THE RELATIONSHIP BETWEEN THE DURATION OF TYPE 2 DIABETES MELLITUS AND SMALL DENSE LOW DENSITY LIPOPROTEIN CHOLESTEROL CONCENTRATION

Abstract

Background: Diabetes mellitus is a worldwide disorder and dyslipidaemia is the most common
cause of death in type 2 DM. The incidence of diabetes is fast rising in Africa. This study
investigated the effect of duration of type 2 DM on lipid indices especially small, dense low density
lipoprotein (sdLDL), a low density lipoprotein (LDL) sub-fraction with high atherogenic potential
Methods: Patients who were confirmed diabetics of varying duration attending diabetic clinics in
JUTH and healthy non-diabetic controls were evaluated for dyslipidaemia
Results: Two hundred and seventy-seven (277) subjects comprising 176 type 2 diabetics and 101
healthy controls were studied. Mean serum levels of total cholesterol (TC), triglyceride (TG), low
density lipoprotein cholesterol (LDL-C) and small, dense low density lipoprotein cholesterol
(sdLDL-C) were significantly higher in diabetic than control group. HDL-C level was same in both
groups. Among all lipid indices studied, only mean serum sdLDL showed a significant stepwise
increase over 5 years intervals with increasing duration of DM. Increase in the mean serum TG level was significant only after 10 years of diagnosis. Conclusion/Recommendations: Atherosclerosis is a common complication in type 2 DM and is due
to many factors including hyperglycaemia, insulin resistance and abnormal lipid metabolism. Small
dense LDL—a highly atherogenic LDL fraction, may be increased in type 2 diabetics even when
other lipid fractions are within or near reference ranges. Early detection and control of this
atherogenic dyslipidaemia may help to prevent long-term complications such as hypertension, stroke, CAD and diabetic nephropathy.

THE RELATIONSHIP BETWEEN THE DURATION OF TYPE 2 DIABETES MELLITUS AND SMALL DENSE LOW DENSITY LIPOPROTEIN CHOLESTEROL CONCENTRATION