The Association of Glycated Hemoglobin and Lipid Profile with Peripheral Artery Disease in Metabolic Syndrome Patients from Northwestern Algeria
DOI:
https://doi.org/10.21123/bsj.2024.9366Keywords:
Glycated hemoglobin, lipid profile, lipid ratio, metabolic syndrome, peripheral artery disease.Abstract
Glycated hemoglobin (HbA1c) was incorporated as an indicator of dysglycemia, as opposed to fasting glycaemia, for the purpose of classifying patients based on their vascular incidents. This choice was made due to HbA1c's robust correlation with vascular factors like pulse wave velocity, intima media thickness, and the albumin/creatinine ratio (ACR). However, the relationship between HbA1c and lipid profile in developing artery disease remain uncertain. We set out to investigate the association of HbA1c and lipid profile with peripheral artery diseases (PAD) in patients with metabolic syndrome (MetS) in north-western Algeria. Our cross sectional study was carried out during six months. The BMI was calculated as weight(kg)/height2(m2). Ankle-brachial index (ABI)<0.9 and angiography was used to diagnosed PAD and MetS was defined according NCEP-ATPIII criteria. Statistical test, involving correlations and linear regression, were employed to establish the link between HbA1c, fasting glycemia, lipid profile, and the occurrence of PAD in individuals with MetS. In a sample of 300 MetS patients, 53% were male. Positive associations were observed between HbA1c, fasting blood glucose (FBG) (r=0.753, p<0.001), and triglycerides (TG) (r=0.288, p<0.001), with a negative correlation seen with high-density lipoprotein (HDL) (r= -0.356, p<0.001). HbA1c exhibited no significant correlation with total cholesterol (TC) and low-density lipoprotein (LDL). Lipid ratios (LDL/HDL, TC/HDL, TG/HDL) were positively linked to HbA1c (r=0.232, r=0.332 and r=0.43, respectively). Linear regression affirmed these findings. HbA1c displayed positive ties with FBG and TG, while negatively correlated with HDL, showing independence from LDL and TC. Notably, all three lipid ratios showed significant associations with HbA1c
Received 10/09/2023
Revised 12/12/2023
Accepted 14/12/2023
Published Online First 20/02/2024
References
Ahmed M, Kumari N, Mirgani Z, Saeed A, Ramadan A, Ahmed MH, Almobarak AO. Metabolic syndrome; Definition, Pathogenesis, Elements, and the Effects of medicinal plants on it's elements. J Diabetes MetabDisord. 2022; 21(1): 1011-1022. https://doi.org/10.1007/s40200-021-00965-2.
Retterstøl K, Narverud I, Selmer R, Berge KE, Osnes IV, Ulven SM, et al. Severe hypertriglyceridemia in Norway: prevalence, clinical and genetic characteristics. Lipids Health Dis. 2017; 16(1): 115. https://doi.org/10.1186/s12944-017-0511-9.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25): 3143-3421 https://doi.org/10.1161/circ.106.25.3143.
Dobrowolski P, Prejbisz A, Kuryłowicz A, Baska A, Burchardt P, Chlebus K, et al Metabolic syndrome - a new definition and management guidelines: A joint position paper by the Polish Society of Hypertension, Polish Society for the Treatment of Obesity, Polish Lipid Association, Polish Association for Study of Liver, Polish Society of Family Medicine, Polish Society of Lifestyle Medicine, Division of Prevention and Epidemiology Polish Cardiac Society, "Club 30" Polish Cardiac Society, and Division of Metabolic and Bariatric Surgery Society of Polish Surgeons. Arch Med Sci. 2022; 18(5): 1133-1156. https://doi.org/10.5114/aoms/152921.
Quillard T, Franck G, Mawson T, Folco E, Libby P. Mechanisms of erosion of atherosclerotic plaques. Curr Opin Lipidol. 2017; 28(5): 434-441. https://doi.org/10.1097/MOL.0000000000000440.
Sirignano P, Margheritini C, Ruggiero F, Panzano C, Filippi F, Rizzo L, et al. The Ability to Look Beyond: The Treatment of Peripheral Arterial Disease. J Clin Med. 2023; 12(9): 3073. https://doi.org/10.3390/jcm12093073.
Mohammed A. Correlation between HbA1c and lipid profile in patients with Type 2 diabetes mellitus. Kirkuk J Med Sci. 2023; 11(1): 101-107. https://doi.org/10.32894/kjms.2022.136535.1043.
Naeem M, Khattak RM, Rehman M ur, Khattak MNK. The role of glycated hemoglobin (HbA1c) and serum lipid profile measurements to detect cardiovascular diseases in type 2 diabetic patients. SE Asia J Pub Health. 2016; 5(2):30-34. https://doi.org/10.3329/SEAJPH.V5I2.28310.
Annani-Akollor M E, Laing E F, Osei H, Mensah E, Owiredu E W, Afranie B O et al. Prevalence of metabolic syndrome and the comparison of fasting plasma glucose and HbA1c as the glycemic criterion for MetS definition in non-diabetic population in Ghana. Diabetol Metab Syndr. 2019; 11: 26. https://doi.org/10.1186/s13098-019-0423-0.
Osei K, Rhinesmith S, Gaillard T, Schuster D. Is glycosylated hemoglobinA1c a surrogate for metabolic syndrome in nondiabetic, first degree rela tives of African–American patients with type 2 diabetes? J Clin Endocrinol Metab. 2003; 88(10): 4596–601. https://doi.org/10.1210/jc.2003-030686.
Cavero-Redondo I, Martínez-Vizcaíno V, Álvarez-Bueno C, Agudo-Conde C, Lugones-Sánchez C, García-Ortiz L. Metabolic Syndrome Including Glycated Hemoglobin A1c in Adults: Is It Time to Change? J Clin Med. 2019 Dec 1; 8(12): 2090. https://doi.org/10.3390/jcm8122090.
Van Bortel LM, Laurent S, Boutouyrie P, Chowienczyk P, Cruickshank J K, De Backer T, et al. Expert consensus document on the measurement ofaortic stiffness in daily practice using carotid-femoral pulse wave velocity. JHypertens. 2012; 30: 445–448. https://doi.org/10.1097/HJH.0b013e32834fa8b0.
de Groot E, Hovingh GK, Wiegman A, Duriez P, Smit AJ, Fruchart JC, et al. Measurement of arterial wall thickness as a surrogate marker for atherosclerosis. Circulation. 2004; 109(23 Suppl 1): III33-8. https://doi.org/10.1161/01.CIR.0000131516.65699.ba.
KDIGO. Chapter 1: Definition and classification of CKD. Kidney Int Suppl. 2013; 3: 19–62. https://doi.org/10.1038/kisup.2012.64.
Reng RS, Onwuegbuzie GA, Anumah F. Pattern of serum lipid profile of type 2 diabetes patients in a tertiary hospital in Nigeria. Int J Res Med Sci. 2021. 25; 9(7): 1854-8. https://doi.org/10.18203/2320-6012.ijrms20212501.
Sarkar S, Meshram A. HbA1c and lipid profile levels in the known type 2 diabetic group in the rural region of Vidarbha, Maharashtra, India. J Evid Based Med Health. 2017; 4: 1915–1920. https://doi.org/10.18410/jebmh/2017/374
Genuth S, Eastman R, Kahn R, Klein R, Lachin J, Lebovitz H, et al. Implications of the United kingdom prospective diabetes study. Diabetes Care. 2003; 26 Suppl 1: S28-S32. https://doi.org/10.2337/diacare.26.2007.s28.
Yost M L. The Current US Prevalence of Peripheral Arterial Disease. Vasc Dis Manag. .2023; 20(4): 67-73.
Smolderen KG, Ameli O, Chaisson CE, Heath K, Mena-Hurtado C. Peripheral artery disease screening in the community and 1-year mortality, cardiovascular events, and adverse limb events. AJPM Focus. 2022; 1(1): 100016. https://doi.org/10.1016/j.focus.2022.100016.
Gninkoun CJ, A Kerekou Hode, AhoudjinouMJ, Padonou GS , Dedjan H, Fanou J. Prevalence and Risk Factors for Peripheral Arterial Disease in Type 2 Diabetic Out Patients in A Care Center in Cotonou. J Diabetes Complications. 2021; 5(2); 1-4. https://doi.org/10.33425/2639-9326.1090.
Merghit R, AitAthmane M, Lakehal A. Frequency of Peripheral Artery Disease in association with coronary artery disease: a cross-sectional monocentric study in eastern Algeria. Batna J Med Sci. 2020; 7(2): 74-8. https://doi.org/10.48087/BJMSoa.2020.72O2
Vidula H, Liu K, Criqui MH, Szklo M, Allison M, Sibley C, et al. Metabolic syndrome and incident peripheral artery disease - the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis. 2015; 243(1): 198-203.https://doi.org/10.1016/j.atherosclerosis.2015.08.044.
Petra M G, Jobien K O, Yolanda van der G, Ale A, Ton J R, FrankL J Vi. Prevalence of the metabolic syndrome in patients with coronary heart disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic aneurysm. Atherosclerosis. 2004; 173(2): 361-367. https://doi.org/10.1016/j.atherosclerosis.2003.12.033.
Stoberock K, Kaschwich M, Nicolay SS, Mahmoud N, Heidemann F, Rieß H C, et al. The interrelationship between diabetes mellitus and peripheral arterial disease. Vasa. 2021; 50(5): 323-330. https://doi.org/10.1024/0301-1526/a000925.
Song P, Rudan D, Zhu Y, Fowkes F J I, Rahimi K, Fowkes F G R, et al. Global, regional, and national prevalence and risk factors for peripheral artery disease in 2015: an updated systematic review and analysis. Lancet Glob Health. 2019; 7(8): 1020-1030. https://doi.org/10.1016/S2214-109X(19)30255-4.
Mohammedi K, Woodward M, Hirakawa Y, Zoungas S, Williams B, Lisheng L, et al. Microvascular and Macrovascular Disease and Risk for Major Peripheral Arterial Disease in Patients With Type 2 Diabetes. Diabetes Care. 2016; 39(10):1796-1803. https://doi.org/10.2337/dc16-0588.
Bougrini Hafida. Dépistage de l’artériopathie oblitérante des membres inférieurs chezles coronariens. These de doctorat. Marakech, Université Cadi Ayyad Faculté de Medcine et depharmacie Marrakech, Maroc. 2013.
Althouse AD, Abbott JD, Forker AD, Bertolet M, Barinas-Mitchell E, Thurston R, et al. Risk factors for incident peripheral arterial disease in type 2 diabetes: results from the Bypass Angioplasty Revascularization Investigation in type 2 Diabetes (BARI 2D) Trial. Diabetes Care. 2014 ; 37(5) : 1346-1352 https://doi.org/10.2337/dc13-2303.
NdambweMoussio V, Jemea B, Bayiha J, EpackaEwane M, Ngo Nonga B. Prévalence de l’Artériopathie Oblitérante des Membres Inférieurs chez les Patients Diabétiques à l’Hôpital Général de Douala. Health Sci Dis. 2021; 22(4): 29-34.
Soyoye DO, Ikem RT, Kolawole BA, Oluwadiya KS, Bolarinwa RA, Adebayo OJ. Prevalence and Correlates of Peripheral Arterial Disease in Nigerians with Type 2 Diabetes. Adv Med. 2016: 3529419. https://doi.org/10.1155/2016/3529419.
Al-Shaheeb S, Hashim HK, Mohammed AK, Al-mashhadani A H, Al-Fandi A. Assessment of lipid profilewith HbA1c in type 2 diabetic Iraqi patients. Revis Bionatura 2022; 7(3): 29. https://doi.org/10.21931/RB/2022.07.03.29.
Hussain A, Ali I, Ijaz M, Rahim A. Correlation between hemoglobin A1cand serum lipid profile in Afghani patients with type 2 diabetes:hemoglobin A1c prognosticates dyslipidemia.Ther Adv Endocrinol Metab. 2017; 8: 51–57. https://doi.org/10.1177/2042018817692296.
Kundu D, Saikia M, Paul T. Study of the correlation between totallipid profile and glycosylated hemoglobin among the indigenouspopulation of Guwahati. Int J Life- Sci Sci Res. 2017; 3 :1175–1180.
Alzahrani SH, Baig M, Aashi MM, Al-Shaibi FK, Alqarni DA, Bakhamees WH. Association between glycated hemoglobin (HbA1c) and the lipid profile in patients with type 2 diabetes mellitus at a tertiary care hospital: a retrospective study. Diabetes Metab Syndr Obes. 2019; 12: 1639-1644. https://doi.org/10.2147/DMSO.S222271
Singh G, Kumar A. Relationship among HbA1c and lipid profile inPunjabi type 2 diabetic population. J Exercise Sci Physiother. 2011; 7: 99–102.
Artha IMJR, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Mahariski PA, et al. High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vasc Health Risk Manag. 2019; 15: 149-157. https://doi.org/10.2147/VHRM.S209830.
Downloads
Issue
Section
License
Copyright (c) 2024 Baghdad Science Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
