Fasting and postprandial lipid parameters: A comparative evaluation of cardiovascular risk assessment in prediabetes and diabetes.

Chakraborty, Montosh; Singh, Prerna; Dsouza, Jyothi M P; Pethusamy, Karthikeyan; Thatkar, Pandurang V · J Family Med Prim Care · 2020

cross_sectional · Level IV

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Abstract

Dyslipidemia plays a crucial role in atherogenesis, in both prediabetes and diabetes. There persists a lacuna in the evaluation of postprandial lipid parameters in prediabetes. To comparatively evaluate fasting and postprandial blood lipid parameters and atherogenic lipid ratios for cardiovascular risk assessment, in prediabetes and diabetes. Fifty-one patients diagnosed with diabetes mellitus and thirty-two with prediabetes were selected for the study. Lipid profile and blood glucose were analyzed in fasting and postprandial blood samples. Kolmogorov-Smirnov test, Shapiro-Wilk test, one-way ANOVA, and Pearson's regression analysis were applied. Postprandially, triglycerides (TG) was increased significantly in diabetes compared to controls (<i>P</i> < 0.01) and prediabetics (<i>P</i> < 0.05). Among the lipid ratios, triglyceride/high density lipoprotein (TG/HDLc) was significantly increased postprandially in diabetes compared to controls (<i>P</i> < 0.05). A comparative analysis of fasting and postprandial parameters within each group showed a significant increase in postprandial TG/HDLc compared to the fasting state in prediabetes (<i>P</i> < 0.001) and diabetes (<i>P</i> < 0.001). Postprandial TG (<i>P</i> < 0.01) and TG/HDLc (<i>P</i> < 0.01) showed a stronger correlation with HbA<sub>1c</sub> compared to fasting TG (<i>P</i> < 0.05) and TG/HDLc (<i>P</i> > 0.05). The prevalence of dyslipidemia and insulin resistance was higher in postprandial state than the fasting state in prediabetes and diabetes. Postprandial TG and the TG/HDLc reflect lipid abnormalities than the corresponding fasting variables in diabetes and prediabetes. Postprandial TG and TG/HDLc are better reflectors of cardiovascular status in prediabetes and diabetes.