Department of Family Medicine, Universiti Putra Malaysia, Malaysia.
Diabetes Res Clin Pract. 2012 Jun;96(3):339-47. doi: 10.1016/j.diabres.2012.01.017. Epub 2012 Feb 2.
Numerous studies with compelling evidence had shown a clear relationship between dyslipidaemia and cardiovascular (CV) events in patients with diabetes mellitus. This was an observational study based on secondary data from the online registry database Adult Diabetes Control and Management (ADCM) looking into the determinants of uncontrolled dyslipidaemia in type 2 diabetes mellitus patients. Independent predictors were identified using multivariate logistic regression. A total of 303 centres (289 health clinics, 14 hospitals) contributed a total of 70,889 patients (1972 or 2.8% patients were from hospital). About thirty eight percent were reported to have dyslipidaemia. There were 40.7% patients on lipid-lowering agents and of those above age 40 years old, only 38.1% of them were on a statin. Malay ethnicity and younger age groups (<50 years old) were two major determinants of uncontrolled LDL-C, TG and HDL-C. Female gender and uncontrolled blood pressure were determinants of uncontrolled LDL-C, and poor glycaemic control was related independently to high TG. This study has highlighted the suboptimal management of diabetic dyslipidaemia in Malaysia. Pharmacological treatment of dyslipidaemia could be more effective. Healthcare stakeholders in this country, especially in the primary care, have to recognize these shortfalls and take immediate remedial measures.
大量具有确凿证据的研究表明，糖尿病患者的血脂异常与心血管（CV）事件之间存在明确关系。这是一项基于在线注册数据库成人糖尿病控制和管理（ADCM）中的二级数据进行的观察性研究，旨在研究 2 型糖尿病患者血脂控制不佳的决定因素。使用多元逻辑回归识别独立预测因素。共有 303 个中心（289 个健康诊所，14 家医院）共贡献了 70889 名患者（1972 名或 2.8%的患者来自医院）。据报道，约有 38%的患者存在血脂异常。有 40.7%的患者使用降脂药物，在年龄超过 40 岁的患者中，只有 38.1%的患者使用他汀类药物。马来族裔和年龄较小的人群（<50 岁）是 LDL-C、TG 和 HDL-C 控制不佳的两个主要决定因素。女性和未控制的血压是 LDL-C 控制不佳的决定因素，而血糖控制不佳与高 TG 独立相关。这项研究突出了马来西亚糖尿病患者血脂异常管理的不足。血脂异常的药物治疗可能更有效。该国的医疗保健利益相关者，特别是在初级保健方面，必须认识到这些不足，并立即采取补救措施。
