Assessment of Atherogenic Indicus in Type 2 Diabetes Mellitus

Introduction: Worldwide, Diabetes mellitus is the most common chronic disorder and risk factor for Coronary Artery Disease (CAD). The atherogenic indices including atherogenic index of plasma is a novel indicator of diabetic dyslipidemia, which is equivalent to the risk predictor of CAD. Aim: To compare the atherogenic indices including atherogenic index of plasma, cardiac risk ratio and atherogenic coefficient in individuals with Type 2 diabetes mellitus and in control group. Materials and Methods: The present study included 280 participants; of which 70 were healthy age and sex matched controls and 210 were known cases of Type 2 diabetes mellitus (30-60 years). Lipid profile was assessed by enzymatic assay and atherogenic indices including, atherogenic index of plasma, cardiac risk ratio and atherogenic coefficient were calculated. Patients with chronic liver/kidney disease and on lipid lowering drugs were excluded. Statistical analysis was done with SPSS version 20.0 and chi-square and one sample t-test was applied, p<0.05 were considered as statistically significant. Results: Duration of diabetes was 6 to 10 years, the average BMI was 26.09 kg/m(2). Among 210 diabetic patients 73 (34.76%) were of normal weight, 128 (60.95%) overweight and 09 (4.29%) obese; 87% had diabetic dyslipidemia. High level of HbA1c (8.8 +/- 1.5%) was associated with increase in duration of diabetes, the average duration of Type 2 diabetes in study population was 9.8 +/- 4.4 years. Significantly increased levels of cholesterol (188.3 +/- 31.9), triglyceride (161.3 +/- 19.4) and LDL-C (114.9 +/- 30.9) and decreased HDL-C (41.17 +/- 3.19) in diabetic patients as compared to control (165.5 +/- 35.5, 114.5 +/- 9.28, 94.4 +/- 34.4 and 48.17 +/- 3.4 respectively) (p<0.001) was noted. The atherogenic indices showed significantly increased levels of Atherogenic Index of Plasma (AIP) {(0.22 +/- 0.07) vs (0.04 +/- 0.01)) (p<0.001): Cardiac Risk Ratio (CRR) ((4.60 +/- 0.81) vs (2.44 +/- 0.71)) and Atherogenic Coefficient (AC) {(3.60 +/- 0.81) vs (2.44 +/- 0.71)} (p<0.001) in Type 2 diabetic patients vs control group. Conclusion: All diabetic patients having at least one kind of dyslipidemia, assessment of atherogenic indices, especially atherogenic index of plasma gives valuable information about future risk of abnormal cardiac event. Thus, it could be a better marker and predictor for increased risk of CAD in Type 2 diabetes.