Dyslipidemia is commonly associated with diabetes (T2DM). This has been demonstrated for the Caucasian population, but few data are available for Asian Indians. The paper aims to investigate serum lipids (separately or in combination) and their association with glucose intolerance status (T2DM and prediabetes) in a rural Bangladeshi population. A sample of 2293 adults (≥20 years) were included in a community based cross-sectional survey in 2009. Anthropometric measures, blood pressure, blood glucose (fasting and 2-h oral glucose tolerance test) and fasting serum lipids (total cholesterol, T-Chol; triglycerides, Tg; low density lipoprotein cholesterol, LDL-C and high density lipoprotein cholesterol, HDL-C) were registered. Analysis of covariance (ANCOVA) and regression analysis were performed. High Tg levels were seen in 26% to 64% of the participants, depending on glucose tolerance status. Low HDL-C levels were seen in all groups (>90%). Significant linear trends were observed for high T-Chol, high Tg and low HDL-C with increasing glucose intolerance (p for trend <0.001). T2DM was significantly associated with high T-Chol (Odds ratio (OR): 2.43, p < 0.001), high Tg (OR: 3.91, p < 0.001) and low HDL-C (OR: 2.17, p = 0.044). Prediabetes showed a significant association with high Tg (OR: 1.96, p < 0.001) and low HDL-C (OR: 2.93, p = 0.011). Participants with combined high Tg and low HDL-C levels had a 12.75-fold higher OR for T2DM and 4.89 OR for prediabetes. In Asian Indian populations an assessment of serum lipids is warranted not only for T2DM patients, but also for those with prediabetes.
BackgroundRecent data suggest that the prevalence of obesity and its associate cardiometabolic risks are increasing in Bangladesh. Published data of obesity in Bangladeshi industry workers is scarce. The purpose of this study was to assess the prevalence of general and central obesity in Bangladeshi factory workers and their associations with diabetes and hypertension.MethodsA total of 791 male factory workers aged ≥20 years in capital Dhaka city of Bangladesh were investigated in a population-based cross-sectional survey. According to the International Association for the Study of Obesity and the International Obesity Task Force guidelines for Asian population, general obesity was defined as body mass index (BMI) ≥25 kg/m2, central obesity was defined as a waist circumference (WC) of ≥90 cm and waist hip ratio (WHR) of ≥0.90. Pearson’s correlation coefficient and logistic regression analysis were used to observe the association between anthropometric indices (BMI, WC and WHR) and cardiometabolic risk indicators (FBG, 2hBG, SBP and DBP).ResultsThe prevalence of overweight (BMI 23–24.9 kg/m2) and general obesity (BMI ≥25 kg/m2) in this study population was 29.8 and 43.5 % respectively. Central obesity defined by WC and WHR was 35.3 and 78.3 % respectively. Both general and central obesity were found to be significantly associated with diabetes and hypertension in separate logistic regression analyses.ConclusionThe prevalence of general and central obesity in Bangladeshi factory workers was high, and it was associated with diabetes and hypertension.
Similar to many other countries around the world, Bangladesh is also suffering from a pandemic of diabetes. It makes the most significant contribution to morbidity and mortality in this country. Despite the high burden of diabetes, health care is still geared toward episodic care. The government has not yet invested substantial efforts into developing a national policy to detect, prevent, and control diabetes. Still, diabetes care is restricted to capital and other big cities. More than 60% of people with diabetes usually sought treatment and advice from private facilities, including the Diabetic Association of Bangladesh. For the past six decades, the Association has been trying to develop a proper organizational framework, health care, educational institutions, rehabilitation facilities for poor people with diabetes, appropriate diabetes prevention, and education programs. To address the pandemic, the country should focus on nationwide diabetes prevention and control programs, such as creating community awareness and changing lifestyle practices through well-designed public health programs. The country also needs public–private partnerships and multi-sectoral approaches to overcome the diabetes burden.
Background and Aims The traditional and non-traditional lipid have been recognized to be involved in various atherosclerotic disease process. Several studies showed that, there is relation with renal function and dyslipidemia. Early detection of these modifiable risk factors and initiation of treatment may prevent or retard the progression of renal disease. Aim of this study was to evaluate the association of the traditional and non-traditional lipid abnormalities with renal function. Methods This cross sectional study was carried out in a rural area of Bangladesh. Renal function was evaluated by estimation of enzymatic creatinine, eGFR (CKD-EPI) and spot ACR. Total cholesterol (TC), triglyceride (TG), LDL and HDL was measured as traditional lipids and Apo-A1, APO-B, Lipo (a) as non-traditional lipids. Traditional dyslipidemia (TDLP) and non-traditional dyslipidemia (nTDLP) means abnormality in any of their components. Other tests include urine microscopy, Hb%, FBS, HbA1c, serum albumin and uric acid as additional risk marker. Results Total 201 patients were included for analysis. The mean age was 41± 13 years and male/female ratio 48:52. Around 48% were overweight. Among these 20% were hypertensive, 14% diabetic, nephropathy in13% and rest 53% had no known chronic disease. The mean value of creatinine was 0.8±0.2 mg%; eGFR was 94±23 ml/min/1.73m2, ACR was 9.70 (median), TG 182±104 mg/dl, TC 96 ±47 mg/dl; LDL 121 ± 39 mg/dl and HDL 38±6. The value of Apo-Al was 1.3 g/l (0.2-13.9), Apo-B 1.04 g/l (0.2-2.6) and Lipoprotein (a) was 17.3mg/dl (1.1-81.8). Mean value of FBS was 6.2 ±2.3 mmol/l, HbA1c 6.1 ±1.5%, Hb% 13.5 ± 1.6 g% and albumin was 4.8 ±0.5 mg%. When measured the TDLP was present in 81% and normal traditional lipids present in 19%. Similarly as a whole 50% had nTDLP and non-traditional lipids were normal in other half. Around 16% were free from both TDLP and nTDLP. The eGFR was lower in – TG >150 group than in < 150 (90 ± 24 vs. 98 ± 21 mg%, p<0.02); TC >200 than <200 (91 ± 23 vs. 100 ± 22 mg%, p<0.001); LDL >100 and < 100 (91± 23 vs. 100 ± 22 mg%, p<0.015) but no difference for components of nTDLP. The ACR was higher (> 30 mg/g) in 76% vs 24% (p<0.001) when TG is > 150 and < 150 mg%; 60% vs. 40% (p<0.05) when TC is > 200 and < 200mg%; and 81% vs. 19% (p<0.04) when LDL > 100 and < 100mg%. No such difference for renal functional parameters for non-traditional lipid components. In this study, eGFR had significant negative correlation with TC (r = -0.34 & p<0.001), TG (r = -0.24 & p<0.001), LDL (r = -0.25 & p<0.001) and only ACR had positive correlation with TG (r = 0.17 & p = 0.012). The nTDL wasn't associated with altered eGFR or ACR. Conclusion In this study it was observed that traditional lipid components were altered in 81% whereas non-traditional lipids were altered in 50% rural subjects. Only the traditional dyslipidemia was associated with lower eGFR and higher ACR.
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