Dyslipidemia and Its Components Across Body Mass Index Levels Among Type II Diabetic Patients in the West of Iran

Neda Izadi, Mer A. Rahimi, Hamid R. Shetabi, Seyed S. Hashemi Nazari, Farid Najafi

Abstract


Background: The combination of dyslipidemia, obesity, and hyperglycemia can accelerate the progression to cardiovascular disease. Therefore, this study aimed to investigate dyslipidemia and its components across body mass index (BMI) levels among type II diabetic patients. Methods: The data for this cross‑sectional study were extracted from the records of diabetic patients during 2014 to 2015. About 2,300 diabetic patients had been registered, and finally, the records of 2,110 patients which were fully completed were investigated. Dyslipidemia was defined based on the NCEP/ATP III classification of lipid profile. In order to investigate about nonlinear relationship between BMI and dyslipidemia, and its components, restricted cubic spline method was used. Results: The median age of patients was 55 (IQR = 14) years. 61.11% was females. The median of BMI, triglyceride, cholesterol, HDL‑Chol, and LDL‑Chol were 28.3 kg/m2, 167, 193, 41, and 110 mg/dL in patients, respectively. The prevalence of dyslipidemia was 91.29% (95% CI: 90.05–92.54). Being overweight, diabetic patients were associated with an increased risk of dyslipidemia (OR = 1.87–2.78), hypertriglyceridemia (OR = 1.64; 95% CI: 1.29–2.09), and hypo‑HDL (OR = 1.55; 95% CI: 1.20–2.01). Similarly, obesity also increased the risk of dyslipidemia (OR = 1.94; 95% CI: 1.28–2.95), hypertriglyceridemia (OR = 1.66; 95% CI: 1.29–2.12), and hypo‑HDL (OR = 1.86; 95% CI: 1.41–2.43). The nonlinear dose–response relationship was associated with a significant increase then decrease in the risk of dyslipidemia, hypertriglyceridemia, and hypo‑HDL in men and women as per 1 kg/m2 increase in BMI. Conclusions: With regards to the result, we know that there is no linear relationship between lipid profiles and BMI, the bell‑shape association between dyslipidemia, hypertriglyceridemia, and hypo‑HDL needs to be further investigated in both diabetic and general population in men and women separately. In addition, for public health section, an appropriate intervention is of most important priorities.

Keywords


Body mass index; diabetic; dyslipidemias; lipids

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References


Uttra KM, Devrajani BR, Ali Shah SZ, Devrajani T, Das T,

Raza S. Lipid profile of patients with diabetes mellitus

(A multidisciplinary study). World Appl Sci J 2011;12:1382‑4.

Wu Z, Yao C, Zhao D, Wu G, Wang W, Liu J. Cardiovascular

disease risk factor levels and their relations to CVD rates in

China – Results of Sino‑MONICA project. Eur J Cardiovasc

Prev Rehabil 2004;11:275‑83.

Dixit AK, Dey R, Suresh A, Chaudhuri S, Panda AK, Mitra A,

et al. The prevalence of dyslipidemia in patients with diabetes

mellitus of ayurveda Hospital. J Diabetes Metab Disord

;13:58.

(NCEP) NCEP. Third report of the national cholesterol education

program (NCEP) expert panel on detection, evaluation, and

treatment of high blood cholesterol in adults (Adult treatment

panel III) final report. Circulation 2002;106:3143‑421.

Tabatabaei‑Malazy O, Qorbani M, Samavat T, Sharifi F, Larijani B,

Fakhrzadeh H. Prevalence of dyslipidemia in Iran: A systematic

review and meta‑analysis study. Int J Prev Med 2014;5:373‑93.

Chinyere O, Sola AO. Dyslipidemia and its relationship with

different anthropometric measures in Nigerian adults. IOSR J

Dent Med Sci 2013;9:7‑12.

Sarfraz M, Sajid S, Ashraf MA. Prevalence and pattern of

dyslipidemia in hyperglycemic patients and its associated factors

among the Pakistani population. Saudi J Biol Sci 2016;23:761‑6.

Klop B, Elte JW, Cabezas MC. Dyslipidemia in obesity:

Mechanisms and potential targets. Nutrients 2013;5:1218‑40.

Flock MR, Green MH, Kris‑Etherton PM. Effects of adiposity

on plasma lipid response to reductions in dietary saturated fatty

acids and cholesterol. Adv Nutr 2011;2:261‑74.

Klop B, Jukema JW, Rabelink TJ, Castro Cabezas M.

A physician’s guide for the management of hypertriglyceridemia:

The etiology of hypertriglyceridemia determines treatment

strategy. Panminerva Med 2012;54:91‑103.

Sheth J, Shah A, Sheth F, Trivedi S, Nabar N, Shah N, et al.

The association of dyslipidemia and obesity with glycated

hemoglobin. Clin Diabetes Endocrinol 2015;1:6.

Regmi P, Gyawali P, Shrestha R, Sigdel M, Mehta K, Majhi S.

Pattern of dyslipidemia in type‑2 diabetic subjects in Eastern

Nepal. J Nepal Assoc Med Lab Sci 2009;10:11‑3.

Ghayour‑Mobarhan M, Kazemi‑Bajestani S, Ferns G. Lipid

clinics are urgently required in the Iranian public health system.

Int J Prev Med 2010;1:172‑5.

World Health Organization. Obesity: Preventing and Managing

the Global Epidemic, Report of a WHO Consultation (WHO

Technical Report Series 894);2000.

Available from: http://embargo.vizhub.healthdata.org/

collaborators/gbd‑compare/. [Last accessed on 2018 Apr 27].

Bekele S, Yohannes T, Eshete Mohammed A. Dyslipidemia and

associated factors among diabetic patients attending Durame

General Hospital in Southern Nations, Nationalities, and People’s

region. Diabetes Metab Syndr Obes 2017;10:265‑71.

Rao W, Su Y, Yang G, Ma Y, Liu R, Zhang S, et al.

Cross‑sectional associations between body mass index and

hyperlipidemia among adults in Northeastern China. Int J Environ

Res Public Health 2016;13. doi: 10.3390/ijerph13050516.

VinodMahato R, Gyawali P, Raut PP, Regmi P, Singh KP,

Pandeya DR, et al. Association between glycaemic control

and serum lipid profile in type 2 diabetic patients: Glycated

haemoglobin as a dual biomarker. Biomed Res India

;22:375‑80.

Prabhavathi K, Selvi KT, Poornima KN, Sarvanan A. Role

of biological sex in normal cardiac function and in its disease

outcome ‑ A review. J Clin Diagn Res 2014;8:BE01‑4.

Amundson DE, Djurkovic S, Matwiyoff GN. The obesity

paradox. Crit Care Clin 2010;26:583‑96.

Hainer V, Aldhoon‑Hainerova I. Obesity paradox does exist.

Diabetes Care 2013;36:S276‑81.

Hashemi Nazari SS, Shakiba M, Khalili D, Hadaegh F, Tohidi M,

Azizi F. High‑density lipoprotein cholesterol, a protective or a

risk factor for developing coronary heart disease? Tehran lipid

and glucose study. J Clin Lipidol 2015;9:553‑8.