Article Sidebar
Main Article Content
Abstract
RÉSUMÉ
Background. The association between HbA1c and cardiovascular disease (CVD) risk is well established. Aim. to investigate the association between HbA1c and selected cardiometabolic markers in diabetic patients in the Adamaoua region. Materials and Methods. A cross sectional study was conducted at the Hypertension and Diabetes units of the Ngaoundere Regional and Protestant Hospitals from June 2015 to February 2016 in Ngaoundere, Adamawa Region, Cameroon. Recruited participants provided a written consent and subsequently filled a questionnaire on sociodemographic data. Blood pressure (BP) and anthropometric parameters were measured. Venous blood was collected for fasting blood glucose (FBG), lipid profile, glycated hemoglobin (HbA1c) and uric acid measurements. Data were analysed using SPSS version 20.0, with statistical significance considered at p < 0.05. Results. A total of 191 diabetic participants were enrolled. The majority (78.7%) of them recorded a poor glycaemic control (HbA1c > 7.9%). HbA1c levels varied inversely with waist-to-hip ratio and directly with serum uric acid. Apart from uric acid, waist-to-hip ratio, and high density lipoprotein cholesterol (HDLc), the means of all other study variables were significantly associated with increasing HbA1c category. Conclusion. Glycated hemoglobin is a potential predictor of dyslipidemia, overweight, and hypertension in both diabetic and non-diabetic persons in our setting.
ABSTRACT
Contexte. Le lien entre la fraction c de l’hémoglobine glycosylée (HbA1c) et le risque cardiovasculaire est bien établi. Objectif : analyser la relation entre l’ HbA1c et quelques marqueurs cardiométaboliques dans un groupe de sujets diabétiques de la région de l’Adamaoua. Matériels et méthodes. Nous avons mené une étude transversale dans les unités de prise en charge du diabète et de l’hypertension artérielle des hôpitaux Régional et Protestant de Ngaoundéré au Cameroun, de Juin 2015 à Février 2016. Après un consentement éclairé des participants, les données sociodémographiques ont été collectées ; la pression artérielle et les données anthropométriques ont été mesurées. Un échantillon de sang veineux a été prélevé chez les participants à jeun pour le dosage du glucose, des lipides, de l’HbA1c et de l’acide urique. Les données ont été analysées à l’aide du logiciel SPSS version 20.0 et les valeurs de p < 0,05 étaient considérées comme significatives. Résultats : Un total de 191 personnes diabétiques ont été recrutées. La majorité (78,7%) de ces participants avaient un mauvais controle glycémique (HbA1c > 7,9%). Il y avait une corrélation négative statistiquement significative entre le taux d’HbA1c et le rapport tour de hanche/tour de taille et une corrélation positive significative entre ce même paramètre et le taux sérique d’acide urique. A l’exception de l’acide urique, du HDLc et du rapport tour de hanche /tour de taille, tous les autres paramètres étudiés étaient significativement associés au taux HbA1c. Conclusion : le taux d’hémoglobine glycosylée est un potentiel facteur prédictif des dyslipidémies, du surpoids et de l’hypertension artérielle dans notre contexte, autant chez les diabétiques que les autres.
Keywords
Article Details
References
- Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WBet al. Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation 2013; 127:143-152.
- Iciar MT, Sevillano-Collantes C, Amparo SG, Canizo-Gomez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength. World journal of diabetes 2014; 5: 444-470.
- Selvin E, Wattanakit K, Steffens MW, Coresh J, Sharrett AR.HbA1c and peripheral arterial disease in diabetes: the Atherosclerosis Risk in Communities study. Diabetes Care 2006; 29:877-882.
- Kawasumi M, Tanaka Y, Uchino H, Shimizu T, Tamura Y, Sato F et al.Strict glycemic control ameliorates the increase of carotid IMT in patients with type 2 diabetes. Endocr J 2006; 53:45-50
- Khaw KT, Wareham N, Luben R, Bingham S, Oakes S, Welch A et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk). BMJ 2001; 322:15-18
- Gardiner HM, Pasquini L, Wolfenden J, Kulinskaya E, Li W, Henein M.Increased periconceptual maternal glycated haemoglobin in diabetic mothers reduces fetal long axis cardiac function. Heart 2006; 92:1125-1130.
- Selvin E, Coresh J, Golden SH, Brancati FL, Folsom AR, Steffes MW. Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study. Arch. Intern. Med. 2005; 165:1910-1916
- Selvin E, Coresh J, Shahar E, Zhang L, Steffes M, Sharrett AR.Glycemia (haemoglobin A1c) and incident of ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Lancet Neurol 2005; 4:821-826.
- Ravipati G, Aronow WS, Ahn C, Sujata K, Saulle LN, Weiss MB. Association of hemoglobin A1c level with the severity of coronary artery disease in patients with diabetes mellitus. Am J Cardiol 2006; 97:968-969.
- Mbouemboue OP, Derew D, Ngoufack TJO, Tamanji MT. A Community-Based Assessment of Hypertension and Some Other Cardiovascular Disease Risk Factors in Ngaoundéré, Cameroon. International Journal of Hypertension. 2016; ID 4754636.
- World Health Organization. The WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance/Non-Communicable Diseases and Mental Health, WHO, Geneva, Switzerland, 2005.
- Nathan DM. The clinical information value of the glycosylated hemoglobin assay. The New England Journal of Medecine 1984; 310; 340-346
- Friedwald WT, Levy RI and Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentri-fuge. Clinical Chemistry 1972; 18: 449-502.
- Cote G. Les dyslipidémies: dépistage, diagnostic et traitement. Québec: Société québécoise de lipidologie, de nutrition et de métabolisme, 27 p, 2008.
- Tietz, NW in: Wu, Alan HB editor. Clinical guide on laboratory tests. 3rd Ed. Philadelphia, W.B Saunders Co; 1995.
- Burtis CA, Ashwood E. Tietz Textbook of Clinical chemistry. 3rd edition. Saunders: Philadelphia; 1999. ISBN-13: 978-0721656106.
- Petitti DB, Imperatore G, Palla SL, Daniels SR, Dolan LM, Kershnar AK et al. Serum Lipids and Glucose Control: The SEARCH for Diabetes in Youth Study. Arch Pediatr Adolesc Med 2007; 161:159-165
- Vinod Mahato R, Gyawali P, Raut PP, Regmi P, Singh KP, Pandeya DR et al. Association between glycaemic control and serum lipid profile in type 2 diabetic patients: Glycated haemoglobin as a dual biomarker. Biomedical Research2011; 22: 375-380
- Khan HA, Sobki SH, Khan SA. Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts dyslipidaemia. Clin Exp Med 2007; 7:24-29.
- Laverdy OG, Hueb WA, Sprandel MC, Kalil-Filho R, Maranhão RC. Effects of glycemic control upon serum lipids and lipid transfers to HDL in patients with type 2 diabetes mellitus: novel findings in unesterified cholesterol status. Exp Clin Endocrinol Diabetes 2015; 123:232-9.
- Kim SH, Jung IA, Jeon YJ, Cho WK, Cho KS, Park SH et al. Serum lipid profiles and glycemic control inadolescents and young adults with type 1 diabetes mellitus. Ann. Pediatr Endocrinol Metab 2014; 19:191-196.
References
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WBet al. Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation 2013; 127:143-152.
Iciar MT, Sevillano-Collantes C, Amparo SG, Canizo-Gomez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength. World journal of diabetes 2014; 5: 444-470.
Selvin E, Wattanakit K, Steffens MW, Coresh J, Sharrett AR.HbA1c and peripheral arterial disease in diabetes: the Atherosclerosis Risk in Communities study. Diabetes Care 2006; 29:877-882.
Kawasumi M, Tanaka Y, Uchino H, Shimizu T, Tamura Y, Sato F et al.Strict glycemic control ameliorates the increase of carotid IMT in patients with type 2 diabetes. Endocr J 2006; 53:45-50
Khaw KT, Wareham N, Luben R, Bingham S, Oakes S, Welch A et al. Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European Prospective Investigation of Cancer and Nutrition (EPIC-Norfolk). BMJ 2001; 322:15-18
Gardiner HM, Pasquini L, Wolfenden J, Kulinskaya E, Li W, Henein M.Increased periconceptual maternal glycated haemoglobin in diabetic mothers reduces fetal long axis cardiac function. Heart 2006; 92:1125-1130.
Selvin E, Coresh J, Golden SH, Brancati FL, Folsom AR, Steffes MW. Glycemic control and coronary heart disease risk in persons with and without diabetes: the atherosclerosis risk in communities study. Arch. Intern. Med. 2005; 165:1910-1916
Selvin E, Coresh J, Shahar E, Zhang L, Steffes M, Sharrett AR.Glycemia (haemoglobin A1c) and incident of ischemic stroke: the Atherosclerosis Risk in Communities (ARIC) Study. Lancet Neurol 2005; 4:821-826.
Ravipati G, Aronow WS, Ahn C, Sujata K, Saulle LN, Weiss MB. Association of hemoglobin A1c level with the severity of coronary artery disease in patients with diabetes mellitus. Am J Cardiol 2006; 97:968-969.
Mbouemboue OP, Derew D, Ngoufack TJO, Tamanji MT. A Community-Based Assessment of Hypertension and Some Other Cardiovascular Disease Risk Factors in Ngaoundéré, Cameroon. International Journal of Hypertension. 2016; ID 4754636.
World Health Organization. The WHO STEPwise Approach to Chronic Disease Risk Factor Surveillance/Non-Communicable Diseases and Mental Health, WHO, Geneva, Switzerland, 2005.
Nathan DM. The clinical information value of the glycosylated hemoglobin assay. The New England Journal of Medecine 1984; 310; 340-346
Friedwald WT, Levy RI and Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentri-fuge. Clinical Chemistry 1972; 18: 449-502.
Cote G. Les dyslipidémies: dépistage, diagnostic et traitement. Québec: Société québécoise de lipidologie, de nutrition et de métabolisme, 27 p, 2008.
Tietz, NW in: Wu, Alan HB editor. Clinical guide on laboratory tests. 3rd Ed. Philadelphia, W.B Saunders Co; 1995.
Burtis CA, Ashwood E. Tietz Textbook of Clinical chemistry. 3rd edition. Saunders: Philadelphia; 1999. ISBN-13: 978-0721656106.
Petitti DB, Imperatore G, Palla SL, Daniels SR, Dolan LM, Kershnar AK et al. Serum Lipids and Glucose Control: The SEARCH for Diabetes in Youth Study. Arch Pediatr Adolesc Med 2007; 161:159-165
Vinod Mahato R, Gyawali P, Raut PP, Regmi P, Singh KP, Pandeya DR et al. Association between glycaemic control and serum lipid profile in type 2 diabetic patients: Glycated haemoglobin as a dual biomarker. Biomedical Research2011; 22: 375-380
Khan HA, Sobki SH, Khan SA. Association between glycaemic control and serum lipids profile in type 2 diabetic patients: HbA1c predicts dyslipidaemia. Clin Exp Med 2007; 7:24-29.
Laverdy OG, Hueb WA, Sprandel MC, Kalil-Filho R, Maranhão RC. Effects of glycemic control upon serum lipids and lipid transfers to HDL in patients with type 2 diabetes mellitus: novel findings in unesterified cholesterol status. Exp Clin Endocrinol Diabetes 2015; 123:232-9.
Kim SH, Jung IA, Jeon YJ, Cho WK, Cho KS, Park SH et al. Serum lipid profiles and glycemic control inadolescents and young adults with type 1 diabetes mellitus. Ann. Pediatr Endocrinol Metab 2014; 19:191-196.