Lipid Profile and Coronary Heart Disease Risk in Adult Diabetic Patients in Soba University Hospital (July - December 2009)

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Background:Diabetes mellitus is one of the main threats to human health in the twenty first centuryin Sudan and worldwide. Uncontrolled diabetes mellitus will be complicated bydyslipidemia which leads to serious cardiovascular events increasing diabetesmorbidity and mortality. Coronary heart disease is the number one cause of deathamong diabetics. Despite all these facts, no study assessing coronary heart disease riskin diabetics has been conducted in Sudan up to date.Design:Prospective hospital based cross-sectional study.Setting:Diabetes outpatient clinic in Soba University Hospital during the period from July toDecember 2009.Objectives:This study is conducted to determine the lipid profile patterns in adult diabeticpatients in Soba University Hospital and to calculate the estimated coronary heartdisease risk using Framingham scoring system.Methods:This study included 80 adult diabetic patients. Diabetic patients with other causes ofdyslipidemia were excluded from the study. Eligible patients were consented, datawere collected by detailed questionnaire and two blood samples were collected fromeach patient. The fasting lipid profile (triglyceride, total cholesterol, LDL-cholesteroland HDL-cholesterol), fasting blood glucose and the 2 hours postprandial bloodglucose were measured by the auto-analyzer COBAS INTEGRA 400 plus (ROCHE).Then, for each patient we used some of the lipid profile parameters (total cholesterol,LDL-cholesterol and HDL-cholesterol) together with other Coronary heart diseaserisk predictors like age, smoking, blood pressure values to calculate the Coronaryheart disease risk in the following 10 years using the Framingham scoring system.The data were analyzed using the MATLAB and the SPSS programs.Results:It was found that 53% of the studied cases had diabetes mellitus chroniccomplications. Evidence of ischemic cardiac disease was found in 21% of the cases,mainly in type 2 patients. Hypertension was found in 29% of the cases. The studiedcases showed increased body mass index, the mean was 27 kg/m2 which representsoverweight (SD 3.99). Obesity and overweight were found in 70% of the cases mostlyoccurring in type 2 patients. The short-term glycemic control was poor in 65% of thecases. All these markedly contributed to the poorer diabetes mellitus control, thedyslipidemia and the higher coronary heart disease risk. The lipid profile testing wasrequested only in 27.5% of the cases, reflecting the decreased awareness about theimportance of dyslipidemia in diabetics among the medical staff who used to takecare of them. The lipid profile of the studied cases was interpreted according to theNational Cholesterol Education Program (NCEP) guidelines. It showed .hypertriglyceridemiain 36%, hypercholesterolemia in 31%, decreased HDL-cholesterol tolevels conferring increased coronary heart disease risk in 95% and increased LDLcholesterolin 77% of the studied cases. Both type 1 and 2 diabetics had mean lipidprofile values showing borderline high LDL, moderate risk HDL, normal triglyceride.The mean total cholesterol was borderline high in type 1 and desirable in type 2patients. The lipid profile of type 1 patients is worse than that of type 2 in respect tothe degree & the number of patients having the dyslipidemia. It further worsenedsignificantly with prolonged disease duration,(P < 0.05 ). The mean estimatedcoronary heart disease risk in the next 10 years was 14%, which was calculated usingthe Framingham scoring system. This is high in comparison with low risk individuals(person the same age, optimal blood pressure, LDL-C 100-129mg/dl or cholesterol160-199 mg/dl, HDL-C 45 mg/dl for men or 55 mg/dl for women, non-smoker, nodiabetes) in whom the risk was 6%.Conclusion:According to our knowledge, it is the first time such a study is done in Sudanestimating the coronary heart disease risk in diabetics using the Framingham scoringsystem. The studied cases showed dyslipidemia in the form of: decreased HDLcholesterol,increased LDL-cholesterol, hypertriglyceridemia and hypercholesterolemia(in decreasing order of frequency).The lipid profile in type 1 patients was worsethan type 2. The estimated coronary heart disease risk in the next 10 years was foundto be remarkably high in the studied cases. These alarming findings should drawattention of health policy makers to increase the awareness about the importance oflipid profile testing in diabetics, implement coronary heart disease risk calculation andadopt a more efficient multidisciplinary team approach in diabetes management.

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رقم الوثيقة

fab62558-61b3-4e1f-879b-fd69e69437db

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0

نوع الوسائط

Crawler

نوع المحتوى

الرسائل العلمية

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رسائل ماجيستير

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pdf text

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1638192_1.pdf

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ألقاب المؤلفين

[{"name_ar":"Abd Elhafiz Khattab","title_ar":"اشراف","title_en":"Supervision"},{"name_ar":"Lina Gafar Ahmed Elnourani Elzubair","title_ar":"اعداد","title_en":"Preparation"}]

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English

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اسم المصدر

Lipid Profile and Coronary Heart Disease Risk in Adult Diabetic Patients in Soba University Hospital (July - December 2009)

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عدد الصفحات

0

إشراف وإعداد

الإشراف

Abd Elhafiz Khattab

الإعداد

Lina Gafar Ahmed Elnourani Elzubair

الاقتباسات الببليوغرافية