<p>Dyslipidemia in diabetes: a population-based study in Bali</p>

Abstract

Purpose To establish the lipid pattern in subjects with diabetes mellitus (DM) and factors that are correlated with insulin resistance and lipid disorders in a population of Bali. Methods A cross-sectional population-based study which enrolled 1840 subjects (age 13–100 years) from 7 villages was carried out. Several clinical parameters were measured including age, gender, body mass index, waist circumference (WC), fasting blood glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein (apo) A (apoA), apoB, non-HDL-C, T/HDL-C ratio, LDL-C/apoB ratio, apoB/A ratio, plasma insulin, and homeostasis of model assessment-insulin resistance (HOMA-IR). Results TC, TG, and non-HDL-C levels were higher in DM subjects than in normal glucose tolerance (NGT) subjects in both genders; total/HDL-C ratio was higher in subjects with DM than in NGT subjects only in men; LDL-C levels, apoB levels, and apoB/A ratios were higher and LDL/apoB was lower in subjects with DM than in NGT in women. In subjects with DM, the target for LDL-C (79%), non-HDL-C (85.2%), apoB (80%), HDL-C (34.9%), TG (46.7%), and small-dense low density lipoprotein (42.2%) was not achieved. Conclusion FBG was correlated with TC, TG, LDL-C, apoB, non-HDL-C levels, LDL/apoB, and apoB/apoA ratios. Subjects with DM had higher levels of TC, TG, and non-HDL-C levels in both genders; T/HDL-C ratio only in men; LDL-C, apoB/apoA ratio and lower LDL/apoB ratio only in women. Obesity was correlated with lipid levels. WC was correlated with LDL/apoB ratio, insulin level, HOMA-IR, and TG; highest absolute strength of correlation was with LDL/apoB ratio. Insulin resistance was correlated with lipid levels or ratios, especially in women. In women, HOMA-IR had a positive correlation with total/HDL-C ratio, non-HDL-C, apoB, and a negative correlation with HDL-C levels.

Hypertriglyceridemia and Other Plasma Lipid Profile Abnormalities among People Living with Diabetes Mellitus in Ethiopia: A Systematic Review and Meta-Analysis

“…The pooled prevalence of high LDL-C was 41.13%, which is akin to an evidence in the United States (53%) [ 66 ]. However, LDL-C in our study is lower than other studies in Thailand (56.54%) [ 28 ], Tanzania (72.3%) [ 57 ], India (57.3%) [ 58 ], Brazil (79%) [ 64 ], Yemen (67.5%) [ 65 ], and Jordan (91.5%) [ 59 ]. The reason for the lower estimated high LDL-C in our review could be due to variations in sample size and scope of the study.…”

“…Finally, we estimated the prevalence of abnormally low HDL-C (44.36%) among people living with DM which is in line with other nation-wide studies in Saudi Arabia (40%) [67], Korea (41.2%) [69], and China (40.8%) [68] and local studies in India (35.7%) [58] and Brazil (34.9%) [64]. The estimate of low HDL-C is higher than studies in the United States (23%) [66] and Yemen (25.5%) [65].…”

“…This higher percentage could be related with the defects of insulin action [60,61], in that low insulin or insulin resistance leads to reduced fatty acid mobilization into cells and increases lipolysis, both of which contributed to high plasma lipid levels [62]. Other studies in in Thailand (49.94%) [28], Botswana (38.9%) [63], Tanzania (53.8%) [57], India (56.1%) [58], Brazil (46.7%) [64], and Yemen (39.2%) [65] also reported similar findings. However, the pooled prevalence of 8 BioMed Research International hypertriglyceridemia, in this study, is lower than a finding of the local study in Jordan (83.1%) [59].…”

Transcription factor 7-like 2 single nucleotide polymorphisms rs290487 and rs290481 are associated with dyslipidemia in the Balinese population

“…Due to westernization and urbanization in the past three decades, the Balinese population has undergone lifestyle changes that raised the prevalence of metabolic syndrome (MetS) and metabolic disorders, such as obesity and diabetes mellitus (DM). These traits are known to be closely associated with dyslipidemia through insulin resistance ( Athyros et al, 2011 ; Suastika et al, 2011 , 2019 ), which also increase the Balinese’s risk for dyslipidemia. A cross-sectional survey study carried out in Bali Island had reported the frequency of dyslipidemia in normal glucose tolerance subject group as follows, high LDL-C (73.8%), high non-HDL-C (53.9%), low HDL-C (31.3%), and high TG (20.4%).…”

“…A cross-sectional survey study carried out in Bali Island had reported the frequency of dyslipidemia in normal glucose tolerance subject group as follows, high LDL-C (73.8%), high non-HDL-C (53.9%), low HDL-C (31.3%), and high TG (20.4%). Meanwhile, both impaired fasting glycemia (IFG) and DM subject groups had relative higher percentage in all parameters, showing a positive correlation between glucose impairment with dyslipidemia ( Suastika et al, 2019 ).…”