Klisic Aleksandra, Kavaric Nebojsa, Jovanovic Milovan, Zvrko Elvir, Skerovic Verica, Scepanovic Andjelka, Medin Darko, Ninic Ana
Primary Health Care Center, Podgorica, Montenegro.
Clinical Center of Montenegro, Podgorica, Montenegro.
J Res Med Sci. 2017 Nov 28;22:122. doi: 10.4103/jrms.JRMS_284_17. eCollection 2017.
Recent studies hypothesize that dyslipidemia can predict glycated hemoglobin (HbA1c) and could be important contributing factor to the pathogenesis of type 2 diabetes mellitus (DM2). Therefore, we aimed to evaluate the influence of lipid parameters on long-term glycemic control in DM2.
A total of 275 sedentary DM2 (mean [±standard deviation] age 60.6 [±10.0] years) who volunteered to participate in this cross-sectional study were enrolled. Anthropometric (body weight, body hight, and waist circumference), biochemical parameters (fasting glucose, HbA1c, lipid parameters, creatinine), as well as blood pressure were obtained.
Total cholesterol (odds ratio [OR] =1.30, 95% confidence interval [CI] [1.02-1.66], = 0.032), triglycerides (OR = 1.34, 95% CI (1.07-1.67), = 0.010), and low density lipoprotein cholesterol (OR = 1.42, 95% CI [1.10-1.83], = 0.006) were the independent predictors of higher HBA1c, and as they increased by 1 mmol/L each, probabilities of higher HBA1c increased by 30%, 34%, and 42%, respectively. Low level of high-density lipoprotein cholesterol (HDL-c) was found to be the independent predictor of higher HBA1c (OR = 0.44, 95% CI [0.20-0.67], = 0.039), and increase in HDL-c by 1 mmol/L, reduced the probability of higher HBA1c by 56%.
Unfavorable lipid profile can predict HbA1c level in DM2 patients. Early diagnosis of dyslipidemia, as well as its monitoring and maintaining good lipids control can be used as a preventive measure for optimal long-term glycemic control.
近期研究推测，血脂异常可预测糖化血红蛋白（HbA1c），且可能是2型糖尿病（DM2）发病机制中的重要促成因素。因此，我们旨在评估血脂参数对DM2患者长期血糖控制的影响。
共有275名自愿参与这项横断面研究的久坐不动的DM2患者（平均年龄[±标准差]为60.6[±10.0]岁）入组。获取了人体测量学指标（体重、身高和腰围）、生化参数（空腹血糖、HbA1c、血脂参数、肌酐）以及血压。
总胆固醇（优势比[OR]=1.30，95%置信区间[CI][1.02 - 1.66]，P = 0.032）、甘油三酯（OR = 1.34，95%CI（1.07 - 1.67），P = 0.010）和低密度脂蛋白胆固醇（OR = 1.42，95%CI[1.10 - 1.83]，P = 0.006）是较高HbA1c水平的独立预测因素，且每升高1 mmol/L，较高HbA1c水平的概率分别增加30%、34%和42%。高密度脂蛋白胆固醇（HDL - c）水平较低是较高HbA1c水平的独立预测因素（OR = 0.44，95%CI[0.20 - 0.67]，P = 0.039），HDL - c每升高1 mmol/L，较高HbA1c水平的概率降低56%。
不良血脂谱可预测DM2患者的HbA1c水平。血脂异常的早期诊断及其监测以及维持良好的血脂控制可作为实现最佳长期血糖控制的预防措施。
