Dyslipidemia in diabetes: a population-based study in Bali
Received 13 May 2019
Accepted for publication 15 August 2019
Published 2 September 2019 Volume 2019:12 Pages 313—321
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Ketut Suastika,1 I Made Siswadi Semadi,1 I Made Pande Dwipayana,1 Made Ratna Saraswati,1 Wira Gotera,1 Anak Agung Gde Budhiarta,1 Kinuyo Matsumoto,2 Naemi Kajiwara,2 Hiroshi Taniguchi3
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Denpasar, Bali, Indonesia; 2Graduate School of Life Science, Kobe Women’s University, Kobe, Japan; 3Department of Diabetology, Graduate School of Health Sciences, Kobe University, Kobe, Japan
Correspondence: Ketut Suastika
Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University/Sanglah Hospital, Jalan Kamboja, Denpasar, Bali, Indonesia
Tel +62 81 138 0916
Purpose: To establish the lipid pattern in subjects with diabetes mellitus (DM) and factors that are correlated with insulin resistance and lipid disorders in a population of Bali.
Methods: A cross-sectional population-based study which enrolled 1840 subjects (age 13–100 years) from 7 villages was carried out. Several clinical parameters were measured including age, gender, body mass index, waist circumference (WC), fasting blood glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo) A (apoA), apoB, non-HDL-C, T/HDL-C ratio, LDL-C/apoB ratio, apoB/A ratio, plasma insulin, and homeostasis of model assessment-insulin resistance (HOMA-IR).
Results: TC, TG, and non-HDL-C levels were higher in DM subjects than in normal glucose tolerance (NGT) subjects in both genders; total/HDL-C ratio was higher in subjects with DM than in NGT subjects only in men; LDL-C levels, apoB levels, and apoB/A ratios were higher and LDL/apoB was lower in subjects with DM than in NGT in women. In subjects with DM, the target for LDL-C (79%), non-HDL-C (85.2%), apoB (80%), HDL-C (34.9%), TG (46.7%), and small-dense low density lipoprotein (42.2%) was not achieved.
Conclusion: FBG was correlated with TC, TG, LDL-C, apoB, non-HDL-C levels, LDL/apoB, and apoB/apoA ratios. Subjects with DM had higher levels of TC, TG, and non-HDL-C levels in both genders; T/HDL-C ratio only in men; LDL-C, apoB/apoA ratio and lower LDL/apoB ratio only in women. Obesity was correlated with lipid levels. WC was correlated with LDL/apoB ratio, insulin level, HOMA-IR, and TG; highest absolute strength of correlation was with LDL/apoB ratio. Insulin resistance was correlated with lipid levels or ratios, especially in women. In women, HOMA-IR had a positive correlation with total/HDL-C ratio, non-HDL-C, apoB, and a negative correlation with HDL-C levels.
Keywords: HOMA-IR, dyslipidemia, diabetes
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