Endocrine Abstracts (2017) 49 EP520 | DOI: 10.1530/endoabs.49.EP520

A novel lipid tetrad index as predictor of premature coronary artery disease in diabetic patients

Saswati Das & S. K. Gupta


Maulana Azad Medical College, Delhi, India.


Background: The aim of this study was to explore if evaluation of lipid risk factors like Lipoprotein(a) (Lp(a)) and conventional lipid profile parameters can be a efficient predictor of the cardiovascular risk in the patients of Diabetes.

Methods: Sixty individuals with angiographically proven premature CAD and 30 healthy individuals matched for age and sex were studied a tertiary health care centre, New Delhi, India, over a period of 18 months. CAD patients were divided into two groups based on presence (n=30) (group I) and absence (n=30) (group II) of type 2 diabetes mellitus (DM). The serum levels of Lipoprotein (a) were measured by ELISA and routine lipid profile (serum triglyceride, total cholesterol, HDL-C and LDL-C) was measured by automated analyzer. Angiographic clinical vessel scoring was also done for all the patients.

Results: Lipoprotein (a) levels for Group I was 40.26±8.23 mg/dl, Group II was 40.81±11.16 mg/dl respectively which was significantly (i.e. P<0.01) higher than the levels in healthy controls (Lp(a)=16.39±5.71 mg/dl). We found a significant increase in mean levels of Total cholesterol (TC), Low Density Lipoprotein-Cholesterol (LDL-C) and Triglyceride (TG) in cases than controls (P<0.01). In contrast High Density Lipoprotein-Cholesterol (HDL-C) values decreased. Non HDL-C was calculated using the equation=(Total Cholesterol[TC]−LDL-C). Lipid Tetrad Index (LTI) and Atherogenic Index were also calculated for all patients. The Modified Lipid Tetrad Index that we propose was calculated using the equation MLTI=(non HDL-C×triglycerides×lipoprotein(a)/HDL-C). On analyzing by cumulative probability plot the new modified Lipid Tetrad Index defined by us is able to discriminate case and control populations more precisely than the existing LTI and Atherogenic Index. The Modified Lipid Tetrad Index has a better sensitivity and specificity than the existing LTI and also has a better correlation with the angiographic vessel score in all patients.

Conclusion: The new proposed Modified Lipid Tetrad Index is a better marker and predictor of severity of premature CAD diabetic patients from India, than the existing Lipid Tetrad Index and Atherogenic Index.

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