Atherogenic risk pattern among Nigerian hypertensive and diabetic patients undergoing follow-up visit in a tertiary hospital

Abstract

Objectives: Cardiovascular risk can be predicted using lipid ratios such as the atherogenic index which is defined as the base 10 logarithm of the ratio of plasma triglyceride (TG) to high density lipoprotein cholesterol (HDL-C)-it is a useful prognostic parameter for guiding timely interventions and has also been employed as a predictor of cardiovascular risk. However, this is rarely used in the clinical practice in developing countries including Nigeria. Methods: This study was a hospital-based cross-sectional study of 382 hypertensive and diabetic patients attending outpatient clinics of a tertiary hospital in Nigeria. Atherogenic risk profile, was categorized as low risk (<0.1), intermediate risk (0.1-0.24), and high risk (>0.24). Predictors were established using regression analysis. Level of significance was set at p-value of <0.05 and 95% confidence interval. Results: The mean age of participants was 56±12 years, 31.4% of participants had high atherogenic risk. This was higher among female patients (60.0%). Participants with high TC, high LDL, uncontrolled blood pressure had odds of 1.64, 1.43 and 1.17 times of developing high atherogenic risk respectively. Conclusion: A significant proportion of participants in this study population were at risk of developing atherosclerosis. Key identified populations at risk of CVD should be considered for routine artherogenic assessment.

Atherogenic index of plasma and its cardiovascular risk factor correlates among patients with type 2 diabetes in Uganda

“…Contrary to other studies 12 , 17 , 23 , we didn't show a significant relationship between AIP and LDL despite 78.4% of the study participants having elevated LDL probably the two measures assess different abnormalities in an individual. Whereas the importance of LDL cholesterol in the development of atherosclerosis is well documented, and it being the principal target for prevention of CHD, the heterogeneity of the LDL particles has been recently elucidated 24 Different forms of LDL that include small dense LDL particles and oxidized LDL have been described and these constitute the kinetic abnormalities of LDL other than the quantitative abnormality that is routinely assessed by the usual lipid profile.…”

“…Our findings are consistent with a study done in Nigeria by Bolarinwa et al that found a high AIP in 31.4% of diabetic and hypertensive patients attending a tertiary hospital 17 . This study is similar to ours in that they were both cross-sectional hospital-based studies with similar patients studied.…”

“…Consistent with earlier studies 12 , 17 , 21 – 23 , AIP positively and significantly correlated with waist circumference and waist-hip ratio. We didn't not show significant relationship between AIP and BMI similar to a study by Steve Raoul Noumegni et al 19 .…”

“…In our study population, more than 50% had diabetic dyslipidaemia characterised by a high LDL (mean 3.502mmol/ l±1.181), high triglyceride (mean 2.078mmol/l±1.24) and low HDL (mean 1.33mmol/l±0.372), this type of dyslipidaemia typical of diabetes is highly atherogenic and is not surprising that 56.4% of our study participants had a high plasma atherogenicity as determined by the AIP. This is in tandem with several other studies 12,17,23,25 .…”

“…In a similar study by Olamoyegun et al, AIP showed no significant difference between sexes in predicting cardiovascular disease risk 15 .. Consistent with earlier studies 12,17,[21][22][23] , AIP positively and significantly correlated with waist circumference and waist-hip ratio. We didn't not show significant relationship between AIP and BMI similar to a study by Steve Raoul Noumegni et al 19 .…”