Chiveto Dexter Tadiwanashe, Musarurwa Cuthbert, Mapira Herbert T, Kaseke Farayi, Nyengerai Tawanda, Kaseke Timothy, Gori Elizabeth
Department of Laboratory Diagnostic and Investigative Sciences - Chemical Pathology Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Immunology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Diabetes Metab Syndr Obes. 2024 Aug 27;17:3187-3196. doi: 10.2147/DMSO.S473042. eCollection 2024.
Type 2 diabetes mellitus (T2DM) frequently presents with modified cardiometabolic risk profiles, indicative of an elevated susceptibility to cardiovascular disease (CVD). Cardiometabolic risk factors such as obesity, hyperglycemia, hypertension, insulin resistance and dyslipidemia are known contributors to increased CVD hazard in individuals with T2DM. This study evaluated the glycemic control-based cardiometabolic risk profiles of black Zimbabweans with T2DM.
A cross-sectional study of 116 T2DM patients recruited from diabetic clinics at Parirenyatwa and Sally Mugabe Hospitals, Harare, Zimbabwe, was conducted. Blood samples were collected for glycated hemoglobin (HbA1c) and lipid profile assessment. The Framingham risk scores (FRS) based on body mass index (BMI) and lipid profile were used to determine CVD risk. Parametric variables were analyzed using one-way analysis of variance (ANOVA) with post hoc Bonferroni correction, while non-parametric variables were compared using the Kruskal-Wallis test with post hoc Dunn test for multiple comparisons.
The overall frequency of dyslipidemia was 83.6% (n=97) and hypoalphalipoproteinemia was the most prevalent dyslipidemia (79.3%). Median HDLC levels were significantly lower in participants with poor glycemic control (1.12 mmol/L) compared to those with good glycemic control group (1.37 mmol/L) (p=0.011). Despite lack of significant variations in Framingham Risk Scores, there was a trend towards lower FRS-BMI in the good control group (29.8%) compared to the inadequate control (35.4%) and poor control (32.7%) groups (p=0.078).
Duration since DM diagnosis was observed to be an important risk factor for poor glycemic control being significantly shorter in those with good glycemic control compared to those with inadequate and poor control. Overall, there was no significant difference in HbA1c status by age but individuals with poor glycemic control were significantly older than those with good control. The most prevalent dyslipidemia among the study participants was hypoalphalipoproteinemia which is reportedly associated with genetic predisposition, warranting further investigations.
2型糖尿病（T2DM）常伴有改变的心脏代谢风险特征，表明心血管疾病（CVD）易感性升高。肥胖、高血糖、高血压、胰岛素抵抗和血脂异常等心脏代谢危险因素是T2DM患者CVD风险增加的已知因素。本研究评估了津巴布韦黑人T2DM患者基于血糖控制的心脏代谢风险特征。
对从津巴布韦哈拉雷的帕里伦亚瓦医院和萨利·穆加贝医院的糖尿病诊所招募的116例T2DM患者进行了横断面研究。采集血样进行糖化血红蛋白（HbA1c）和血脂谱评估。基于体重指数（BMI）和血脂谱的弗明汉风险评分（FRS）用于确定CVD风险。参数变量采用单因素方差分析（ANOVA）并进行事后邦费罗尼校正分析，非参数变量采用Kruskal-Wallis检验并进行事后邓恩检验进行多重比较。
血脂异常的总体发生率为83.6%（n = 97），低α脂蛋白血症是最常见的血脂异常（79.3%）。血糖控制不佳的参与者的高密度脂蛋白胆固醇（HDLC）中位数水平（1.12 mmol/L）显著低于血糖控制良好组（1.37 mmol/L）（p = 0.011）。尽管弗明汉风险评分没有显著差异，但与控制不佳（35.4%）和控制差（32.7%）组相比，良好控制组的FRS-BMI有降低趋势（29.8%）（p = 0.078）。
观察到自糖尿病诊断以来的病程是血糖控制不佳的一个重要危险因素，血糖控制良好者的病程明显短于控制不佳和控制差者。总体而言，HbA1c状态按年龄无显著差异，但血糖控制不佳者明显比控制良好者年龄大。研究参与者中最常见的血脂异常是低α脂蛋白血症，据报道与遗传易感性有关，值得进一步研究。
