Glycated hemoglobin as surrogate indicator of dyslipidemias and impending complications in type 2 diabetes patients

Abstract

ABSTRACT Introduction: Prevention of long-term complex metabolic complications of type 2 diabetes mellitus (T2DM) can be achieved by good glycemic control. Different studies have highlighted several biomarkers and their connection with T2D risk and glycated hemoglobin (HbA1c) level is now universally accepted as the most reliable indicator of long-term glycemic control. However, few of them have explored the interconnection of these biomarkers as well as the prospective alterations in the diabetes biomarker correlation between diabetes, blood biochemical markers, age, and body mass index (BMI). Diabetes and dyslipidemia commonly coexist and dyslipidemia is a major risk factor for cardiovascular, neurological, and eye complications but there is a lack of evidence on the pattern of dyslipidemia and whether Hb1Ac level is related with serum lipid profile in T2DM patients. Aim: To determine a multi-level approach to establish a relationship between mean Hb1Ac level in the study and correlate its association with the serum lipid profile, age, BMI, and neurological complications in T2DM patients. Materials and Methods: A total of 105 T2DM patients with a mean age of 54.1 ± 10.08 years were included in this cross-sectional study. The whole blood and sera were analyzed for fasting blood sugar, HbA1c, total cholesterol, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-DL-C (LDL-C), and very LDL-C (VLDL-C). Neurological assessment done by simple screening methods including the 10 g monofilament and the 128-Hz tuning fork test for the detection of early neuropathies. The correlation of HbA1c with the lipid ratios and individual lipid indexes was done by Pearson correlation test (r) using SPSS version 28.0 software. Results: Mean Hb1Ac level was 7.36 ± 1.78 which was abnormal in 61.9% of the total enrolled diabetic patients. Mixed dyslipidemias were common with abnormal TG, LDL and VLDL values followed by abnormal HDL-C values in 83.8% of the total enrolled diabetic patients. The Hb1Ac levels showed significant positive correlation with serum cholesterol, TG, LDL and VLDL levels but showed statistically significant negative correlation with serum HDL levels in the study. Duration of diabetes and Hb1Ac values also showed positive correlation with ophthalmological and neurological complications at presentation in the study. Conclusion: Apart from a reliable indicator of long-term glycemic control, HbA1c can also be used as a predictor of dyslipidemia and early diagnosis of dyslipidemia can prevent cardiovascular neurological and eye complications in T2D patients.