Lipids-risk categories in Omani type 2 diabetics. Impact of the national cholesterol educational program

ABSTRACT

To evaluate the impact of the National Cholesterol Educational Program Adult Treatment Panel III [ATP III] and the Framingham Offspring Study on Omani diabetic subjects. 221 subjects with type 2 diabetes [86 females and 135 males] and 156 non-diabetic subjects [70 females and 86 males] aged 30-70 years attending Sultan Qaboos University Hospital between 1999-2002 were recruited. Lipid profile, glucose,%HbA[1c], apoproteinA-1 and apoproteinB were measured. Low density lipoprotein was calculated using the Friedwald formula. ATP-III and Framingham Offspring Study guidelines were used to classify lipid parameters into coronary heart disease-risk categories. Diabetic compared to non-diabetic subjects had significantly higher triglycerides of >1.7 mmol/L [p=0.01] and lower low density lipoprotein cholesterol of >4.2 mmol/L [p=0.012] and, in female subjects only, lower high density lipoprotein cholesterol of <1.15 mmol/L for [p<0.0001]. In addition, 57% of diabetic subjects had abnormal aplipoproteinB of >1.2 g/L compared to 49% of non-diabetic subjects. Combined raised levels of triglycerides, apolipoproteinB and low levels of high density lipoprotein were found in 42% of diabetic compared to 26% of the non-diabetic subjects [p=0.05]. Diabetic subjects had significantly higher [p=0.008] NCEP risk-score for coronary artery disease, however, only 34% conformed to a NCEP 10-year-risk score of >10%. A substantial proportion of the Omani diabetic subjects were dyslipidaemic according to the ATP III guidelines. This study recommends the implementation of a lower cut-off threshold for starting lipid-modifying agents for Omani diabetics when using the 10-year Framingham Risk Scoring equation