Correlations of Serum Lipid Parameters and Atherogenic Indices With Left Ventricular Diastolic Dysfunction Among Apparently Healthy Patients With Type 2 Diabetes Mellitus: A Multicenter In-Hospital Cross-Sectional Study.

Background: In adolescents with Type 1 diabetes, lipid ratios are predictors of left ventricular diastolic dysfunction (LVDD). However, whether this also applies to adults with Type 2 Diabetes Mellitus (T2DM) is unclear. This study is aimed at assessing the correlations of serum lipid parameters and atherogenic indices with LVDD in patients with T2DM. Methods: This cross-sectional study included 203 patients with T2DM aged 59.9 ± 13.6 years (111 males, sex ratio: 1 : 2 in favor of males) from eight randomly selected urban hospitals. Demographic information was collected, an anthropometric assessment was performed, and blood pressure was measured. Fasting blood samples were obtained to assess total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), glucose, and glycated hemoglobin. The atherogenic index of plasma (AIP), Castelli Risk Index I (CRI-I), Castelli Risk Index II (CRI-II), atherogenic coefficient, and non-HDL-C were determined using specific formulas. Diastolic function was assessed using echocardiography as per the 2016 updated guidelines of the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI). Results: Approximately 47.8% of the participants had LVDD. Compared with participants with normal diastolic function, those with LVDD were more likely to be older than 55 years (p < 0.001), tended to have obesity (p = 0.045), had a higher risk of developing dyslipidemia (p = 0.041), and higher AIP and CRI-II (p < 0.05) levels while having similar low HDL-C and hypertriglyceridemia frequencies. In the multivariate model adjusting for age, high AIP (adjusted odds ratio [aOR], 3.37; 95% confidence interval [CI], 1.22-5.34) and high CRI-II (aOR: 3.80; 95% CI: 2.25-6.35) were independent determinants of LVDD. Conclusions: These results highlight the importance of considering atherogenic indices, primarily AIP and CRI-II in the management of T2DM patients. High AIP and high CRI-II could serve as surrogate markers of LVDD, an early cardiovascular manifestation in patients with T2DM.

Hyperbolic relation between beta-cell function and insulin sensitivity for type 2 diabetes mellitus, malaria, influenza, Helicobacter pylori, Chlamydia pneumoniae, and hepatitis C virus infection-induced inflammation/oxidative stress and temporary insulin resistance in Central Africans

Background/aim: We calculated the homeostatic model assessment (HOMA) for estimating insulin sensitivity and beta-cell function in normal, healthy nondiabetics with infections (malaria, influenza, HIV, Helicobacter pylori, Chlamydia pneumoniae, and hepatitis C virus), type 2 diabetic black patients, and healthy controls from Kinshasa, DR Congo. Materials and methods: A case-control study was carried out between 2006 and 2007 for black Central African participants managed for HOMA.Results: In total, 219 patients and 110 healthy controls were matched for sex and age. The hyperbolic product for 85 infected patients occupied an intermediate position between the hyperbolic product for 110 controls and that of 134 type 2 diabetics. Inflammation/oxidative stress was present in all infected patients, as well as in the type 2 diabetics. Of the patients, 39.3% and 49.8% had insulin resistance and metabolic syndrome, respectively. Insulin resistance was more prevalent in nondiabetics with inflammation/oxidative stress (47.1%; P = 0.041) than in type 2 diabetics (34.3%). Type 2 diabetics had higher insulin sensitivity and lower beta-cell function but a similar HOMA-IR score. Conclusion: We recommend the assessment of insulin resistance in Central African patients with severe infections and type 2 diabetes.