Blood Sugar, Lipid Profile And Thier Correlation: A Pilot Study In Puducherry S. JAGAN AROKIARAJ

Transcription

1 Blood Sugar, Lipid Profile And Thier Correlation: A Pilot Study In Puducherry S. JAGAN AROKIARAJ 1 Department of Anatomy, JIPMER, Puducherry Abstract The present investigation was conducted to evaluate the effect of age and sex on blood sugar and lipid profile of 300 patients viz., 157 males and 143 females presented to peripheral diagnostic centre in Puducherry. In addition correlation was also studied between blood sugar levels and different lipid profiles. The patients were classified in to three age groups viz., (106), (155) and (39) years. The serum samples were analyzed for total cholesterol(tc), triglycerides(tg), high density lipoproteins (HDL), low density lipoproteins (LDL), very high density lipoproteins (VLDL). The results of the statistical analysis revealed that there was a significant difference in the fasting as well as the post-prandial blood sugar levels within different age groups with higher values being observed in years age followed by years and least value being observed in younger age group. However, there was no significant difference in the lipid profile between different age groups. The results of effect of sex revealed that there was a highly significant difference in triglycerides and VLDL with higher values being observed in males compared to female patients, whereas no significant difference was observed in other parameters. The correlation study revealed that a strong correlation existed between post-prandial blood sugar level with Triglycerides and a highly significant correlation was established between total cholesterol, triglycerides, LDL, VLDL. Hence, the results clearly suggest that lipid profile is directly influenced by the blood sugar levels and hence evaluation of lipid profile in diabetic patients will help prevent dyslipidemia and thereby incidence of coronary heart diseases. Key words: Blood sugar, Diabetes, Triglycerides, LDL, VLDL, Correlation. I. Introduction Diabetes mellitus is a group of metabolic disease characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both [1]. One of the biggest health problems of this century, which is also the major risk factors in patients with diabetes, is the prevalence of obesity. Nowadays, 1.1 billion adults worldwide have excessive body fat and 313 million of them are obese. Several studies have reported the prevalence of abdominal obesity in people with diabetes. Diabetic individuals are more prone to dyslipidemia as compared to normal individuals, therefore, the chance of mortality and morbidity is high in diabetic individuals[2]. Type 2 diabetes is associated with a cluster of interrelated plasma lipid and lipoprotein abnormalities [3]. The lipoprotein abnormalities commonly present in type 2 diabetes include an abnormally high level of triglycerides (TG), a high proportion of small dense low density lipoprotein cholesterol (LDL), low high density lipoprotein cholesterol (HDL), and postprandial lipemia [4]. Prevalence of diabetes and pre-diabetes in India in 2011 was 62.4 and 77.2 million respectively [5]. Several authors have indicated the importance of blood sugar and lipid profile in relation to age as well as sex of the individual patients. Detection of diabetes related lipid abnormalities at an early stage will reduce the risk for cardiovascular and cerebrovascular diseases. Hence, the present study was undertaken to evaluate the effect of age and sex on blood sugar and lipid profile and to investigate the correlation between different lipid profile and sugar levels All rights Reserved Page 140

2 human patients. The study analyzes the pattern of risk factor like blood sugar and lipid profiles and non-modifiable risk factors like age and gender. II. MATERIALS AND METHODS The present study was conducted at Peripheral diagnostic center in Puducherry. A total of 300 patients consisting of 157 males and 143 females of different age groups were used in this study. All the patients were informed about the study and consent was obtained. The patients were then categorized into three different age groups viz., years (n=106), years (n=155) and years (n=39) to study the influence of age on various blood profiles. 2.1 Collection of blood and isolation of serum: Blood samples were drawn from cubital vein after 10 hours of overnight fasting in both fasting as well as post-prandial state from all individuals in morning using disposable syringes and then shifted in properly labeled vacutainer tubes. Blood samples were then centrifuged at 2000 rpm for 10 min at 4 C to isolate serum. The Sera samples were aliquoted and stored at 20 C for future analysis. 2.2 Estimation of biochemical parameters: All the biochemical analysis was performed in Peripheral diagnostic center (ISO accredited laboratory) Puducherry. The Fasting blood sugar, total cholestrol (TC), Triglycerides (TG), High Density Lipoproteins (HDL) were estimated using enzymatic methods in automated CPC analyzer. The Low density lipoproteins (LDL), was calculated using Friedwall formula and VLDL based on TG/5. TC/HDL and LDL/HDL ratios were also calculated. Prior to analysis the CPC analyzer was calibrated with normal and abnormal calibrators and control. 2.3 Statistical analysis: The statistical analysis of data was performed using SPSS software version 12.0 for windows 11. The data was analyzed using One Way Analysis of variance (ANOVA) and all data are expressed as a mean ± SE of the mean (SEM). Pearson correlation coefficient was carried out to determine the correlation between different parameters. III. RESULTS AND DISCUSSION The effect of age on different blood and serum parameters are presented in Table 1. Fasting blood sugar is generally used as one of the cheapest diagnostic biomarker to separate diabetic from non-diabetic subjects. In the present study the effect of age on blood sugar levels as well as lipid profile were evaluated and the results revealed that a significant (P < 0.05) difference was observed in both fasting as well as post-prandial blood sugar levels in different age groups. It was evident that the blood sugar levels were higher with increase in the age with higher levels in age group years as compared to other age groups. The results of our study are in agreement with the findings of several researchers who have opined that age is one of the major factor that influences blood sugar levels in human [6,7, 8]. The results were in contrary to the findings of Ali et al [9] who observed that age did not influence the fating blood glucose level. Results of the lipid profile did not reveal any significant difference in lipid profile between different age groups, whereas numerically higher values were recorded for total cholesterol, triglycerides, LDL and VLDL in age group years. This could possibly be attributed to eating habits and western lifestyle of young Indian population. However, contrary to the finding of our study it was observed that among the three age groups viz., yrs yrs yrs, levels of all the lipid constituents were high in year age group in both males and females All rights Reserved Page 141

3 The mean ± SE of blood sugar and lipid profile of male and female patients are presented in Table 2. The results of the study clearly indicated that sex did not have any significant influence on both fasting as well as post-prandial blood sugar levels. The results were consistent with the findings of [9,10] who indicated no effect of sex on blood sugar parameters. However, there was a highly significant (P < 0.01) difference in triglycerides as well as VLDL in males and females with higher values being observed in males compared to females. Similarly, several epidemiological studies have found a sex difference in lipoprotein distribution [11]. Results of the correlation of various parameters are presented in Table 3. The correlation results indicates that no correlation could be noticed between fasting blood sugar and other lipid profiles, whereas correlation was observed between post-prandial and triglyceride levels. Between the various lipid profiles a high correlation existed between total cholesterol, TG, LDL and VLDL, indicating that these parameters have a strong correlation. By correlating the effect of age and gender on lipid profile in these patients, it may be concluded that in old age, persons with high sugar levels are more prone to dyslipidemia as compared to other age groups. Similar correlation between blood sugar and lipid profile have been established by several researchers [12,13]. The results of our study indicated that lipid profile is directly influenced by the blood sugar levels and hence evaluation of lipid profile in diabetic patients will help prevent dyslipidemia and thereby incidence of coronary heart diseases. BIBLIOGRAPHY [1] American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care. 28: [2] Pathak, R. and Pathak, A Study of life style habits on risk of type 2 diabetes. Int J Appl Basic Med Res. 2: [3] Haffner, S.M Lipoprotein disorders associated with type 2 diabetes mellitus and insulin resistance. Am J Cardiol 90: [4] Goldberg, I.J Clinical review 124: Diabetic dyslipidemia: causes and consequences. J Clin Endocrinol Metab. 86: [5] Anjana, R.M.; Pradeepa, R. and Deepa, M ICMR INDIAB Collaborative Study Group. Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: phase I results of the Indian Council of Medical Research-INdiaDIABetes (ICMRINDIAB) study. Diabetologia. 54: [6] Oyama N, Gona P, Salton CJ. Differential impact of age, sex, and hypertension on aortic atherosclerosis: the Framingham Heart Study. Arterioscler Thromb Vasc Biol 2008; 28: [7] Sadikot,S.M.; Nigam, A.; Das, S.; Bajaj, S.; Zargar, A.H. and Prasannakumar, K.M The burden of diabetes and impaired fasting glucose in India using the ADA 1997 criteria: prevalence of diabetes in India study (PODIS). Diabetes Res Clin Pract. 66(3): [8] Kutty, V.R.; Soman, C.R.; Joseph, A.; Kumar. K.V. and Pisharody, R Random capillary blood sugar and coronary risk factors in a south Kerala population. J Cardiovasc Risk. 9: [9] Ali, F.; Jamil, H.; Anwar, S.S. and Wajid, N Characterization of lipid parameters in diabetic and non-diabetic atherosclerotic patients. Journal of Geriatric Cardiology. 12: [10] Ghazanfari, Z.; Haghdoost, A.A. and Alizadeh, S.M A Comparison of HbA1c and Fasting Blood Sugar Tests in General Population. Int J Prev Med. 1: [11] Barr, D.R.; Russ, E.M. and Eder, H.A Protein-lipid relationships in human plasma. Am J Med. 11: [12] Vijayaraghavan, K Treatment of dyslipidemia in patients with type 2 diabetes. Lipids Health Dis. 9: 144. [13] Khan, H.A.; Sobki, S.H. and Khan, S.A Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts dyslipidaemia. Clin Exp Med 7: Table 1. Mean ± SE of blood sugar and lipid profile of patients in different age group Parameter Age group F- Value years years years (n=106) (n=155) (n=39) Fasting Blood sugar a ± b ± b ± * PP Blood sugar a ± b ± b ± * Total Cholesterol ± ± ± All rights Reserved Page 142

4 Triglycerides ± ± ± NS HDL ± ± ± NS LDL ± ± ± NS VLDL ± ± ± NS TC/ HDL 3.87 ± ± ± NS LDL/HDL 2.29 ± ± ± NS * Significant (P 0.05), NS- Non-significant, means bearing different superscript within rows differ significantly Table 2. Mean ± SE of blood sugar and lipid profile of patients based on sex Parameter Age group F- Value Male (n=157) Female (n=143) Fasting Blood sugar ± ± NS PP Blood sugar ± ± NS Total Cholesterol ± ± NS Triglycerides ± ± ** HDL ± ± NS LDL ± ± NS VLDL ± ± ** TC/ HDL 3.67 ± ± NS LDL/HDL 2.12 ± ± NS ** Highly Significant (P 0.01), NS- Non-significant, means bearing different superscript within rows differ All rights Reserved Page 143

5 Table 3: Correlation between blood sugar and different lipid profile parameters FBS PP TC TG HDL LDL VLDL TC:HDL LDL:HDL FBS Pearson Correlation Sig. (2-tailed) PP Pearson Correlation Sig. (2-tailed) TC Pearson Correlation Sig. (2-tailed) TG Pearson Correlation Sig. (2-tailed) HD Pearson Correlation Sig. (2-tailed) LDL Pearson Correlation Sig. (2-tailed) VLDL Pearson Correlation Sig. (2-tailed) TC:HDL Pearson Correlation Sig. (2-tailed) LDL:HDL Pearson Correlation Sig. (2-tailed) **. Correlation is significant at the 0.01 level (2-tailed). *. Correlation is significant at the 0.05 level All rights Reserved Page 144