TYPE 2 DIABETES MELLITUS, HYPERTENSION AND CONCURRENT TYPE 2 DIABETES, AND HYPERTENSION: PATIENTS AND METHODS

10 Feb
2010

Patients were made of age and sex-matched indigenous Nigerian normotensive type 2 diabetes mellitus patients; normoglycaemic hypertensives and patients with concurrent type 2 diabetes and hypertension (40 patients per group). They were recruited at the medical outpatients’ clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto, Northwestern Nigeria. Age and sex-matched volunteers certified clinically and biochemically to be healthy; normotensive and normoglycaemic served as controls. They were made of hospital staff, blood donors and medical students.

The diagnosis of diabetes mellitus was based on the World Health Organisation criteria. Patients on oral hypoglycaemic drugs or whose diagnosis of diabetes was made at the age of 40 years and above with no record of ketosis were considered to have type 2 diabetes mellitus. Systolic blood pressure > 140mmHg and/or diastolic > 90mmHg measured using standard procedures were required to make a diagnosis of hypertension. Height and weight were measured to the nearest centimeters and grams respectively with the subjects lightly clothed and without shoes. Obesity was defined as body mass index > 30Kg/m2buy levitra uk

The duration of diagnosis of diabetes mellitus was 4.3 ±1.4 years and 4.2 ±1.9 years among the normotensive and diabetic hypertensives respectively. The duration of diagnosis of hypertension was 6.0 ± 3.2 and 5.8 ± 2.2 years among the normoglycaemic hypertensives and type 2 diabetic hypertensives, respectively.

Patients with lipid-altering diseases: nephrotic syndrome, hepato-biliary disease and hypothyroidism were excluded. Other exclusion criteria included frank proteinuria detected by multistix, alcohol consumption, cigarette smoking and use of lipid altering drugs, including lipid lowering drugs, contraceptive medications, diuretics and beta blockers.

Sample Collection and Analysis

After an overnight fasting for 12 to 14 hours, about 6 mis of blood was withdrawn into heparinized bottles of fluoride oxalate and cen-trifuged at 100 rpm for five minutes. The supernatant was separated into appropriate containers for analysis. Samples were analyzed within 72 hours of collection. Those that could not be analyzed on the same day of collection were stored at a temperature of 4° C. Fasting blood glucose was measured by glucose oxidase test using aminophenazone as oxygen carrier. Total plasma cholesterol was determined using ferric per-chlorate methods. High-density (HDL) cholesterol was determined after precipitation of LDL-cholesterol with phosphtungstate and magnesium. Triglyceride was measured using the colorimetric enzymatic method.

Low-density lipoprotein (LDL) cholesterol was calculated from the formula: LDL-cholesterol = Total cholesterol – Triglyceride -HDL-cholesterol

Atherogenic index (AI) was defined as the ratio of total plasma cholesterol: HDL – cholesterol

Plasma cholesterol and triglyceride values were determined in milligram % and converted to millimol/liter by multiplying with a factor of 0.02586 and 0.01129, respectively. A pre-pre-pared laboratory standard for lipid analysis was used to ensure quality assurance of the specimen. canadian cialis

Definition of Dyslipidaemia

Dyslipidaemia was defined as below using the European Atherosclerosis Society except hypertriglyceridaemia that was defined on the basis of the local value for Nigerians because it differs significantly from the Europeans. •Total cholesterol (TC) > 5.2mmol/L •Low-density canadian lipoprotein (LDL) cholesterol > 3.5mmol/L •Triglyceride (TG) > 1.75mmol/L •High-density lipoprotein (HDL) cholesterol < 0.9mmol/L •Atherogenic index (AI) > 5.8

Statistical Analysis

Data entry and analysis were done using EPI-Info software. Means are presented as values ± standard deviation. Student’s f-test and chi-square test were used to compare means and proportions between two groups respectively. Analysis of variance (ANOVA) and chi-square tests were utilized in comparing the means and proportions respectively between normogly-caemic hypertensives, normotensive type 2 diabetics, and type 2 diabetic hypertensives.

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