The Pattern of Dyslipidemia and its Associated Factors among Recently Diagnosed Patients with Type 2 Diabetes Mellitus at Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia: A Comparative Cross Sectional Study

Abstract

Dyslipidemia which is a common phenomenon in type-2 diabetes mellitus (T2DM) patients, significantly increases cardiovascular events.  In this study, the prevalence and pattern as well as possible risk factors of dyslipidmia in Ethiopian patients recently diagnosed with T2DM  was determined. This hospital-based crosssectional study enrolled 127 patients with T2DM from a tertiary referral hospital, St.  Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. A semi-structured questionnaire was used to obtain  demographic and cardio-metabolic risk factors while information on comorbidities, full fasting lipid profile, fasting blood glucose, and  glycated hemoglobin A1c were abstracted from the medical charts. Dyslipidemia was defined according to the Third Report of the  National Cholesterol Education Programme (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in  Adults criteria, while elevated levels of non-HDLc was defined as non-HDLc levels ≥ 130 mg/dl. A Chi-square test, student’s t-test and  Kruskal-Wallis test were used accordingly. Multivariate logistic regression analyses were performed to determine factors associated with  component lipid abnormalities. The prevalence of dyslipidemia in T2DM patients was 92.1%. There was no significant difference in the  prevalence of dyslipidemia between the female and male sexes (95.12 % vs. 86.67 %, p = 0.17), although the prevalence of individual lipid  abnormality varied with gender. The prevalence of high total cholesterol, high triglycerides, low HDLc and high LDLc was 28.35%, 52.76%,  64.57%, and 69.29%, respectively. The prevalence of low HDLc (p = 0.002) and high LDLc (p = 0.037) was significantly higher among  females than males, though the difference was barely significant for high total cholesterol (p = 0.05). The prevalence of mixed  atherogenic dyslipidemia, combined dyslipidemia and isolated dyslipidemia was 37 (29.1%), 34 (26.8%), and 27 (21.3%), respectively. The  mixed atherogenic dyslipidemia was the most common pattern of dyslipidemia (37, 29.1%), with the proportion being higher in women  than in men (36.6% vs. 15.6%, p = 0.013). The female gender, age less than 50 years, and not being on statin treatment, physically inactive,  not being hypertensive, and being on metformin + insulin regimen were significantly associated with different component lipid abnormalities in patients with T2DM. The study indicated a high prevalence of dyslipidemia in patients with T2DM attending clinic at  SPMMCH with atherogenic mixed dyslipidemia being the commonest pattern. This implies that most of the T2DM patients are at a higher  risk of cardiovascular disease. Therefore, it is mandatory to screen, implement routine treatments, and educate diabetic patients about  diabetic dyslipidemia and its associated risk factors.