Patients with pre-diabetes should be screened for lipid levels
The prevalence of dyslipidemia in pre-diabetic subjects has been found to be significantly higher than in controls.
This outcome of an observational study was reported remotely last week as part of the canceled American Association of Clinical Endocrinologists (AACE) 29th Annual Scientific & Clinical Congress (EMBRAACE 2020).
Mohammed Riyaz, MBBS, of the Esani Diabetic and Multispeciality Centre, and Mohammed Muzammil, BS, of the Shadan Institute of Medical Sciences, Hyderabad, India, set out to evaluate dyslipidemia in pre-diabetic subjects.
The study questioned the prevalence of hypertension and dyslipidemia in pre-diabetic subjects with a family history of type 2 diabetes (first-degree relative) vs normal patients. Pre-diabetic patients were compared with subjects with normal glucose tolerance.
Overall, 111 patients were included, of whom 60 were diagnosed as pre-diabetic, 51 as normal healthy controls. The study was carried out for 15 months.
Inclusion criteria were:
· Impaired fasting glucose: fasting blood sugar 110–125 mg/dL
· Impaired glucose tolerance: 2-h plasma glucose 140–199 mg/dL
Exclusion criteria were:
· Type 2 diabetes
· Type 1 diabetes
· Present smokers
· Present alcoholism
· Age >70 years
Enrolled patients underwent the following investigations:
· Fasting blood sugar
· 2-h oral glucose tolerance test
· Total cholesterol
· HDL cholesterol
· LDL cholesterol
· VLDL cholesterol
Mean total cholesterol was higher in patients (182.18 ± 37.84 mg/dL) than in controls (146.57 ± 39.94 mg/dL), t = 4.8, P < .001.
Mean triglycerides were higher in patients (133.23 ± 36.38 mg/dL) than in controls (104.51 ± 32.28 mg/dL), t = 4.37, P < .001.
Mean LDL cholesterol was higher in patients (132.50 ± 32.924 mg/dL) than in controls (91.84 ± 20.10 mg/dL), t = 7.68, P < .001.
Mean HDL cholesterol was lower in patients (33.45 ± 7.34 mg/dL) than in controls (45.43 ± 7.68 mg/dL), t = 8.7, P < .001.
Dr. Riyaz and Mr. Muzammil explained that pre-diabetes in the precursor to type 2 diabetes. Pre-diabetes is defined as:
Impaired fasting glucose: fasting blood glucose is elevated above normal levels but not high enough to be classified as diabetes
Impaired glucose tolerance: 2-h glucose 140–199 mg/dL on the 75-g oral glucose tolerance test
Patients with impaired fasting glucose/impaired glucose tolerance are at significant risk of diabetes and are an important target group for primary prevention.
The prevalence of dyslipidemia was found to be significantly higher in pre-diabetic subjects than in controls, but hypertension in pre-diabetic patients was similar to controls.
Impaired fasting glucose and impaired glucose tolerance were associated with conditions linked to obesity and dyslipidemia, such as high triglycerides, high total cholesterol, and hypertension.
Obesity, hypertension, and dyslipidemia are important cardiovascular risk factors in pre-diabetic patients. Differences between pre-diabetic patients and normal subjects were demonstrated.
Assessing and treating these risk factors is therefore important in reducing cardiometabolic risk.
The prevalence of hypertension did not, however, differ between groups. In pre-diabetic patients, the incidence of hypertension was higher than in controls.
The prevalence of dyslipidemia in pre-diabetic subjects was significantly higher than in controls.
Further, large, randomized, controlled trials are needed to assess hypertension and dyslipidemia in pre-diabetic subjects based on glucose intolerance status.
Dr. Riyaz and Mr. Muzammil concluded that patients with pre-diabetes should be screened for lipid levels. Elevated lipemic levels have been clearly shown to raise cardiovascular risk directly and indirectly.
Hence, prompt identification and correction of dyslipidemia can help prevent ensuing complications.