PATTERN OF DYSLIPIDAEMIA AND ITS ASSOCIATION WITH HYPOVITAMINOSIS D IN TYPE 2 DIABETES MELLITUS

Authors

  • Farhat Bashir United Medical & Dental College, Karachi.
  • Zia Ullah Khan
  • Naresh Kumar Seetlani
  • Zaman Sheikh

Abstract

Background: Macrovascular atherosclerosis is an important long-term complication of type 2 diabetes mellitus. Concurrent dyslipidaemia acts as an additional risk factor for these complications. Hypovitaminosis D has been associated with adverse cardiovascular events. These modifiable risk factors of cardiovascular disease are inter-related. In the presence of an increasing incidence of type 2 diabetes mellitus and its associated metabolic abnormalities and widespread vitamin D deficiency in Pakistan, this association needs to be investigated. The purpose of our study was to determine the pattern of dyslipidaemia and its association with low vitamin D levels in South Asian diabetics. Methods: The study was designed as a quantitative cross-sectional study. It was conducted at the Department of Medicine, Sir Syed College of Medical Sciences and Hospital, Karachi from January to June 2014. A total of 168 adult consecutive patients with type 2 diabetes mellitus of both the genders were included. Data was collected and analysed using SPSS-20.0. The association of dyslipidaemia with vitamin D status was computed through Chi-square test. Results:  We found that dyslipidaemia is highly prevalent in patients with type 2 diabetes mellitus in Pakistan. High total cholesterol, LDL cholesterol and triglycerides show significant association with vitamin D deficiency. Conclusion: In order to decrease the development of diabetic complications aggressive management of hyperglycaemia and dyslipidaemia is required. Vitamin D supplementation may play a dual role in these situations.Keywords: Dyslipidaemia; Type 2 diabetes mellitus; Vitamin D; Hypovitaminosis D

Author Biography

Farhat Bashir, United Medical & Dental College, Karachi.

Associate Professor, Department of Medicine.

References

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380(9859):2095–128.

Roth GA, Forouzanfar MH, Moran AE, Barber R, Nguyen G, Feigin VL, et el. Demographic and Epidemiologic Drivers of Global Cardiovascular Mortality. N Engl J Med 2015;372(14):1333–41.

Alexander CM, Landsman PB, Teutsch SM, Haffner SM. NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES III participants age 50 years and older. Diabetes 2003;52(5):1210–4.

Ginsberg HN. Identification and treatment of hypertriglyceridemia as a risk factor for coronary heart disease. Curr Cardiol Rep 1999;1(3):233–7.

Karhapää P, Pihlajamäki J, Pörsti I, Kastarinen M, Mustonen J, Nuemela O, et al. Diverse associations of 25-hydroxyvitamin D and 1,25-dihydroxy-vitamin D with dyslipidaemias. J Intern Med 2010;268(6):604–10.

Auwerx J, Bouillon R, Kesteloot H. Relation between 25-hydroxyvitamin D3, apolipoprotein A-I, and high density lipoprotein cholesterol. Arterioscler Thromb 1992;12(6):671–4.

Hollick MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266–81.

Lips P. Vitamin D deficiency and secondary hyperparathyroidismin the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 2001;22(4):477–501.

Harinarayan CV, Joshi SR. Vitamin D status in India—its implications and remedial measures. J Assoc Physicians India 2009;57:40–8.

Islam MZ, Akhtaruzzaman M, Lamberg-Allardt C. Hypovitaminosis D is common in both veiled and nonveiled Bangladeshi women. Asia Pac J Clin Nutr 2006;15(1):81–7.

Pittas AG, Dawson-Hughes B, Li T, Van Dam RM, Willett WC, Manson JE, et al. Vitamin D and calcium intake in relation to type 2 diabetes in women. Diabetes Care 2006;29(3):650–6.

Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 2007;167(11):1159–65.

Nakhjavani M, Esteghamati AR, Esfahanian F, Heshmat AR. Dyslipidaemia in type 2 diabetes mellitus. Acta Med Iran 2006;44(2):111–8.

Gilani SY, Bibi S, Ahmed N, Shah SR. Gender differences of dyslipidaemia in type 2 diabetics. J Ayub Med Coll Abbottabad 2010;22(3):146–8.

Mooradian AD. Dyslipidaemia in type II diabetes mellitus. Nat Clin Pract Endocr Metab 2009;5(3):150–9.

Eckel RH. Diabetic Dyslipidaemia and Cardiovascular Risk. Curr Diab Rep 2008;8(6):421–3.

Khattab M, Khader YS, Al-Khawaldeh A, Ajlouni K. Factors associated with poor glycemic control among patients with type 2 diabetes. J Diabetes Complications 2010;24(2):84–9.

Khurram M, Gul H, Rahman F, Khar HTB, Faheem M. Lipid Abnormalities in Patients with Type 2 Diabetes. J Rawalpindi Med Coll 2013;17(2):167–8.

Pittas AG, Lau J, Hu FB, Dawson-Hughes B. The role of vitamin Dand calcium in type 2 diabetes. A systematic review and meta-analysis. J Clin Endocrinol Metab 2007;92(6):2017–29.

Chaudhuri JR, Mridula KR, Anamika A, Boddu DB, Misra PK, Lingaiah A, et al. Deficiency of 25-Hydroxyvitamin D and Dyslipidemia in Indian Subjects. J Lipids 2013;2013:623420.

Cigolini M, Iagulli MP, Miconi V, Galiotto M, Lombardi S, Targher G. Serum 25-hydroxyvitamin D3 concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diabetes Care 2006;29(3):722–4.

Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117(4):503–11.

Published

2017-10-15