Dyslipidemia in diabetes: a population-based study in Bali

• Published in: International journal of general medicine 2019-09, Vol.12, p.313-321
• Main Authors: Suastika, Ketut, Semadi, I Made Siswadi, Dwipayana, I Made Pande, Saraswati, Made Ratna, Gotera, Wira, Budhiarta, Anak Agung Gde, Matsumoto, Kinuyo, Kajiwara, Naemi, Taniguchi, Hiroshi
• Format: Article
• Language: English
• Subjects: Adults; Age; Analysis; Apolipoproteins; Blood glucose; Body mass index; Cardiovascular disease; Cholesterol; Diabetes; Diabetes mellitus; Dyslipidemia; Endocrinology; Fasting; Glucose; HOMA-IR; Homeostasis; Hospitals; Insulin; Insulin resistance; Internal medicine; Lipids; Lipoproteins; Low density lipoproteins; Medicine; Metabolic disorders; Metabolism; Obesity; Original Research; Population; Population-based studies; Towns; Triglycerides; Womens health
• ISSN: 1178-7074; 1178-7074
• DOI: 10.2147/IJGM.S215548

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. 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). 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. 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.