A study on the lipid ratios and inflammatory markers in pre-diabetic and diabetic patients


  • Shailaza Shrestha Department of Biochemistry, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India
  • Preeti Sharma Department of Biochemistry, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India
  • Pradeep Kumar Department of Biochemistry, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India
  • Mahendra Prasad Department of Biochemistry, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India




Atherogenic indices/cardiac risk indices, Diabetes, Inflammation, Pre-diabetes


Background: One of the leading causes of diabetic mortality is cardiovascular disease. Diabetes progression is preceded by pre-diabetic phase which is also at higher cardiovascular risk. Both hyperglycemia and atherosclerotic processes are inflammatory phenomenon. Keeping this in view, it was aimed to evaluate atherogenic indices and correlate them with inflammatory mediators.

Methods: This study included 80 controls, 80 pre-diabetic and 80 diabetic patients. Anthropometric parameters (BMI, WHR) and blood parameters like fasting glucose, HbA1c, lipid profile (cholesterol, HDL, LDL TG, VLDL), adiponectin, IL-6, CRP, fibrinogen and uric acid were analysed.

Results: Significantly high atherogenic indices were observed in pre-diabetic and diabetic subjects compared to healthy controls. The indices were also significantly correlated with BMI, fasting sugar, HbA1c, cholesterol, HDL, TG and LDL. The correlation with HDL was negative and with other parameters, the correlation was positive. In pre-diabetic patients, adiponectin showed significant negative correlation while fibrinogen and CRP showed significant positive correlation with cardiac risk indices. IL-6 was positively correlated only with AIP while correlation of uric acid with these indices was insignificant. In case of diabetic patients, the cardiac risk indices were significantly correlated with adiponectin, IL-6, CRP, fibrinogen and uric acid. The correlation with adiponectin was negative.

Conclusions: The altered atherogenic indices and their significant association with inflammatory markers signify the direct association of inflammation with CVD risks. Thus, there is requirement of novel approaches that can retard inflammatory responses and arrest unwanted cardiac health outcomes.


Tandon N, Anjana RM, Mohan V, Kaur T, Afshin A. The increasing burden of diabetes and variations among the states of India: The global burden of disease study. 1990-2016. Lancet Global Health. 2018;6(12):e1352-62.

Ford ES, Zhao G, Li C. Pre-diabetes and the risk for cardiovascular disease: A systematic review of the evidence. J Am Coll Cardiol. 2010;55(13):1310-17.

Tabak AG, Herder C, Rathmann W, Brunner EJ, Kivimaki M. Prediabetes: A high-risk state for diabetes development. Lancet. 2012;379(9833):2279-90.

Chakraborty M, Gouroju S, Singh P, Thatkar PV, Bagchi D. Tracking lipid profile and atherogenic indices in the prediabetics of Andaman Nicobar Islands: A retrospective hospital-based study. J Family Med Prim Care. 2019; 8(3):1117-22.

Zhang Y, Dall TM, Mann SE, Chen Y, Martin J, Moore V, et al. The economic cost of undiagnosed diabetes. Popul Health Manag. 2009;12(2):95-101.

Anjana RM, Pradeepa R, Deepa M. ICMR– INDIAB Collaborative Study Group. Prevalence of diabetes and prediabetes (impaired fasting glucose and/ or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research-India Diabetes (ICMRINDIAB) study. Diabetologia. 2011;54(12):3022-7.

Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215-22.

Kansal S, Kamble TK. Lipid profile in prediabetes. J Assoc Physicians India. 2016;64(3):18-21.

Balgi V, Harshavardan L, Sahna E, Thomas SK. Pattern of lipid profile abnormality in subjects with prediabetes. Int J Sci Study. 2017;4(11):150-3.

Bafna A, Maheshwari RS, Ved RK, Sarkar PD, Batham AR. Study of atherogenic indices in nephritic syndrome. Int J Biol Med Res. 2012;3(3):2257-60.

Nimmanapalli HD. Lipid ratios, atherogenic coefficient and atherogenic index of plasma as parameters in assessing cardiovascular risk in type 2 diabetes mellitus. Int. J Res Med Sci. 2016;4(7):2863-2.

Bhardwaj S, Bhattacharjee J, Bhatnagar MK, Tyagi S. Atherogenic index of plasma, Castelli risk index and atherogenic coefficient–New parameters in assessing cardiovascular risk. Int J Pharm Bio Sci. 2013;3(3):359-64.

Mahat R, Singh N, Rathore V, Gupta A, Shah R. Relationship between atherogenic indices and carotid intima-media thickness in prediabetes: A cross-sectional study from Central India. Med Sci. 2018;6(3):pii:E55.

Ranjit PM, Guntuku GS, Pothineni RB. Comparison of lipid profile and new atherogenic indices among the coronary artery disease (CAD) negative and -positive diabetic dyslipidemia subjects. Int J Med Sci Public Health. 2015;4(11):1574-9.

Miyazaki Y, Furugen M, Akasaka H, Saitoh S, Miura T. Atherogenic lipids profile relates to postprandial hyperglycemia and hyperinsulinemia due to whole body insulin resistance in prediabetic subjects. J Diabetes Mellitus. 2012;2(3):272-8.

Farid SM. Gender-related differences in lipid profile and atherogenic indices in patients with type 2 diabetes mellitus in Jeddah, Saudi Arabia. Glob J Bio-Sci Biotechnol. 2017;6(3):430-8.

Kansal S, Kamble TK. Lipid Profile in Prediabetes. J Assoc Physicians India. 2016;64(3):18-21.

Boden G, Laakso M. Lipids and glucose in type 2 diabetes: What is the cause and effect? Diabetes Care. 2004;27(9):2253-59.

Cure MC, Tufekci A, Cure E, Kirbas S, Ogullar S, Kirbas A, et al. Low-density lipoprotein subfraction, carotid artery intima-media thickness, nitric oxide, and tumor necrosis factor alpha are associated with newly diagnosed ischemic stroke. Ann Indian Acad Neurol. 2013;16(4):498-503.

Palem SP. Indicator for predicting cardiovascular risk in addition to endothelial dysfunction in type 2 diabetic subjects. JCDR. 2018;12(6):BC21-4.

Onat A, Can G, Kaya H, Hergenc G. Atherogenic index of plasma (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. J Clin Lipidol. 2010;4(2):89-98.

Regmi P, Baral B, Raut M, Khanal MP. Atherogenic index of plasma for prediction of future cardiovascular disease in prediabetes and diabetes population. Atherosclerosis. 2016;252(9):e120.

Thiyagarajan R, Subramanian SK, Sampath N, Trakroo M, Pal P, Bobby Z. Association between cardiac autonomic function, oxidative stress and inflammatory response in impaired fasting glucose subjects: Cross-sectional study. PLoS ONE. 2012;7(7):e41889.

Miric DJ, Kisic BM, Danic SF, Danic SF, Grbic R, Dragojevic I, et al. Xanthine oxidase activity in type 2 diabetes mellitus patients with and without diabetic peripheral neuropathy. J Diab Res. 2016;2016:4370490(1-7).

Akdogan M, Budak YU, Huysal K. The association of hematologic inflammatory markers with atherogenic index in type 2 diabetic retinopathy patients. Clin Ophthalmol. 2016;10(317):1797-801.

Zhen Li, Qi Huang, Li Sun, Bao T, Dai Z. Atherogenic index in type 2 diabetes and its relationship with chronic microvascular complications. Int J Endocrinol. 2018;2018:1765835(1-9).

Juarez-Perez CA, Madrid GA, Haro-Garcia LC, Gopar NR, Cabello LA, Jimenez RC, et al. Increased cardiovascular risk using atherogenic index measurement among healthcare workers. Arch Med Res. 2015;46(3):233-9.

Nansseu JRN, Moor VJA, Nouaga MED, Awona BZ, Tchanana G, Ketcha A. Atherogenic index of plasma and risk of cardiovascular disease among Cameroonian postmenopausal women. Lipids Health Dis. 2016;15(1):49.

Akbas EM, Timuroglu A, Ozcicek A, Ozcicek F, Demirtas L, Gungor A, et al. Association of uric acid, atherogenic index of plasma and albuminuria in diabetes mellitus. Int J Clin Exp Med. 2014;7(12):5737-43.

Lippi G, Montagnana M, Salvagno GL, Targher G, Guidi GC. Epidemiological association between uric acid concentration in plasma, lipoprotein (a), and the traditional lipid profile. Clin Cardiol. 2010;33(2):E76-80.




How to Cite

Shrestha, S., Sharma, P., Kumar, P., & Prasad, M. (2019). A study on the lipid ratios and inflammatory markers in pre-diabetic and diabetic patients. International Journal of Research in Medical Sciences, 7(9), 3452–3460. https://doi.org/10.18203/2320-6012.ijrms20193928



Original Research Articles