Relationship of blood lipid levels with Hba1c and obesity in patients with type 2 diabetes mellitus.

Objective: Dyslipidemia play an important role in the development of coronary artery disease (CAD) which is the world’s leading cause of mortality. Diabetes mellitus and obesity can cause CAD by different ways; dyslipidemia is common in both of them, that can lead to CAD. We investigate the effect of obesity and poor glycemic control on lipid profile in diabetic patients, in our country.
Material and Method: One hundred and sixty five patients (82 male) who admitted to Istanbul Education and Research Hospital Outpatient Diabetes department, whose known diabetes age was less than 5 years, not taking any anti-lipidemic medicine in the last 6 months, not having ischemic heart disease, diabetes controlled by only oral antidiabetics, non-smoker and not drinking alcohol, don’t having any endocrine disorder with possible affect on blood lipid levels, were enrolled to the study. The relationship between lipid levels and HbA1c, body mass index (BMI) and diabetes age were assessed. Student’s t test, ANOVA and Pearson correlation tests were used for comparisons. p<0.05 was considered significant.
Results: It was determined that when BMI value increased, cholesterol, triglyceride and LDL levels increased (r=0.46 p<0.001, r=0.58 p<0.001, r=0.34 p<0.01, respectively) and HDL levels decreased (r=-0.37 p<0.001 ). In patients having high HbA1c levels, total cholesterol, triglyceride and LDL cholesterol levels were found high (r=0.27 p<0.001, r=0.29 p<0.001, r=0.20 p<0.05, respectively). A positive correlation was found between the increasing diabetes age and HbA1c levels (r=0.28, p <0.001) was determined, but no significant corelation with blood lipid levels was detected.
Conclusion: We found similar but not identical results with previous international studies, in this study done in our country. Lipid profile was adversely effected in diabetic patients having obesity and poor glycemic control.

Tip 2 diyabet hastalarýnda kan lipid düzeylerinin Hba1c ve obezite ile iliþkisi

Amaç: Dislipidemi, dünyadaki bir numaralý mortalite nedeni olan koroner arter hastalýðýnýn (KAH) geliþiminde önemli yere sahiptir. Diyabet ve obezite farklý yollarla KAH geliþimine neden olmakla birlikte, dislipidemi KAH’na neden olan ortak yönlerinden biridir. Biz de ülkemizde diyabet hastalarýnda obezite ve kötü glisemik kontrolün lipid profili üzerinde nasýl bir etki yaptýðýný araþtýrdýk.
Gereç ve Yöntem: Ýstanbul Eðitim ve Araþtýrma Hastanesi Diyabet Polikliniði’ne baþvuran, bilinen diyabet yaþý 5‘i geçmeyen, son 6 ay içerisinde herhangi bir hiperlipidemi tedavisi almayan, kanýtlanmýþ iskemik kalp hastalýðý olmayan, sadece oral antidiyabetik ilaç kullanan, sigara ve alkol kullanmayan, kan lipid düzeyini etkileyecek bilinen bir endokrin bozukluðu olmayan 82’si erkek 165 hasta alýndý. Lipid düzeyleri ile HbA1c, vücut kitle indeksi (VKÝ) ve diyabet yaþý arasýndaki iliþkiler deðerlendirildi. Karþýlaþtýrmalarda student’s t, ANOVA ve Pearson korelasyon testleri kullanýldý. p<0.05 anlamlý kabul edildi.
Bulgular: VKÝ deðerleri arttýkça total kolesterol, trigliserid ve LDL kolesterol düzeylerinin de arttýðý (r=0.46 p<0.001, r=0.58 p<0.001, r=0.34 p<0.01, sýrasýyla), HDL kolesterol düzeylerinin ise düþtüðü
saptandý (r=-0.37 p<0.001). HbA1c deðeri yüksek olan hastalarda total kolesterol, trigliserid ve LDL kolesterol düzeylerinin yüksek olduðu (r=0.27 p<0.001, r=0.29 p<0.001, r=0.20 p<0.05, sýrasýyla) görüldü. Diyabet yaþý artýkça HbA1c düzeyleri arasýnda doðru bir orantý (r=0.28 p<0.001) saptanýrken, kan lipid düzeyinde anlamlý bir iliþki saptanmadý.
Sonuç: Ülkemizde yaptýðýmýz bu çalýþmada bire bir olmasa da daha önce yapýlan uluslararasý çalýþmalarla benzer sonuçlara ulaþtýk. Obez ve kötü glisemik kontrole sahip diyabet hastalarýnda lipid profili olumsuz etkilenmektedir.