Association between dyslipidaemia and micro and macrovascular complications in type 2 diabetic patients
Francisco Javier del Cañizo-Gómez, Manuela Belén Silveira Rodríguez, Tomás González-Losada, Inmaculada Moreno-Ruíz, Carlos de Gorospe Pérez-Jáuregui & Amparo Segura-Galindo
Various risk factors act synergistically for the development of micro and macrovascular complications in type 2 diabetes mellitus (T2DM) patients. The contributions of risk factors have yet to be clearly identified and quantified, but diabetic dyslipidaemia has specific importance.
Objective: To investigate the association of dyslipidaemia with micro and macrovascular complications in a T2DM population.
Materials and methods: Cross sectional study in 874 consecutive out-patients who visited our clinic in Madrid, Spain for a routine follow-up. Total cholesterol (TCh), HDL-Ch, and triglycerides (TGs) were measured and LDL-Ch was calculated (Friedewald) in all of the subjects after an overnight fast. All patients were evaluated for the presence of micro and macrovascular complications such diabetic nephropathy (DN), diabetic retinopathy (DR) and coronary artery disease (CAD), using standard techniques. Estimated values of TCh>240 mg/dl; TGs>150 mg/dl, HDL-Ch<40 mg/dl and LDL-Ch>130 mg/dl were considered as abnormal. Multiple regression analysis was done to evaluate the association of micro and macrovascular complications with abnormal lipid profile. A level of P<0.05 was considered statistically significant (SPSS, version 13.0).
Results: The mean age of the study group was 65.6±12.6 years with average duration of diabetes 13.0±10.2. Data regarding lipid profile showed that in all patients with T2DM studied, TCh>240 mg/dl was seen in 15% of patients, LDL-Ch>130 mg/dl in 27.9%, HDL<40 mg/dl in 18.9%, and TGs>150 mg/dl in 37.8%. Regression analysis revealed an association of high TCh (P=0.015) and LDL-Ch (P=0.033), and low HDL-Ch (P=0.001) with CAD; and low HDL-Ch (P=0.000, 0.001) and high TGs (P=0.002, 0.048) with DN and DR respectively.
Conclusions: The present study has shown a strong association of abnormalities of lipid profile and micro and macrovascular complications in the T2DM patients studied, mainly low HDL-Ch levels. Hence, appropriate preventive and new treatment strategies to increase the HDL-Ch should be considered timely in T2DM patients.