Is high density lipoprotein cholesterol useful in diagnosis of metabolic syndrome in native Africans with type 2 diabetes?
BACKGROUND
High-density lipoprotein (HDL) hypocholesterolemia predicts metabolic syndrome among Caucasians and is one of the World Health Organization (WHO) diagnostic criteria of the syndrome. Plasma lipid levels are, however, influenced by genetic and environmental factors.


OBJECTIVE
To determine the relationship between HDL cholesterol and metabolic syndrome among native Africans with type 2 diabetes.


METHODS
Indigenous Nigerians with type 2 diabetes (N = 254) aged 35-80 years (mean: 52.0 +/- 11.7 years) with male:female ratio of 1.5:1 were studied prospectively. Outcome measures included anthropometric indices, plasma lipid concentrations, uric acid, microalbuminuria, and predictive values.


RESULTS
Of the 254 diabetic patients, 150 (54.3%) had metabolic syndrome. Dyslipidemia occurred in 184 (72.4%) patients. Of these, 54 (29.4%) had HDL hypocholesterolemia. Mean HDL cholesterol among patients with HDL hypocolesterolemia and those with normocholesterolemia were 32.4 +/- 5.7 mg/dL and 51.3 +/- 9.9 mg/dL, respectively. Prevalence of metabolic syndrome did not differ significantly between the two groups (56% vs 70.4%; P = .08). Linear regression analysis showed no association between HDL cholesterol and metabolic syndrome (r = 0.01; P = .2), body mass index (r = 0.02; P = .4), waist circumference (r = 0.07; P = .42) and microalbuminuria (r = 0.03; P = .8). A positive correlation occurred between HDL cholesterol and triglyceride concentrations (r = 0.6). The sensitivity, specificity, and positive and negative predictive values of HDL hypocholesterolemia in the diagnosis of metabolic syndrome were 25%, 84.6%, 70.4%, and 44%, respectively.


CONCLUSIONS
High-density lipoprotein cholesterol may not be a reliable diagnostic tool of metabolic syndrome among native Africans with type 2 diabetes.
Isezuo
Simeon A
SA
Department of Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. sisezuo@skannet.com
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000208:ethnology*; D008875:Middle Aged; D009549:Nigeria; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors
D008076:Cholesterol, HDL