Lipid ratios, atherogenic coefficient and atherogenic index of plasma as parameters in assessing cardiovascular risk in type 2 diabetes mellitus

Background:Cardiovascular disease (CVD) is responsible for morbidity and mortality in type 2 diabetes mellitus (T2DM) patients. Diabetes alters the utilization of lipids and lipoproteins which lead to diabetes induced atherogenic dyslipidemia, one of the most important risk factor for the development of atherosclerosis. The relationship between elevation of serum lipids and vascular complications of diabetes has long been of interest. The use of LDL-c alone for assessment of cardiovascular risk would ignore the TG-rich lipoproteins. Lipid ratios, atherogenic coefficient and atherogenic index of plasma have been found to indicate an atherogenic risk and are better predictors of cardiovascular risk than lipids alone. Hence the present study is taken up to evaluate the lipid ratios, atherogenic coefficient, atherogenic index of plasma in assessing the CV risk in type 2 diabetes mellitus.Methods: This case-control prospective study included three groups. (Group 1: control, group II: T2DM without complications, group III: T2DM with complications, n=25). Total cholesterol, triglycerides and HDL-c were analysed using commercially available kits on spectrophotometer. Nitric oxide was estimated spectrophotometrically by Griess method. VLDL, LDL, Lipid ratios, non-HDL cholesterol, AC and AIP were calculated in all the three groups. Statistical analysis was performed using SPSS version 22.0.Results: All of the atherogenic indices were found to be significantly different upon comparing these indices in both patients and control groups.Conclusions: The ratios contribute significantly to the estimation of CVD risk  in type 2 diabetes mellitus especially, when the absolute values of lipid profile seem normal or not markedly deranged or in centres with insufficient resources.