Hypertriglyceridemia and Other Plasma Lipid Profile Abnormalities among People Living with Diabetes Mellitus in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Background. Dyslipidemia is one of the leading causes of cardiovascular complications in diabetes mellitus (DM) patients. Though it is a major public health problem in Ethiopia, there is no a nation-wide study to determine dyslipidemia among DM patients yet. Therefore, this systematic review and meta-analysis intended to estimate the prevalence of hypertriglyceridemia and other plasma lipid abnormalities among people living with DM in Ethiopia. Methods. We systematically searched PubMed, Google Scholar, African Journals Online, Hinari, and direct Google. Studies conducted until May 9, 2020, that reports the prevalence of dyslipidemia among people living with DM were included. The DerSimonian and Laird random-effects model was used to determine the pooled prevalence of lipid profile abnormalities. Heterogeneity was checked using the $I^2$ statistic, whereas publication bias was tested by funnel plot and Egger’s test. Besides, subgroup and sensitivity analyses were performed. Results. We used 18 primary studies, including 4961 participants living with DM, which met the eligibility criteria for the meta-analysis of hypertriglyceridemia. The estimate of hypertriglyceridemia (≥150 mg/dl) was 48.15% (95% CI: 38.15-58.15, $I^2=98.4\%$ ) after performing the main meta-analysis using the random-effects model. The subgroup analysis showed a higher pooled estimate of hypertriglyceridemia among T2DM (57.80% (95% CI: 50.50-65.10), $I^2=92.5\%$ ), studies that used probability sampling technique (59.09% (95% CI: 43.58-74.59), $I^2=98.6\%$ , $p<0.001$ ), and studies from primary data sources (51.43% (95% CI: 40.72-62.13), $I^2=98.0\%$ , $p<0.001$ ). Moreover, the estimated pooled prevalence of the total plasma cholesterol ( $\text{TC}\ge 200\text{mg}/\text{dl}$ ) was 34.08% (95% CI: 28.41-39.75, $I^2=92.4\%$ ), $\text{LDL}-\text{C}\ge 100\text{mg}/\text{dl}$ was 41.13% (95% CI: 27.15-55.11, I2 = 98.8%), and $\text{HDL}\le 40\text{mg}/\text{dl}\text{for}\text{men}\text{and}\le 50\text{mg}/\text{dl}\text{for}\text{women}$ was 44.36% (95% CI: 31.82-56.90, $I^2=98.8\%$ ). Conclusions. The pooled prevalence of hypertriglyceridemia and other lipid abnormalities among DM patients was relatively high in Ethiopia. It strongly suggests the need to give maximal attention to the adherence of DM management to reduce the circulatory lipid profile abnormalities and subsequent complications. Prospero Registration. CRD42020182291.