The Association of Glycated Hemoglobin With Lipid Profile Indices in Type 2 Diabetic Patients

  • Hamidreza Samimagham ORCID Department of Nephrology, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
  • Mariana Bargak ORCID Department of Endocrinology, Hormozgan University of Medical Sciences, Bandarabbas, Iran.
  • Mehran Ghasemzadeh ORCID Department of Endocrinology, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
  • Mitra Kazemi Jahromi ORCID Mail Department of Endocrinology, Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Keywords:
Glycated hemoglobinA1C (HbA1C), Estimated glomerular filtration rate(eGFR), Lipid profile, Diabetes

Abstract

The high risk of lipid abnormalities in type 2 diabetic (T2D) patients with uncontrolled hyperglycemia may be associated with an increased risk of cardiovascular complications. The aim of the current study was to investigate the association between glycated hemoglobin )HbA1c( and lipid profile levels in T2D patients. This cross-sectional study was conducted on 802 T2D patients, aged≥ 40 years, visiting the Abu Reyhan Clinic of Shahid Mohammadi Hospital in Bandar Abbas, Iran. Serum lipid profiles were measured by the enzymatic method. Diabetes was defined based on the criteria of the American Diabetes Association. The association of HbA1c and estimated glomeruli filtration rate (eGFR) with lipid profile indices was assessed using the Spearman correlation coefficient test and linear regression model. The mean±SD age of participants (27.7% of men) was 53.55±5.56 years. The mean±SD of HbA1c and eGFR for all subjects were 8.97±2.14 and 86.30±17.48, respectively. In this study,a positive association was observed between HbA1c and fasting blood glucose (r=0.619, β=0.635), total cholesterol (r=0.165, β=0.188), triglycerides (r=0.103, β=0.095), and low-density lipoprotein cholesterol (r=0.162, β=0.173), (P<0.01). Also, an inverse association has been observed between eGFR level and TGs (r=-0.08, β=-0.096) and FBS (r=-0.123, β=-0.172), (P<0.05). Our findings suggested that HbA1c is not only an applicable predictor of long-term glycaemic control but also can be considered as a potential biomarker for predicting lipid abnormalities in T2D patients.

References

1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.
2. Aguiree F, Brown A, Cho NH, Dahlquist G, Dodd S, Dunning T, et al. IDF diabetes atlas. 2013.
3. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88-98.
4. Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World journal of diabetes. 2015;6(13):1246-58.
5. Economic costs of diabetes in the U.S. In 2007. Diabetes Care. 2008;31(3):596-615.
6. Bahia LR, Araujo DV, Schaan BD, Dib SA, Negrato CA, Leao MP, et al. The costs of type 2 diabetes mellitus outpatient care in the Brazilian public health system. Value Health. 2011;14(5 Suppl 1):S137-40.
7. Dake AW, Sora ND. Diabetic Dyslipidemia Review: An Update on Current Concepts and Management Guidelines of Diabetic Dyslipidemia. Am J Med Sci. 2016;351(4):361-5.
8. Lee J, Son H, Ryu OH. Management Status of Cardiovascular Disease Risk Factors for Dyslipidemia among Korean Adults. Yonsei Med J. 2017;58(2):326-38.
9. Saydah SH, Miret M, Sung J, Varas C, Gause D, Brancati FL. Postchallenge hyperglycemia and mortality in a national sample of U.S. adults. Diabetes Care. 2001;24(8):1397-402.
10. Moss SE, Klein R, Klein BE. Cause-specific mortality in a population-based study of diabetes. American journal of public health. 1991;81(9):1158-62.
11. Jaiswal M, Schinske A, Pop-Busui R. Lipids and lipid management in diabetes. Best Pract Res Clin Endocrinol Metab. 2014;28(3):325-38.
12. International Expert C. International Expert Committee report on the role of the A1C assay in the diagnosis of diabetes. Diabetes care. 2009;32(7):1327-34.
13. Sakurai M, Saitoh S, Miura K, Nakagawa H, Ohnishi H, Akasaka H, et al. HbA1c and the risks for all-cause and cardiovascular mortality in the general Japanese population: NIPPON DATA90. Diabetes care. 2013;36(11):3759-65.
14. Hussain A, Ali I, Ijaz M, Rahim A. Correlation between hemoglobin A1c and serum lipid profile in Afghani patients with type 2 diabetes: hemoglobin A1c prognosticates dyslipidemia. Ther Adv Endocrinol Metab. 2017;8(4):51-7.
15. Khan HA, Sobki SH, Khan SA. Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts dyslipidaemia. Clin Exp Med. 2007;7(1):24-9.
16. Klisic A, Kavaric N, Jovanovic M, Zvrko E, Skerovic V, Scepanovic A, Medin D, Ninic A. Association between unfavorable lipid profile and glycemic control in patients with type 2 diabetes mellitus. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences. 2017;22:122-.
17. VinodMahato R, Gyawali P, Raut PP, Regmi P, Singh KP, Pandeya DR, Gyawali P. Association between glycaemic control and serum lipid profile in type 2 diabetic patients: Glycated haemoglobin as a dual biomarker. 2011.
18. Leon BM, Maddox TM. Diabetes and cardiovascular disease: Epidemiology, biological mechanisms, treatment recommendations and future research. World journal of diabetes. 2015;6(13):1246.
19. Taskinen MR. Diabetic dyslipidaemia: from basic research to clinical practice. Diabetologia. 2003;46(6):733-49.
20. Radin MS. Pitfalls in hemoglobin A1c measurement: when results may be misleading. Journal of general internal medicine. 2014;29(2):388-94.
21. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Annals of internal medicine. 2009;150(9):604-12.
22. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26 Suppl 1:S5-20.
23. Krauss RM, Siri PW. Dyslipidemia in type 2 diabetes. Med Clin North Am. 2004;88(4):897-909, x.
24. Chahil TJ, Ginsberg HN. Diabetic dyslipidemia. Endocrinol Metab Clin North Am. 2006;35(3):491-510, vii-viii.
25. Mooradian AD, Albert SG, Haas MJ. Low serum high-density lipoprotein cholesterol in obese subjects with normal serum triglycerides: the role of insulin resistance and inflammatory cytokines. Diabetes Obes Metab. 2007;9(3):441-3.
26. Hamilton SJ, Watts GF. Endothelial dysfunction in diabetes: pathogenesis, significance, and treatment. Rev Diabet Stud. 2013;10(2-3):133-56.
27. Jaiswal M, Schinske A, Pop-Busui R. Lipids and lipid management in diabetes. Best Practice & Research Clinical Endocrinology & Metabolism. 2014;28(3):325-38.
28. Haffner SM. Management of dyslipidemia in adults with diabetes. Diabetes care. 1998;21(1):160-78.
Published
2020-11-10
How to Cite
1.
Samimagham H, Bargak M, Ghasemzadeh M, Kazemi Jahromi M. The Association of Glycated Hemoglobin With Lipid Profile Indices in Type 2 Diabetic Patients. Acta Med Iran. 58(8):376-382.
QRcode
Section
Articles