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Atherogenic profile of dyslipidemic patients with normal fasting blood glucose levels but with abnormal glucose tolerance (IGT or NIDDM).


 Calleja Homobono B,
 Sanvicente Peter Jay

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Publication Type
Philippine Journal of Cardiology
2002 Apr-Jun
Publication Date


More than 50 percent of patients with type 2 diabetes (DM) have pre-existing cardiovascular disease (CVD) at the time of clinical diagnosis. While the association of CVD with DM is well established, its association with abnormal glucose tolerance (AGT) among patients with normal fasting blood glucose (FBS) levels is less understood. Dyslipidemia has been shown to be a risk marker for AGT in patients with normal FBS. While its qualitative relationship with the presence of AGT has been analyzed, the quantitative profile of each lipid subfraction and their associated risk for having AGT and subsequent CVD has never been established. OBJECTIVES: To do a quantitative analysis of the lipid profile predisposing patients to abnormal glucose tolerance (AGT) and to assess the atherogenic properties of dyslipidemic patients with normal FBS but with AGT. PATIENTS AND METHODS: This is a case-control, cross sectional prospective study conducted at St. Lukes Medical Center and Davao Doctors Hospital. Four hundred thirteen dyslipidemic patients with normal FBS were included. Intervention: Lipid profile and 2-hour standard oral glucose tolerance test (OGTT). RESULTS: Quantitative analysis of the lipid profile of dyslipidemic patients showed significant association with AGT (p0.05) compared to NGT. Incidence of AGT is highest among those with the following lipid profile: total cholesterol (TC)240 mg/dl (73 percent) , triglycerides (TG)200 mg/dl (75 percent), high density lipoprotein cholesterol (HDL-C)35 mg/dl (75 percent), low density lipoprotein cholesterol (LDL-C)130 mg/dl (66 percent) and very low density lipoprotein cholesterol (VLDL-C) 40 mg/dl (75 percent). All lipid subfractions showed significant association with the presence of AGT (p0.05), but only TG, HDL-C, and VLDL-C showed a linear quantitative correlation with the degree of AGT. The relative risks (RR) for having increased atherogenicity are as follows: 1. for LDL/HDL-NGT SIGNIFICANCE: The RR for having CVD mortality due to MI in 10 years for the different lipid ratios are as follows: LDL/HDL-8, -TG/HDL=4, and TC/HDL=8. CONCLUSION: The risk for CV complications can be lowered to as much as 80 percent simply by diagnosing AGT 10 years before its usual clinical diagnosis. Early recognition of AGT in dyslipidemic patients based on quantitative analysis of their lipid profile and risk stratification based on their atherogenic indices would highlight the need for early prevention by longer and more aggressive intervention. (Author)

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