ANALYSIS OF CORRELATION BETWEEN SERUM GLUCOSE AND CHOLESTEROL OF TYPE 2 DIABETIC PATIENTS

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www.wjpr.net Vol 7, Issue 9, 2018. 1086

ANALYSIS OF CORRELATION BETWEEN SERUM GLUCOSE AND

CHOLESTEROL OF TYPE 2 DIABETIC PATIENTS

Kanmani Vennila P.*

Department of Zoology, Assistant Professor, Quaid-e-millath College for Women, Chennai –

60006, Tamilnadu.

ABSTRACT

Type 2 Diabetic patients were observed for the following parameters

like BMI, FBS, PPBS, Cholesterol, HDL and LDL in the serum of both

Men & Women. World Health Organization estimates that more than

180 million people worldwide have diabetes and this number will

double by 2030. It is estimated that 1.1 million people died from

diabetes and 80 percent of diabetes deaths occur in low and

middle-income countries. The level of blood glucose in Men Type 2 Diabetic

patients both in FBS and PPBS are 60-117mg/dl and 180-354 mg/dl

respectively. Whereas in women patients it is from 89 - 112 mg/dl and

220 - 356 m g/dl respectively. The observed fasting blood sugar level

is normal, whereas the PPBS is high both in Men and Women Type 2

Diabetic patients. BMI shows obesity which ranges between 24-36 kg/m2 in men and

26-48kg/m2 in women. When we analyze the cholesterol level, the range is below 240 mg/dl,

which is between 133-234 mg/dl, in men and 170-188mg/dl in women. Estimated correlation

between BMI and Cholesterol shows a negative correlation of -0.005 in men and -0.003 in

women. The higher level of glucose in the serum of PPBS could be because of impaired

glucose metabolism of insulin resistance.

KEYWORDS: Body Mass Index, Fasting Blood Glucose, Post Prandial Blood Glucose,

High Density Lipid, Low Density Lipid.

INTRODUCTION

Diabetes Mellitus is a metabolic disorder with inappropriate hyperglycemia either due to an

absolute or relative deficiency of insulin secretion or reduction in the biologic effectiveness

Volume 7, Issue 9, 1086-1097. Research Article ISSN 2277– 7105

Article Received on 12 March 2018,

Revised on 02 April 2018, Accepted on 23 April 2018,

DOI: 10.20959/wjpr20189-12156

8533

*Corresponding Author

Kanmani Vennila P.

Department of Zoology,

Assistant Professor,

Quaid-e-millath College for

Women, Chennai – 60006,

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www.wjpr.net Vol 7, Issue 9, 2018. 1087 of insulin or both (Guyton and Hall et al., 2011). It is also associated with disturbances

concerned with protein, carbohydrate and lipid metabolism (Brownle et al.,1981). The

decreased uptake of glucose into muscle and adipose tissue leads to chronic extra cellular

hyperglycemia which results in tissue damage and chronic vascular complications in both

Type I and II Diabetes Mellitus (Luscher et al.,2003). Type 2 Diabetes Mellitus also known

as Non-Insulin-Dependent Diabetes Mellitus (NIDDM) which is characterized by either

insufficient insulin production or insulin resistance. It has a gradual onset occurring above 40

years of age (Sapna Smith et al., 2008). Dyslipidemia is a common feature of NIDDM

(Otieno et al.,2005). It is a modifiable risk factor for cardiovascular diseases (Jimoh et al.,

2010) which is the major cause of death in Type 2 Diabetes (Jarvisalo et al., 2002).

Lipoprotein lipase, the main enzyme for metabolism of lipids is insulin dependent and hence

insulin resistance leads to increased amount of circulating lipids (Laakso, 1999).

There is large number of lipoproteins within blood, generally called, from larger to smaller

size: chylomicrons, very low density lipoprotein (VLDL), intermediate density lipoprotein

(IDL), high density lipoprotein (HDL). The most common lipid pattern in T2DM consists of

hypertriglyceridemia (hyper-TG), low high-density lipoprotein (HDL-C) and normal plasma

concentrations of low-density lipoprotein cholesterol (LDL-C). People with Type 2 Diabetes,

regardless of blood sugar control tend to have increased triglycerides, decreased HDL, and

increased LDL (Krantz et al., 2004; M. Rizzo et al.,2006; Chan2006; Syed Raza Ali Shah et

al., 2010). Plaques formed in the arteries of people with Type 2 Diabetes tend to be fattier

and less fibrous than in people with Type 1 Diabetes, leading to an even higher risk of a

plaque dislodging to cause a heart attack or stroke (Anui Juutilainen et al.,2004).

Diabetic women have been reported to have significantly low level of HDL by Gilani et al.,

2001) while in other studies females had higher triglycerides and Blood Pressure compared to

their male diabetic counterpart (Saara Gilani et al.,2010). There is 2-4 times increase in risk

of cardiovascular diseases in women compared to men (Kanaya Am et al.,2002;

Berrett-Connor. E et al.,2004; Lee, et al.,2000).

The BMI trait is influenced by both genetic and non-genetic factors, and it provides a

paradigm to understand and estimate the risk factors for health problems showed a direct

association of BMI with TG, TC, LDL and VLDL (Baral et al.,2006). Previous studies in

which gender differences in dyslipidemia was significantly showed BMI of the patients as

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www.wjpr.net Vol 7, Issue 9, 2018. 1088 Diabetes Mellitus may lead to organ damage, impairment of organ functions, and mortality

due to cardiovascular disease. T2DM is often associated with obesity, hypertension,

hypercholesterolemia and hypertriglyceridemia, cluster of all these risk factors may lead to

cardio metabolic syndrome. Here in our present study we have observed BMI, Cholesterol,

HDL, LDL and Glucose in serum, both the FBS and PPBS levels in Men and Women Type 2

Diabetic patients.

METHODOLOGY

SAMPLE PREPARATION

After taking informed consent, under thorough aseptic precautions, 2 ml of venous sample is

collected from the patient in a plain vacutainer and allowed to clot. After one hour, the

vacutainer is centrifuged at 2500 rpm for 5 min and serum is extracted and stored. The blood

glucose level was estimated by adapting the procedure described by Dubowski (1962) and the

cholesterol was estimated by the method prescribed by Beale and Croft (1962). Similarly,

estimation of HDL and LDL were done by adapting the method of Bachorik et al., (1996).

RESULTS AND DISCUSSION

Diabetes mellitus (DM) is a metabolic disorder of multiple etiologies characterized by

chronic hyperglycemia and abnormal carbohydrate, fat and protein metabolism which results

from defects in insulin secretion and or insulin action. DM is associated with various acute

and chronic complications resulting in systemic damage (World Health Organization).

Worldwide the prevalence of diabetes in adults would increase to 5.4% by the year 2025 from

the prevalence rate of 4.0% in 1995. Consequently, the number of adult with diabetes in the

world would rise from 135 million in 1995 to 300 million in the year 2025 (King et al.,

1998). It is expected that much of this increase in prevalence rate will occur in developing

countries. In developing countries most of the diabetic patients are in the age group of 45-64

years, while in developed countries most of them are 65≥ years. Therefore, diabetic patients

in developing countries are even more vulnerable to develop the micro- vascular

complication.

In our present study, Figure 1 shows the different levels of blood glucose of FBS and PPBS

among Men Type 2 Diabetic patients between the age group of 35-80 years, where the FBS

level is between 60-167 mg/dl and the PPBS level is between 180-354mg/dl. The normal

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www.wjpr.net Vol 7, Issue 9, 2018. 1089 to 167mg/dl, in the case of men and in women it is between 89-112mg/dl. Figure 2 shows the

level of both FBS and PPBS in the case of Women Type 2 Diabetic patients between the age

group of 35-75 years where the level of FBS shows within the range of 89-112 mg/dl and the

PPBS is between 220-356 mg/dl. The normal value of an adult after meal should be less than

180 mg/dl, where the observed value for men are above 180 mg/dl from 219 -354 mg/dl and

in women it is from 220-356 mg/dl.

Figure 3 shows the cholesterol level of Men which ranges between 133-234 mg/dl. The

normal level of blood cholesterol level is less than 200 mg/dl and when it is >240 mg/dl it is

said to be high. Figure 4 shows the different levels of cholesterol in Type 2 Diabetic patients

of women, where the amount varies from 170-188mg/dl in different age group. Here the

result shows within the range of cholesterol both in men and women. So the observed

diabetic patients are having normal level of cholesterol not a higher value. Figure 5 shows

the level of both HDL and LDL in the case of men Type 2 Diabetic patients, where the HDL

level is between 33-63 mg/dl and the LDL level is between 120 to 174 mg/dl. Figure 6 shows

the level of both HDL and LDL in the case of women Type 2 Diabetic patients, where the

HDL level is between 39-62 mg/dl and the LDL level is between 111-175 mg/dl.

The normal value of HDL is >50 and when it is goes <35 mg/dl it is risky. When the LDL is

< 130 mg/dl, it is normal and when it is >240 mg/dl it is highly risky. Here the observed

result of men shows the HDL which are within the range of 50-35, and the LDL is in the

range between 130-160 where there is no risk. Likewise, in women the observed result

shows the range of HDL which is between 56-35 mg/dl and the LDL shows a range between

130-160mg/dl, proves that there is no effect on the risk of cholesterol on trans-fat. The

biggest influence on blood cholesterol level is the “type” of fat you eat. There are two types

of fats, good fat which are monounsaturated and polyunsaturated fats lower your risk of

disease such as heart disease and atherosclerosis.

Table 1 shows the Body Mass Index of Type 2 Diabetic men patients, where it ranges from

24 – 36 kg/m2 shows the higher BMI group of patients. It also shows the Body Mass Index of

women Type 2 Diabetic patients between the age group of 35-75 years, where the Body Mass

Index ranges from 26 to 48 kg/m2 comes under over weight group of people.

A consequence of obesity is seen more in men than in women due to differences in insulin

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www.wjpr.net Vol 7, Issue 9, 2018. 1090 BMI shows the range above the normal weight, which is above 25. This shows that Type 2

Diabetic patients are overweight because of the altered metabolism of carbohydrates.

Table 2 shows the observed cholesterol level and the BMI relation in T2D men patients. In

figure 7, the correlation shows a negative correlation of -0.005 between BMI and

Cholesterol Level of the observed Type 2 Diabetic men patients. Table 2 also shows the

observed cholesterol level and the BMI relation in T2D Women patients. In figure 8, the

correlation shows a negative correlation of -0.003 between BMI and Cholesterol Level of

the observed Type 2 Diabetic women patients. The observed result of Correlation between

the BMI and the Cholesterol of Men and Women shows negative correlation between the

weight of the person with that of their cholesterol level. This correlation says that the level of

HDL and LDL are in the range of borderline not above that and it is proved with the negative

correlation of – 0.005 and -0.003 both in Men and Women, respectively.

It is evident from the observed result that PPBS level in serum is higher in both the genders.

But when you see the correlation between BMI and cholesterol there is a negative correlation.

Since the BMI shows above the normal weight and there is negative correlation between BMI

and cholesterol, we can say that this is because of the impaired way of glucose metabolism.

Diabetes Mellitus is associated with increased prevalence of endothelial cell dysfunction and

vascular diseases. High glucose concentration activates endothelial cells leading to

monocytes adhesion providing further evidence that hyperglycemia might be implicated in

vessel wall lesion contributing to diabetic vascular disease.

Type 2 Diabetic conditions share insulin resistance in several tissues, and when

hyperglycemia develops there are several potential mechanisms for high glucose to increase

the risk of atherothombosis (Laakso. 1999). The pathogenesis of atherosclerotic lesions is

impaired endothelial function, which is tightly linked to insulin resistance. Table 3, figure

9& Table 6, figure 10 depicts the levels of cholesterol & PPBS comparatively both in Men &

Women Type 2 diabetic patients. Impaired glucose metabolism leading to hyperglycemia

and dyslipidemia, controlling hyperglycemia can minimize these lipid disorders and

subsequent vascular conditions. (Marcus, 2001, Lehto et al., 1997).

Diabetes-associate pathophysiological conditions in the endothelium are modifications of

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www.wjpr.net Vol 7, Issue 9, 2018. 1091 immune complexes, alteration of the nitric oxide pathway, and elevated levels of

homocysteine.

The vaso-dilatory action of insulin is dependent on nitric oxide(NO) generation, which

diminishes both blood flow and glucose uptake (Steinberg, et al.,1997). Indeed,

NO-dependent insulin increases in blood flow to skeletal muscle could account for 25 to 40% of

the increase in glucose uptake in response to insulin stimulation (Kim, et al., 2006).

Metabolism of insulin resistance is characterized by pathways-specific impairment e.g., by

pro inflammatory cytokines, interleukin, C-reactive protein [CRP], which in the endothelium

may cause imbalance between production of NO and glucose uptake, resulting in insulin

resistance and endothelial dysfunction.

Low-grade inflammation is linked to insulin resistance and is involved in the pathogenesis of

type 2 diabetes (Dandona. et al., 2004). Inflammatory and insulin signaling pathways are

tightly linked, both of which lead to insulin resistance and endothelial dysfunction,

contributing to cardiovascular complication. High glucose concentrations can also associate

and stimulate the proliferation of vascular smooth muscle cells and migration to the intima,

where they participate in the formation of fibrous cap. Thin fibrous cap, caused by decreased

collagen production or degradation of collagen and matrix by proteinases, and inflammation,

both often observed in Type 2 Diabetes, increased susceptibility to plaque rupture (Laakso

2001). Platelet activity and blood coagulability are increased in type 2 Diabetes, resulting in

enhanced thrombus formation. Since, in our present study, we observed higher level of PPBS

in the serum of Type 2 Diabetic patients, the above discussed insulin resistance and impaired

glucose metabolism could be the cause and it may lead to other complications like cardio

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www.wjpr.net Vol 7, Issue 9, 2018. 1092 CONCLUSION

In the serum of Men and Women Type 2 Diabetic patients the following parameters like

BMI, FBS, PPBS, Cholesterol, HDL and LDL were observed, between 35-80 years in Men

and in Women between 35-75 years of age. The level of blood glucose in the serum of men

patients are both in FBS and PPBS as 60-117mg/dl and 180-354 mg/dl respectively, whereas

in women it is from 89 - 112 mg/dl and 220 - 356 m g/dl respectively. The observed fasting

blood sugar level is normal, whereas the PPBS is high both in Men and Women Type 2

Diabetic patients. When we observed the cholesterol level, both in men and women Type 2

Diabetic patients, the range is below 240 mg/dl. Likewise, the HDL is in the normal range as

>50mg/dl and <35mg/dl and LDL as <240 mg/dl which is a normal range both in men and

women. But the BMI shows the range of obesity between 24-36 kg/m2 in men and

26-48kg/m2 in women. When we analyzed the correlation between BMI and Cholesterol it shows

a negative correlation of -0.005 in men and -0.003 in women. So from this observation we

concluded that the higher level of glucose in the serum of PPBS could be because of impaired

glucose metabolism of insulin resistance. This may lead to other complications like

cardiovascular and endothelial dysfunction. Bearing this in mind, continuous monitoring of

glucose and lipid profile in diabetic patients is essential.

Figure1: Blood Glucose Level of FBS and PPBS (Men)

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www.wjpr.net Vol 7, Issue 9, 2018. 1093 Figure3: Age with Cholesterol Level (Men) Figure 4. Age with Cholesterol level

(Women)

Figure 5: Age with HDL and LDL (Men)

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www.wjpr.net Vol 7, Issue 9, 2018. 1094 Figure 7: Correlation Between the BMI and

Cholesterol in Men Figure 8: Correlation Between the BMI and Cholesterol in Women

Figure 9: Age with Cholesterol & PPBS (Men)

Figure 10: Age with Cholesterol &PPBS (Women)

Table 1: Body Mass Index observed from the diabetic patients (Men and Women).

S.No Men Women

Age BMI kg/ m2 35-40 26

1 35-40 30 40-45 27

2 40-45 36 45-50 46

3 45-50 33 50-55 45

4 50-55 35 55-60 35

5 55-60 24 60-65 44

6 60-65 25 65-70 28

7 65-70 24 70-75 48

8 70-75 29 35-40 26

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www.wjpr.net Vol 7, Issue 9, 2018. 1095 Table 2: Age, Cholesterol and BMI observed from both gender (Men and Women).

S.No Age

Men Women

Cholesterol

mg/dl BMI kg/m2

Cholesterol

mg/dl BMI kg/m2

1 35-40 192 29.5 175 26

2 40-45 170 36 172 26.50

3 45-50 184 33 182 46

4 50-55 188 35 176 45

5 55-60 217 19 150 35

6 60-65 136 23 181 44

7 65-70 180 24 188 20

8 70-75 236 48 175 48

9 75-80 194 32 175 26

Table 3: shows the age with cholesterol &PPBS observed in both the men and women.

S.No Age Cholesterol

mg/dl PPBS mg/dl

Cholesterol

mg/dl PPBS mg/dl

1 35-40 192 354 175 220

2 40-45 170 171 172 166

3 45-50 184 295 182 226

4 50-55 188 172 176 156

5 55-60 217 338 150 315

6 60-65 136 220 181 265

7 65-70 180 180 188 356

8 70-75 236 306 175 225

9 75-80 194 234 -- ---

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Figure

Figure 6: Age with HDL and LDL (Women)

Figure 6:

Age with HDL and LDL (Women) p.8
Figure 7: Correlation Between the BMI and  Cholesterol in Men

Figure 7:

Correlation Between the BMI and Cholesterol in Men p.9
Table 1: Body Mass Index observed from the diabetic patients (Men and Women).

Table 1:

Body Mass Index observed from the diabetic patients (Men and Women). p.9
Table 3: shows the age with cholesterol &PPBS observed in both the men and women.

Table 3:

shows the age with cholesterol &PPBS observed in both the men and women. p.10
Table 2: Age, Cholesterol and BMI observed from both gender (Men and Women).

Table 2:

Age, Cholesterol and BMI observed from both gender (Men and Women). p.10

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