ABSTRACT
Prevalence of type 2 diabetes mellitus [DM] in the Middle East is rising, and dyslipidemia in diabetics contributes to the increasing incidence of cardiovascular disease in this population. Data on the prevalence of dyslipidemia in diabetics in the Middle East and whether it differs from that in the West are scarce. The Jordan Hyperlipidemia And Related Targets Study [JoHARTS] measured levels of fasting serum total cholesterol [TC], triglycerides [TG], low- and high-density lipoprotein cholesterol [LDL-C and HDL-C] in mg/dl in 5000 individuals evaluated at four tertiary-care centers and outpatient clinics. None was on lipid lowering agents at the time of enrollment. The diabetic subgroup [n=1410, 28%] was studied in JoHARTS-3 and consisted of 863 men [61%] and 547 women [39%]. Compared with nondiabetic men, those with DM had lower mean HDL-C level [38.0+10.6 vs 39.4+15.7, P=0.006] and higher mean TG level [186+78.9 vs 169+78.2, P<0.0004], but TC and LDL-C levels were similar in the two groups [208 vs 207; P=0.43, and 130 vs 132; P=0.10, respectively]. Similarly, diabetic women had lower HDL-C [43.8+14.2 vs 47.7+12.2, P<0.0001] and higher TG [189+78.8 vs 149+69.7, P<0.0001] than nondiabetic women. When diabetes coexisted with smoking, the HDL-C levels weree lower than levels among nondiabetic nonsmokers [36.9+10.1 vs 43.2+13.9, P<0.0001], and the TG levels were higher [201.5+80.9 vs 166.6+75.1, P<0.0001]. LDL-C levels <100 were found in 19% of diabetic with CAD, and levels <70 in 5% only. With each 1% increase in glycated hemoglobin [HbA1c] level; there were significant decreases in HDL-C levels [43.1 among those with Hb A1c 6-7% compared with 37.8 for Hb A1c >10%, P=.027] and significant increase in TG levels [185 to 244, P=0.02]