Relationship between the glycemic control, vitamin d status and cardiovascular risk factors including sldl in type 2 diabetes mellitus

Background: T2DM, affects 5.9% of the world's population. Diabetics suffering from complications of chronic hyperglycaemia are also susceptible to deadly cardiovascular diseases (CVD). sLDL, a subtype smaller and heavier than LDL, easily penetrates the walls of arteries. Being atherogenic, it is an emerging risk factor for CVD in T2DM. Objectives: To analyse and correlate glycemic control with vitamin D status, lipid profile including sLDL among T2DM patients and also to clarify the association of sLDL with glycemic control in T2DM. Methods: Total 60 subjects; 30 with T2DM and 30 normal were selected based on the levels of HbA1c. Lipid profile, sLDL, FBS, HbA1c, Profile and Vitamin-D were analysed. Results: HbA1c and FBS ( p< 0.0001) and lipid profile parameters, TC(p < 0.05), TG(p <0.001), LDL, VLDL, Non-HDL, LDL/HDL, TC/HDL, TG/HDL ratios, sLDL (p < 0.0001) and the sLDL/HDL ratio increased significantly and in contrast HDL and Vitamin D levels were significantly decreased (p < 0.05) in Type 2 Diabetic group compared to the control group. HbA1C showed a positive correlation with VLDL(r=0.45, p< 0.001), sLDL(r=0.28; p< 0.05), sLDL/HDL(r=0.53; p< 0.0001), TG(r=0.46; p<0.001), TG/HDL(r=0.50; p< 0.00001) but a negative significant correlation with HDL (r= -0.27; p<0.05), and Vitamin D (although insignificant) in Type 2 Diabetic patients. sLDL in T2DM showed a positive relationship with sLDL/HDL(r=0.655; p<0.00001), TG(r=0.46; p<0.0001), VLDL(r=0.466; p<0.0001), TC (r=0.44; p<0.001), Non-HDL-cholesterol(r=0.421; p<0.001). In contrast, sLDL showed a significant negative correlation with HDL(r= -0.499; p<0.00001), LDL/HDL(r = -0.25; p<0.05)), TC/HDL(r= -0.162) indicating that these decrease while sLDL may increase or vice-versa. sLDL has insignificantly inverse relation with Vitamin D in Type 2 Diabetic patients. Conclusion: sLDL was directly correlated with HbA1c and Triglycerides while inversely related to Vitamin D levels in T2DM. T2DM patients with increased HbA1c due to uncontrolled diabetes showed invariable increase in lipid profile and sLDL although decreased HDL and Vitamin D levels.