Glycated hemoglobin: A surrogate marker of coronary artery diseases?

Abstract

Background: Diabetes mellitus is a global epidemic defined by an elevated glycated hemoglobin (HbA_1c). The symbiotic relationship between diabetes and dyslipidemia has been studied and glycated hemoglobin has been projected as a potential marker for coronary artery diseases. Aim: To study the correlation between the HbA_1c and the lipid ratios / individual lipids Methods: The data was collected from 90 patients of type 2 Diabetes Mellitus over a period of 6 months, after an informed written consent. The study subjects were divided according to the HbA_1c values into three groups - Group A: HbA_1c 7%, Group B: HbA_1c /= 10 % and >/= 7%_, Group C: HbA_1c >10 %. The lipid profiles of the patients after a minimum of 8 hours of fasting were noted. The values of the lipid ratios and the individual lipids were mapped against the HbA_1c values of each group. The correlation between the glycated hemoglobin and the lipid profile was analysed. Results: The maximum number of patients (30%) were in the 6^th decade of life. Among the study subjects, 39 patients (43.33%) were females and 51 patients (56.66%) were males. Group B had the majority of patients (44.4%) followed by group A. There was a positive correlation between HbA_1c and triglycerides (p=0.04) and a negative correlation between HbA_1c and HDL (p=0.003). There was a positive correlation between HbA_1c and LDL/HDL (p=0.022), TG/HDL (p=0.008) and TC/HDL (p=0.007). Thus the TC/HDL ratio was most impaired by a rise in HbA_1c when compared with other lipid ratios. Conclusion: There is a significant positive correlation between HbA_1c and lipid ratios. Lipid ratios in turn are important predictors of CAD. Hence HbA_1c can be used to predict dyslipidemia and CAD in patients with Type 2 diabetes mellitus and can be used as a surrogate marker for the same.