Glycated haemoglobin as a marker of elevated LDL and TAG: a cohort study
Insights
High glycosylated hemoglobin (HbA1c) levels correlate with increased LDL cholesterol and triglycerides in type 2 diabetes patients. Elevated body mass index (BMI) also impacts HDL cholesterol in women, highlighting cardiovascular disease risks.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Clinical Chemistry
Background:
- Patients with type 2 diabetes mellitus (T2DM) often face challenges in managing lipid parameters, particularly those with less stringent glycated hemoglobin (HbA1c) targets, increasing cardiovascular risk.
- Understanding the interplay between HbA1c, lipid profiles (triglycerides, HDL, LDL), and body mass index (BMI) is crucial for early identification of high-risk individuals.
Purpose of the Study:
- To investigate the correlations between glycated hemoglobin (HbA1c), lipid parameters (triglycerides, HDL, LDL), and body mass index (BMI) at the time of diagnosis in patients with newly diagnosed T2DM.
- To identify specific patient groups at increased risk for cardiovascular disease based on these metabolic markers.
Main Methods:
- A 5-year cohort study involving 200 outpatients (117 men, 83 women, aged 30-92) with newly diagnosed T2DM.
- Baseline measurements included HbA1c (IFCC/DCCT methods), lipid profiles (TG, HDL, LDL), BMI, waist circumference, and blood pressure. Patients on statins or fibrates were included.
Main Results:
- Higher HbA1c levels were significantly associated with increased levels of LDL cholesterol (p=0.012) and triglycerides (TAG) (p=0.017) across the entire study group.
- Higher BMI was significantly correlated with lower HDL cholesterol levels specifically in the female subgroup (p=0.010).
Conclusions:
- Glycosylated hemoglobin (HbA1c) serves as a direct indicator of elevated LDL cholesterol and triglycerides, contributing to atherogenicity.
- BMI is an indirect marker, particularly impacting HDL cholesterol in women, and both HbA1c and BMI are valuable for assessing coronary artery disease risk in T2DM patients.
Abstract:
Patients with less severe glycated haemoglobin (HbA1c) targets may find it difficult to achieve the target values of lipid parameters treatment at high cardiovascular risk. We have been monitoring the correlation between levels of triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) with glycosylated haemoglobin (HbA1c) by IFCC method (method of testing according to the International Federation of Clinical Chemistry and Laboratory Medicine) and by DCCT method (Diabetes Control and Complication Trial) as well as body mass index (BMI) at the time of diagnosis of the disease, that could help identify patients with an increased risk of cardiovascular disease. In the cohort study we were monitoring outpatients with newly diagnosed type 2 diabetes mellitus during a 5 year period. Patients (117 men, 83 women), aged from 30 to 92 years were conducted sampling blood glucose, HbA1c (IFCC/DCCT), HDL, LDL, TG. At baseline, the patients height, weight, waist circumference, calculated BMI and blood pressure were measured. Waist circumference was measured in the horizontal plane in the middle of the distance between the upper edge of the iliac crest and the lower edge of the last rib in the breath. Our study did not exclude patients taking statin or fibrate. The high HbA1c values increased the risk of elevating LDL-cholesterol levels and TAG levels in the whole group (p = 0.012) and (p = 0.017), and the high BMI values increased the risk of lowering HDL-cholesterol levels in the female population (p = 0.010). The results of our study stratify the increased risk of atherogenicity in these groups. HbA1c is a direct marker of elevated LDL and TAG, and indirect marker for coronary artery disease risk assessment.
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