Sahani Jayant K, Aggarwal Ramesh, Ghotekar L H, Prakash Anupam, Singh Kuldeep, Gupta Prashasti
Internal Medicine, Lady Hardinge Medical College, New Delhi, IND.
Cureus. 2024 Oct 26;16(10):e72414. doi: 10.7759/cureus.72414. eCollection 2024 Oct.
Introduction Diabetes mellitus is characterized by chronic hyperglycemia due to insulin deficiency, leading to complications in vital organs. Among these, dyslipidemia is common, presenting as low high-density lipoprotein cholesterol (HDL-c), high triglycerides (TG), Apolipoprotein-B (Apo-B), and small dense low-density lipoprotein (sdLDL) predominance, collectively known as diabetic dyslipidemia. To assess the atherogenic risk in individuals with type 2 diabetes, the atherogenic index of plasma (AIP) and atherogenic coefficient (AC) provide valuable insights beyond routine lipid tests. AIP, calculated as log (serum TG/serum HDL-c), correlates positively with the occurrence and severity of diabetic microvascular complications. The AC ((total cholesterol (TC)-HDL-c)/HDL-c) serves as an atherogenicity marker. Waist circumference (WC), reflecting central adiposity and body mass index (BMI), are directly related to both AIP and AC, making them useful non-invasive tools to monitor atherogenicity and predict cardiovascular disease (CVD) risk independently of each other in subjects with type 2 diabetes mellitus. Material and methods This was an observational cross-sectional study conducted in the Department of Medicine of a tertiary care hospital. It included 100 type 2 diabetes mellitus patients more than 18 years of age, including both males and females. Observation and results In our study, there were 42 (42%) males and 58 (58%) females. The mean WC of males and females were 105.40 and 100.98 cm, respectively. The mean for BMI, glycated hemoglobin (HbA1c), and urine albumin-to-creatinine ratio (UACR) was 28.83 kg/m, 8.58%, and 100.62 mg/g, respectively. There was positive Pearson's correlation between AIP and WC of males and females (r = 0.324 and 0.269), AC and WC of males and females (r = 0.139 and 0.097), BMI and AIP (r = 0.350), BMI and AC (r = 0.214), HbA1c and AIP (r = 0.207), HbA1c and AC (r = 0.216), UACR and AIP (r = 0.218), and UACR and AC (r = 0.237). Conclusion This study concludes that there is a positive correlation between anthropometric measures, such as WC and BMI, and plasma atherogenicity indexes, including the AIP and AC. This finding suggests that clinicians can effectively use these non-invasive measurements (BMI and WC) to estimate the presence of dyslipidemia and atherogenicity in patients with type 2 diabetes mellitus during routine outpatient care. Early identification of these risk factors allows for timely lifestyle interventions such as dietary modifications and increased physical activity, which could potentially reduce the risk of future cardiovascular diseases.
引言
糖尿病的特征是由于胰岛素缺乏导致慢性高血糖，进而引发重要器官的并发症。其中，血脂异常很常见，表现为高密度脂蛋白胆固醇（HDL-c）降低、甘油三酯（TG）升高、载脂蛋白B（Apo-B）升高以及小而密低密度脂蛋白（sdLDL）占优势，统称为糖尿病血脂异常。为评估2型糖尿病患者的动脉粥样硬化风险，血浆动脉粥样硬化指数（AIP）和动脉粥样硬化系数（AC）提供了超出常规血脂检测的有价值信息。AIP计算公式为log（血清TG/血清HDL-c），与糖尿病微血管并发症的发生和严重程度呈正相关。AC[（总胆固醇（TC）-HDL-c）/HDL-c]用作动脉粥样硬化性标志物。腰围（WC）反映中心性肥胖，体重指数（BMI）与AIP和AC均直接相关，使其成为在2型糖尿病患者中相互独立地监测动脉粥样硬化性和预测心血管疾病（CVD）风险的有用非侵入性工具。
材料与方法
这是一项在三级护理医院内科进行的观察性横断面研究。研究纳入了100名年龄超过18岁的2型糖尿病患者，包括男性和女性。
观察与结果
在我们的研究中，男性有42名（42%），女性有58名（58%）。男性和女性的平均WC分别为105.40厘米和100.98厘米。BMI、糖化血红蛋白（HbA1c）和尿白蛋白与肌酐比值（UACR）的平均值分别为28.83kg/m、8.58%和100.62mg/g。男性和女性的AIP与WC之间存在正Pearson相关性（r = 0.324和0.269），男性和女性的AC与WC之间存在正Pearson相关性（r = 0.139和0.097），BMI与AIP之间存在正Pearson相关性（r = 0.350），BMI与AC之间存在正Pearson相关性（r = 0.214），HbA1c与AIP之间存在正Pearson相关性（r = 0.207），HbA1c与AC之间存在正Pearson相关性（r = 0.216），UACR与AIP之间存在正Pearson相关性（r = 0.218），UACR与AC之间存在正Pearson相关性（r = 0.237）。
结论
本研究得出结论，人体测量指标如WC和BMI与血浆动脉粥样硬化指数包括AIP和AC之间存在正相关。这一发现表明，临床医生在常规门诊护理期间可以有效地使用这些非侵入性测量方法（BMI和WC）来估计2型糖尿病患者血脂异常和动脉粥样硬化性的存在。早期识别这些危险因素有助于及时进行生活方式干预，如饮食调整和增加体育活动，这可能会降低未来心血管疾病的风险。
