title: Discordance between lipid markers used for predicting cardiovascular risk in patients with type 2 diabetes.
abstract: OBJECTIVE
  Non-high density lipoprotein cholesterol (non-HDL-C) is gaining importance over low density lipoprotein cholesterol (LDL-C) as cardiovascular risk marker in patients with type 2 diabetes. It represents the overall lipid burden and is a surrogate marker for the apolipoprotein B. We studied the discordance between the old (LDL-C) and the new (non-HDL-C) lipid markers in a large group of diabetes patients.
  
  
  METHODS
  The lipid profile data of all diabetes (T2DM, aged 18-75, using oral or injectable anti diabetic agents) patients was analyzed in this study. We excluded patients with type1 diabetes, secondary forms of diabetes and gestational diabetes. Elevated lipid parameters (LDL>100mg/dL and non HDL-C>130mg/dL) were defined as per the guidelines of Adult Treatment Panel III.
  
  
  RESULTS
  The study participants (409 M:360 F) had a mean age of 47.3±12.4 years, BMI of 28.4±5.6kg/m(2) and an A1c of 8.8±2.2%. Elevated LDL-C was observed in 383 patients (49.8%) and elevated non HDL-C in 418 (54.4%) patients. Of the 383 patients with elevated LDL-C, 346 (90.3%) had corresponding elevated levels of non-HDL-C and out of 418 patients with elevated non HDL-C, 346 (83%) had elevated LDL-C. Discordance between the elevated LDL-C and non-HDL-C values were greater among patients with low triglyceride levels when compared with those with high triglycerides (Pearson's χ(2) test=67.7; P<0.001).
  
  
  CONCLUSIONS
  Our data suggest a significant discordance between the LDL-C and non-HDL-C in patients with diabetes. This discordance leads to the residual cardiovascular risk in diabetes patients.
authors.affiliation: Department of Endocrinology, Dr Modi's Clinic, Hyderabad, Telangana, India.
authors.forename: K D
authors.initials: KD
authors.lastname: Modi
authors.affiliation: Department of Personnel & Industrial Relations, IIM, Ahmedabad, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Chandwani
authors.affiliation: Department of Endocrinology, Dr Modi's Clinic, Hyderabad, Telangana, India.
authors.forename: Ishaq
authors.initials: I
authors.lastname: Ahmed
authors.affiliation: Department of Endocrinology, Command Hospital, Chandimandir, Haryana, India. Electronic address: hariendo@rediffmail.com.
authors.forename: K V S Hari
authors.initials: KV
authors.lastname: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids
keywords: Cardiovascular risk; Discordance; LDL cholesterol; Non HDL cholesterol; Type 2 Diabetes