Impact of corpulence parameters and haemoglobin A1c on metabolic control in type 2 diabetic patients: comparison of apolipoprotein B/A-I ratio with fasting and postprandial conventional lipid ratios.

BACKGROUND AND OBJECTIVE: The incidence of diabetes co-morbidities could probably be better assessed by studying its associations with major corpulence parameters and glycaemic control indicators. We assessed the utility of body mass index (BMI), waist circumference (WC), and glycosylated haemoglobin (HbA1c) levels in metabolic control for type 2 diabetic patients. METHODS: Fasting and postprandial blood samples were collected from 238 type 2 diabetic patients aged 57.4±11.9 years. The sera were analysed for glucose, HbA1c, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), and apolipoproteins (apoA-I and apoB). Ratios of lipids and apolipoproteins were calculated and their associations with BMI, WC, and HbA1c levels were analysed. RESULTS: Our investigation showed increases in most fasting and postprandial lipid parameters according to BMI and WC. In men, postprandial HDL-c and TG levels were significantly higher (p<0.05) in overweight and obese patients, respectively, as well as in patients with abdominal obesity. Contrariwise, postprandial TC levels were significantly higher (p<0.01) in overweight and abdominal obese women. However, elevations of apoA-I and apoB levels were according to BMI and WC in both genders. There was a strong influence of BMI, WC, and HbA1c levels on the apoB/apoA-I ratio compared to traditional fasting and postprandial lipid ratios in both men and women. The apoB/apoA-I ratio was more correlated with postprandial TC/HDL and LDL-c/HDL-c ratios in men and with postprandial TG/HDL-c in women. CONCLUSION: The apoB/apoA-I ratio is helpful in assessing metabolic risk caused by overall obesity, abdominal obesity and impaired glycaemia in type 2 diabetic patients.

Ramadan fasting induces modifications of certain serum components in obese women with type 2 diabetes.

OBJECTIVE: To examine the effect of fasting during Ramadan on certain serum components such as fasting serum glucose (FSG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TGs), high density lipoproteins (HDL-C), and low density lipoproteins (LDL-C) parameters in obese women patients with type 2 diabetes. METHODS: We conducted the study in Petit-Vichy Diabetology Center, Sidi-Bel-Abbes, Algeria from October 2003 to March 2004, on 60 obese outpatient women (BMI = 35.41 +/- 3.64 kg/m2), aged 51 +/- 10 years, who had diabetes for 5 +/- 2.5 years. The patients followed no specific diet, on medications, and presenting no degenerative complications. We carried out the study over 3 periods: before (pre-fasting), during (fasting), and after Ramadan month (post-fasting). RESULTS: Comparing Ramadan (fasting period) with non-Ramadan days (pre- and post-fasting periods), we observed significant decreases in FSG (16.72%, p<0.001), in HbA1c (11.3%, p<0.005), and in HDL-C (26.81%, p<0.001) rates, while TC (13.85%, p<0.001), TGs (16.9%, p<0.003), and the LDL-C (22.39%, p<0.0001) levels increased significantly. CONCLUSION: These findings show a beneficial effect of fasting during Ramadan on glucose homeostasis, however, we observed an unbalanced profile on lipids.