects. Methods: This survey was conducted retrospectively among 346 newly-diagnosed/treatment-naïve T1DM adults attending outpatient units of a third-level hospital in Nigeria. Patients’ fasting plasma glucose and lipid parameters at the time of T1DM diagnosis were abstracted from their medical files. Lipid parameters included triglyceride (Tg), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Abstracted parameters were analyzed using descriptive and comparative statistics. Results: Of the 346 studied, 46.8% (n=162) were dyslipidemic (aged: 32.69±6.29) with female predominance (59.3%; p=0.018). Categorically, females predominated among isolated dyslipidemics while males predominated among the combined/mixed dyslipidemics. High plasma Tg concentration (n=142;87.7%) was the most common isolated dyslipidemia without male/female difference (p>0.05); seconded by low HDL-C (n=80;49.4%) with the females predominating (p<0.05). The most combined and mixed dyslipidemia was high plasma Tg/low HDL-C (total n=28, 17.3%; males n=16, 24.2% vs. females n=12, 12.5%; p=0.011) and high plasma Tg/high LDL-C/low-HDL-C (total n=30, 18.5%; males n=18, 27.3% vs. females n=12, 12.5%; p=0.001) concentrations, respectively with male predominance. The female dyslipidemics were younger with lower BMI, higher systolic blood pressure, glycemia, and mean plasma Tg levels (p<0.05). The overall dyslipidemics had poor glycemic status and their risk of dyslipidemia increases with worsening glycemia. Conclusion: Dyslipidemia was common and associated with poor glycemic status among the studied cohorts. This finding informs the need for more rigorous monitoring of dyslipidemia among T1DM subjects to reduce the risk of its complications.
    VL  - 9
    IS  - 3
    ER  - 

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Author Information
  • Department of Chemical Pathology, University of Uyo Teaching Hospital, Uyo, Nigeria

  • Department of Chemical Pathology, University of Uyo Teaching Hospital, Uyo, Nigeria

  • Department of Chemical Pathology, University of Uyo, Uyo, Nigeria

  • Department of Chemical Pathology, University of Uyo, Uyo, Nigeria

  • Department of Biochemistry, Evangel University, Abakaliki, Nigeria

  • Department of Health Information Management, University of Uyo Teaching Hospital, Uyo, Nigeria

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