Role of glycated hemoglobin (HBA1c) as a dual marker to predict glycemic status and dyslipidemia in type II diabetes mellitus

Abstract

INTRODUCTIONDiabetes is a global endemic with rapidly increasing prevalence in both developed and developing countries. 1 DM is a group of metabolic disease characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. Uncontrolled diabetic patients are characterized by hyperglycemia, hyper insulinemia, protein glycation and oxidative stress which cause early appearance of diabetic complications.The chronic hyperglycemia is associated with long-term damage dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart and blood ABSTRACT Background: Type 2 diabetes mellitus (DM) is an endocrinological disease associated with hyperglycemia characterized by both insulin resistance and defective insulin secretion. Glycated hemoglobin (HbA1c) is a routinely used marker for long-term glycemic control. This study is aimed at investigating the relationship between glycemic control and serum lipid profile and to evaluate the role of glycated haemoglobin as an independent risk factor for cardiovascular diseases in patients with type-2 diabetes and to evaluate the diagnostic value of glycated hemoglobin (HbA1c) in predicting diabetic dyslipidemia as a marker of circulating lipids. The aim of the present study was to estimate glycated hemoglobin and lipid profile in patients with type 2 DM and compare it with controls (healthy subjects). The association of glycated hemoglobin with lipid profile evaluated. Methods: This study was conducted in 150 subjects, out of whom 75 were type 2 diabetes mellitus patients (cases) and 75 were non diabetic healthy subjects (controls).The sera were analyzed for HbA1c, fasting blood glucose (FBG), total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL). Results: A significantly increased level of glycated hemoglobin (HbA1c) is observed in cases compared to control. HbA1c showed direct and significant correlations with cholesterol, triglycerides and LDL and inverse correlation with HDL in cases when compared to controls. Our study also revealed a significant positive correlation between lipid profile and glycated hemoglobin. Conclusions: These findings clearly suggest that HbA1c can provide valuable supplementary information about the extent of circulating lipids besides its primary role in monitoring long-term glycemic control. Further studies are warranted to reinforce the potential of HbA1c as a biomarker for screening of high-risk diabetic patients.

Correlation between glycemic control markers and lipid profile in type 2 diabetes mellitus and impaired glucose tolerance

“…[30][31][32] HbA1c also demonstrated direct and significant correlations with cholesterol (r=0.6445), TGL (r= 0.5426), LDL-C(r=0.3584), VLDL (r=0.2245) -a strong positive correlation; whereas HDL-C showed negative correlation (r=-0.4965). 9 Jayesh et al conducted a prospective study on western Indian population that comprised of 430 T2DM patients and 501 non-diabetic control subjects. 33 Sultania et al found significant correlation of HbA1c with TC and LDL.…”

“…7,8 Diabetes mellitus (DM) is a common secondary cause of hyperlipidemia, particularly, if glycaemic control is poor. 9 Based on the American diabetic association (ADA) abnormal lipid profiles are when total cholesterol level ≥200 mg/dl, triglyceride level is ≥150 mg/dl, HDL level is <40 mg/dl in males and <50 mg/dl in females, LDL level is ≥100 mg/dl. Hence dyslipidemia was defined as the presence of one or more of the above-mentioned abnormalities in serum lipids.…”

“…15 Fasting blood glucose (FBG), post prandial blood glucose (PPBG) and glycated hemoglobin (HbA1c) are most widely used as glycemic control markers. HbA1c is used as biomarker of glycemic control over a preceding [8][9][10][11][12] weeks. It is used as an indicator for the state of glycemic control, progression of the disease and development of complications in diabetic patients.…”

“…20 Many studies have compared and correlated FBG, PPBG and HbA1c with lipid profile in T2DM patients. 9,[21][22][23]. But very few studies are done in IGT in this regard.…”

Antioxidant status and hepato-protective role of Anchomanes difformis in streptozotocin-induced diabetes in male Wistar rats

“…Increase in the serum levels of the hepatic enzymes may lead to reduced concentrations of total protein (TP) and albumin in the serum [7]. Poor glycaemic control during diabetes mellitus causes hyperlipidaemia, which is associated with an increased flux of free fatty acid due to insulin resistance [8,9].…”