NDSP-12: Atherogenic index of plasma as a useful marker of cardiovascular disease risk among Pakistani individuals; a study from the second National Diabetes Survey of Pakistan (NDSP) 2016-2017

Aim To assess the correlation between atherogenic index of plasma (AIP) and cardiovascular disease (CVD) risk factors. Methodology This is a sub study of the second National Diabetes Survey of Pakistan (NDSP) 2016–2017, an epidemiological survey including people of > 20 years of age and both genders in all four provinces of Pakistan. Out of 213 clusters, twenty-seven clusters were selected from all over the Pakistan. Households were identified and selected members of every 10th household were counseled to come to the campsite after observing an overnight fast. Standardized techniques were used for measuring height, weight, BMI, waist circumference, and blood pressure. Standard methods were used for analyzing biochemical parameters including oral glucose tolerance test, lipid profile and various lipid derived parameter/ratios were calculated. The AIP was calculated by using formula log10 (TG/HDL) for all survey participants. Statistical analyses were conducted by using statistical package for social sciences, version 20. Results A total of 7351 people (2877 males and 4201females) were selected for this sub-analysis after fulfilling the inclusion criteria. Overall AIP score was calculated as 0.74±0.31 and according to the AIP risk categorization, the majority 6996 (95.2%) fell in the high-risk category of developing CVD, whereas 258(3.5%) were in moderate and only 97(1.3%) people were found in low-risk category. Multiple logistic regression analyses showed male gender and diabetes as risk factor for developing CVD based on AIP score. Furthermore, various lipid derived parameters LDL-C and HDL-C, TG and HDL-C, lipoprotein combined index (LCI) were shown strong correlation with AIP. Conclusion The significant association between AIP and CVD risk factors exists and high levels of AIP in Pakistani population may be an alarming sign in developing cardiovascular disease.

Diabetes Awareness, Treatment, and Control among Mexico City Residents

Early diagnosis and control of diabetes can reduce premature mortality and disability. We described the diabetes prevalence, awareness, treatment, and control in Mexico City. Data came from the Mexico City Representative Diabetes Survey, conducted between May to June 2015. Participants (20–69 y, n = 1307) reported their diabetes condition, treatment, and outcomes. Fasting blood samples were collected and HbA1c, blood glucose, and blood lipids were determined. We used multivariate logistic regression to identify inequalities in diabetes prevalence and awareness. The overall prevalence of diabetes was 13.6% (95% CI: 11.7, 15.7). Of those living with diabetes, 70.5% were aware of their condition. Among those aware of their diabetes, around 10% to 65% received diabetes care according to international guidelines, and around 30% to 40% achieved HbA1c, LDL cholesterol, or blood pressure targets. Overall, only 4.1% of those aware of their diabetes achieved all treatment targets and 35.4% had never presented a diabetes complication. Diabetes prevalence was higher among older age groups and lower among the most educated. Having access to health care was associated with lower odds for diabetes and diabetes awareness. The low rates of diabetes awareness, treatment, and control highlight the urgent need of strengthening diabetes care in Mexico City.