The impact of hemoglobin A1c on low-density lipoprotein cholesterol estimation by different formula in diabetic patients

ABSTRACT Aims: Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods: The study included 107 type 2 diabetic patients (41 males and 66 females), and 122 hypertensive type 2 diabetic patients (39 males and 83 females), aged 15 years and older. Total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C) and high density lipoprotein-cholesterol (HDL-C) concentrations were assayed for each group using standard biochemical methods. Results: The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05). Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L) than hypertensive non-diabetic males (5.76±1.57 mmol/L; P < 0.05). All the other lipid and lipoprotein parameters except HDL-C were non-significantly higher in females with type 2 DM and those with hypertension and type 2 DM, compared with type 2 diabetic and hypertensive type 2 diabetic males, respectively (P > 0.05). Conclusion: This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.

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Validity of a Novel Method for Estimation of Low-Density Lipoprotein Cholesterol Levels in Diabetic Patients

Journal of Atherosclerosis and Thrombosis ◽

10.5551/jat.35972 ◽

2016 ◽

Vol 23 (12) ◽

pp. 1355-1364 ◽

Cited By ~ 13

Author(s):

Hideto Chaen ◽

Shigesumi Kinchiku ◽

Masaaki Miyata ◽

Shoko Kajiya ◽

Hitoshi Uenomachi ◽

...

Keyword(s):

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Diabetic Patients ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Cholesterol Levels ◽

Novel Method

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Abstract 14430: Effect Modification of Statin Therapy on the Relationship of Low-density Lipoprotein Cholesterol With Incident CKD in Us Veterans

Circulation ◽

10.1161/circ.142.suppl_3.14430 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Jui-Ting Hsiung ◽

Maria Marroquin ◽

Kamyar Kalantar-Zadeh

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Us Veterans ◽

The Impact ◽

Statin Use

Background: Studies suggests that in the general population, hyperlipidemia may confer higher risk of developing chronic kidney disease (CKD). But, there is conflicting data as to whether statins can protect renal function or slow renal degradation. We sought to examine the impact of statins on the association of low-density lipoprotein cholesterol (LDL) and risk of incident CKD. Methods: Our cohort included 1,439,756 US veterans without chronic kidney disease (CKD), but with LDL measured between 2004-2006, who were followed until 2014. Incident CKD was defined as over 3 estimated glomerular filtration rate (eGFR) measurements <60 mL/min/1.73m 2 at least 90 days apart. Patients with a statin prescription at the time of LDL measurement were identified. Cox models were used to estimate the associations between LDL with incident CKD. Model adjustments include demographics, comorbidities, smoking status, prescription of fibrate or niacin, body mass index, albumin, high-density lipoprotein cholesterol, and triglycerides. Results: The cohort included 5% females, 16% African Americans, 26% diabetics, and 30% statin-users, with a mean age of 60±13 years. The median [IQR] of LDL and eGFR were 109 [88,133] mg/dL and 83 [72,94] mL/min/1.73m 2 , respectively. A J-shaped association between LDL and incident CKD were observed in both those on statin and not on a statin after adjustment. Low LDL (<70 mg/dL) was associated with a higher risk of incident CKD compared to the reference (LDL 70-<100 mg/dL) regardless of statin use. High LDL ≥160 mg/dL was associated with the highest of risks of incident CKD (HR: 1.08, 95% CI: 1.04, 1.13, and HR: 1.10, 95% CI: 1.07, 1.12, for statin use and no statin use, respectively). Conclusion: Both high and low LDL were associated with higher incident CKD risk independent of statin use in this US veteran cohort. Further studies are needed to understand how to manage cardiovascular disease risk by lowering LDL while simultaneously reducing risk of CKD.

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Practice Transformation: Using Team-Based Care Training to Improve Diabetes Outcomes

Journal of Primary Care & Community Health ◽

10.1177/2150132718817952 ◽

2018 ◽

Vol 9 ◽

pp. 215013271881795

Author(s):

Lori A. Bilello ◽

Christopher Scuderi ◽

Charles J. Haddad ◽

Carmen Smotherman ◽

Edward Shahady

Keyword(s):

Primary Care ◽

Training Program ◽

Hemoglobin A1c ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Care Training ◽

Team Based Care

Background: One of the key factors of the patient-centered medical home (PCMH) transformation require shifting mental models at the individual level and culture change at the practice level on how clinicians and support staff work together. This culture shift requires a reeducation on the roles and communication strategies within the medical practice. The objective of this project was to implement a team-based care training program based on the AHRQ TeamSTEPPS framework in 6 primary care practices affiliated with a Primary Care Practice Based Research Network to increase communication and performance of the care teams. Methods: Clinicians and staff from these sites received external facilitation by a certified TeamSTEPPS master trainer, who is a physician specializing in diabetes care, over a 1-year period. An analysis of their established diabetes patients’ hemoglobin A1c and low-density lipoprotein cholesterol before the training program and posttraining was performed using the paired t test and verified using the Wilcoxon sign rank test. Results: There was a statistically significant decrease in the mean hemoglobin A1c levels from 7.48% to 7.32% ( P < .001) and low-density lipoprotein cholesterol from 92.34 to 88.34 mg/dL ( P = .002) for all the practices combined but only 3 practices saw significant improvement individually. Conclusions: Even though the practices participating in this training are PCMHs and are part of a larger primary care network, they have achieved different levels of success, partly due to leadership and buy-in by staff. Practice leaders and team members need to fully embrace team care concepts and continuously monitor teamwork experiences to support effective team-based care.

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Low‐Density Lipoprotein Cholesterol Corrected for Lipoprotein(a) Cholesterol, Risk Thresholds, and Cardiovascular Events

Journal of the American Heart Association ◽

10.1161/jaha.119.016318 ◽

2020 ◽

Vol 9 (23) ◽

Author(s):

Peter Willeit ◽

Calvin Yeang ◽

Patrick M. Moriarty ◽

Lena Tschiderer ◽

Stephen A. Varvel ◽

...

Keyword(s):

Cardiovascular Disease ◽

Clinical Care ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Cholesterol Content ◽

Lipoprotein Cholesterol ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Lipoprotein A ◽

The Impact

Background Conventional "low‐density lipoprotein cholesterol (LDL‐C)" assays measure cholesterol content in both low‐density lipoprotein and lipoprotein(a) particles. To clarify the consequences of this methodological limitation for clinical care, our study aimed to compare associations of “LDL‐C” and corrected LDL‐C with risk of cardiovascular disease and to assess the impact of this correction on the classification of patients into guideline‐recommended LDL‐C categories. Methods and Results Lipoprotein(a) cholesterol content was estimated as 30% of lipoprotein(a) mass and subtracted from “LDL‐C” to obtain corrected LDL‐C values (LDL‐C corr30 ). Hazard ratios for cardiovascular disease (defined as coronary heart disease, stroke, or coronary revascularization) were quantified by individual‐patient‐data meta‐analysis of 5 statin landmark trials from the Lipoprotein(a) Studies Collaboration (18 043 patients; 5390 events; 4.7 years median follow‐up). When comparing top versus bottom quartiles, the multivariable‐adjusted hazard ratio for cardiovascular disease was significant for “LDL‐C” (1.17; 95% CI, 1.05–1.31; P =0.005) but not for LDL‐C corr30 (1.07; 95% CI, 0.93–1.22; P =0.362). In a routine laboratory database involving 531 144 patients, reclassification of patients across guideline‐recommended LDL‐C categories when using LDL‐C corr30 was assessed. In “LDL‐C” categories of 70 to <100, 100 to <130, 130 to <190, and ≥190 mg/dL, significant proportions (95% CI) of participants were reassigned to lower LDL‐C categories when LDL‐C corr30 was used: 30.2% (30.0%–30.4%), 35.1% (34.9%–35.4%), 32.9% (32.6%–33.1%), and 41.1% (40.0%–42.2%), respectively. Conclusions “ LDL‐C” was associated with incident cardiovascular disease only when lipoprotein(a) cholesterol content was included in its measurement. Refinement in techniques to accurately measure LDL‐C, particularly in patients with elevated lipoprotein(a) levels, is warranted to assign risk to the responsible lipoproteins.

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Lipid levels and low-density lipoprotein cholesterol goal attainment in diabetic patients: rosuvastatin compared with other statins in usual care

Expert Opinion on Pharmacotherapy ◽

10.1517/14656566.9.5.669 ◽

2008 ◽

Vol 9 (5) ◽

pp. 669-676 ◽

Cited By ~ 15

Author(s):

Carolyn R Harley ◽

Sanjay K Gandhi ◽

Herbert Heien ◽

Ken McDonough ◽

Stephanie P Nelson

Keyword(s):

Usual Care ◽

Goal Attainment ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Diabetic Patients ◽

Low Density ◽

Lipid Levels ◽

Low Density Lipoprotein Cholesterol ◽

Cholesterol Goal

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Effect of Chromium on Glucose and Lipid Profiles in Patients with Type 2 Diabetes; A Meta-analysis Review of Randomized Trials

Journal of Pharmacy & Pharmaceutical Sciences ◽

10.18433/j3g022 ◽

2013 ◽

Vol 16 (1) ◽

pp. 99 ◽

Cited By ~ 36

Author(s):

Mohammad Abdollahi ◽

Amir Farshchi ◽

Shekoufeh Nikfar ◽

Meysam Seyedifar

Keyword(s):

Meta Analysis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Diabetic Patients ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Type 2 Dm ◽

Supplement Therapy

Purpose. Chromium (Cr) as an essential trace element in metabolism of carbohydrate, lipid and protein is currently prescribed to control diabetes mellitus (DM). The objective of this meta-analysis was to compare the effect of Cr versus placebo (Pl) on glucose and lipid profiles in patients with type 2 DM. Methods. Literature searches in PubMed, Scopus, Scirus, Google Scholar and IranMedex was made by use of related terms during the period of 2000-2012. Eligible studies were randomized clinical trials (RCTs) with intake of Cr higher than 250 µg at least for three months in type 2 DM. Glycated hemoglobin (HbA1c), fasting blood sugar (FBS), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), triglyceride (TG), and body mass index (BMI) were the main outcomes. Results. Seven out of 13 relevant studies met the criteria and were included in the meta-analysis. HbA1c change in diabetic patients in Cr supplement therapy comparing to Pl was -0.33 with 95%CI= -0.72 to 0.06 (P= 0.1). Change of FBG in Cr therapy vs. Pl was -0.95 with 95%CI= -1.42 to -0.49 (P< 0.0001). TC change in Cr therapy vs. Pl was 0.07 with 95%CI= -0.16 to 0.31 (P= 0.54). TG change in diabetic patients in Cr supplement therapy comparing to Pl was -0.15 with 95%CI= -0.36 to 0.07 (P= 0.18). Conclusions. Cr lowers FBS but does not affect HbA1c, lipids and BMI. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

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Plasma lipoprotein(a) levels: a comparison between diabetic and non-diabetic patients with acute ischemic stroke

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2004000200008 ◽

2004 ◽

Vol 62 (2a) ◽

pp. 233-236 ◽

Cited By ~ 3

Author(s):

Maurus Marques de Almeida Holanda ◽

Rosália Gouveia Filizola ◽

Maria José de Carvalho Costa ◽

Rodrigo Vasconcelos C.L. de Andrade ◽

José Alberto Gonçalves da Silva

Keyword(s):

Ischemic Stroke ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Diabetic Patients ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

OBJECTIVE: The aim of this study was to evaluate lipoprotein(a) (Lp(a)), total cholesterol, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), very low density lipoprotein cholesterol (VLDL ), triglycerides , apolipoprotein A (apo A) and B100 (apo B100), uric acid, glycaemic and insulin plasmatic concentrations in patients affected by acute stroke. In this group of patients, we have compared the variables between type 2 diabetic patients and non-diabetic patients. METHOD: We evaluate a total of 34 non-diabetic patients (22 males and 12 females; mean age 66.71 ± 10.83 years) and a group of 26 type 2 diabetic patients (15 males and 11 females; mean age 66.35 ± 9.92 years) in a cross-sectional study. RESULTS: Mean Lp(a) concentration did not significantly differ between type 2 diabetic patients and non-diabetic subjects (29.49 ± 23.09 vs 44.81 ± 44.34 mg/dl). The distribution of Lp(a)levels was highly skewed towards the higher levels in both groups, being over 30 mg/dl in 50%. Lp(a) concentration was positively correlated with abdominal adiposity, using waist-hip ratio(WHR)(p< 0.05). No association was found between Lp(a) and others risk factors like sex, age, other lipidic parameters and the presence of stroke. CONCLUSIONS: Our results showed that there were no significant differences between diabetic and non-diabetic patients' serum Lp(a) levels, which indicates that elevated Lp(a) levels were associated with ischemic stroke, irrespective of the presence of type 2 diabetes mellitus (type 2 DM).

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