There were 154 participants aged 40–78 years and made up of 91 females and 63 males. The mean age was 52 years. Generally, the mean values for the indices assessed were within the reference range, except for FPG, LDL cholesterol, Non-HDL-cholesterol, BMI and systolic blood pressure, which exceeded the optimal levels (Table 1). The majority (75%) of the respondents were hypertensive. When the various indices were analyzed by gender, there was no statistically significant (P > 0.05; Table 2) difference between the male and female respondents except percentage body fat (P < 0.001; Table 2), which was expectedly higher in females.
Table 1
Clinical and biochemical characteristics of respondents
Variable | Mean ± SD | Range |
---|
Age (years) | 52.20 ± 8.70 | 40–78 |
FPG (mmol/l) | 8.30 ± 4.70 | 3.5–25.1 |
TC (mmol/l) | 5.10 ± 1.00 | 3.1–7.8 |
TG (mmol/l) | 1.20 ± 0.50 | 0.40–2.90 |
HDL-c (mmol/l) | 1.20 ± 0.20 | 0.70–1.60 |
LDL-c (mmol/l) | 3.10 ± 1.00 | 1.20–6.10 |
Non-HDL-c (mmol/L) | 3.90 ± 1.00 | 1.60–6.90 |
RC (mmol/L) | 0.54 ± 0.23 | 0.20–1.30 |
TyG Index | 8.70 ± 0.80 | 7.40–10.70 |
BMI (kg/m2) | 26.90 ± 4.10 | 15.10–40.50 |
CVD risk (%) | 14.30 ± 8.70 | 3.00–45.00 |
hs-CRP (mg/dL) | 1.60 ± 0.80 | 0.11–3.80 |
Adiponectin (µg/ml) | 7.70 ± 4.70 | 1.30–20.00 |
Resistin (ng/mL) | 13.50 ± 3.70 | 4.80–22.30 |
Systolic BP (mmHg) | 142 ± 16.00 | 102–197 |
Diastolic BP (mmHg) | 88 ± 11.00 | 64–124 |
MAP(mmHg) | 106 ± 12.00 | 78–146 |
FPG = fasting plasma glucose; HDL-c = high-density lipoprotein cholesterol; LDL-c low-density lipoprotein cholesterol; RC = remnant cholesterol; CVD = cardiovascular disease; hs-CRP = high sensitivity C-reactive protein; BP = blood pressure; MAP = mean arterial pressure; BMI = body mass index; TG = triglycerides; WC = waist circumference; WHR = waist-to-hip ratio; ALT = alanine amino transferase; GGT gamma-glutamyl transferase; TC = total cholesterol; TyG = triglyceride glucose index; * = significant p-value.
Table 2
Clinical and biochemical characteristics of respondents by gender
Parameter | Male (63) | Female (91) | P-value |
---|
Age (years) | 52.2 ± 7.90 | 54.0 ± 9.07 | 0.217 |
Duration (years) | 4.0 ± 3.10 | 4.6 ± 3.30 | 0.274 |
FPG (mmol/L) | 7.8 ± 4.60 | 8.5 ± 4.80 | 0.372 |
TC (mmol/L) | 5.1 ± 1.00 | 5.1 ± 1.00 | 0.932 |
HDL-c (mmol/L) | 1.2 ± 0.20 | 1.2 ± 0.20 | 0.24 |
LDL-c (mmol/L) | 3.4 ± 1.00 | 3.3 ± 1.00 | 0.576 |
TG (mmol/L) | 1.1 ± 0.50 | 1.2 ± 0.50 | 0.321 |
TyG Index | 8.66 ± 0.78 | 8.81 ± 0.74 | 0.212 |
RC (mmol/L) | 0.52 ± 0.23 | 0.56 ± 0.23 | 0.344 |
Non-HDL (mmol/L) | 3.8 ± 1.00 | 3.9 ± 1.10 | 0.754 |
BMI (Kg/m2) | 26.7 ± 3.90 | 27.0 ± 4.30 | 0.61 |
WHR | 0.90 ± 0.05 | 0.89 ± 0.06 | 0.189 |
CVD Risk (%) | 15.4 ± 10.30 | 13.6 ± 7.30 | 0.186 |
DBP (mmHg) | 87.4 ± 11.50 | 88.2 ± 10.10 | 0.397 |
SBP (mmHg) | 140.7 ± 15.80 | 143.0 ± 16.90 | 0.66 |
ALT (U/L) | 24.5 ± 7.10 | 22.9 ± 8.00 | 0.181 |
GGT (U/L) | 22.3 ± 7.10 | 22.7 ± 8.00 | 0.758 |
Adiponectin (µg/ml) | 7.3 ± 4.85 | 7.9 ± 4.60 | 0.467 |
Resistin (ng/mL) | 13.4 ± 3.40 | 13.6 ± 3.80 | 0.711 |
hs-CRP | 1.6 ± 0.90 | 1.6 ± 0.80 | 0.842 |
Fat (%) | 26.84 ± 8.97 | 33.2 ± 7.9 | < 0.001* |
FPG = fasting plasma glucose; HDL-c = high-density lipoprotein cholesterol; LDL-c = low-density lipoprotein cholesterol; RC = remnant cholesterol; CVD = cardiovascular disease; hs-CRP = high sensitivity C-reactive protein; BP = blood pressure; MAP = mean arterial pressure; BMI = body mass index; TG = triglycerides; WC = waist circumference; WHR = waist-to-hip ratio; ALT = alanine amino transferase; GGT = gamma-glutamyil transferase; TC = total cholesterol; TyG = triglyceride glucose index; * = significant p-value.
In relation to BMI, 2%, 18%, 24% and 56% of respondents were underweight, obese, normal weight and overweight, respectively. Respondents were grouped into underweight/normal weight and overweight/obese categories for comparison of the various indices (Table 3). Total cholesterol, LDL, Non-HDL cholesterol, blood pressure, hs-CRP, resistin and fat percentage levels were significantly (P < 0.05; Table 3) higher in the overweight/obese group. Adiponectin level was significantly (P = 0.021; Table 3) lower in the overweight/obese group, with the remaining indices being comparable (P > 0.05; Table 3) between the two weight groups.
Table 3
Clinical and biochemical characteristics of respondents by weight category
Parameter | Normal/underweight (40) | Overweight/obese (114) | P-value |
---|
Age (years) | 53.80 ± 10.13 | 53.09 ± 8.09 | 0.655 |
Duration (years) | 4.04 ± 3.49 | 4.51 ± 3.09 | 0.482 |
FPG (mmol/L) | 8.24 ± 4.75 | 8.26 ± 4.75 | 0.981 |
TC (mmol/L) | 4.58 ± 0.74 | 5.22 ± 1.00 | < 0.001* |
HDL-c (mmol/L) | 1.19 ± 0.22 | 1.2 ± 0.20 | 0.774 |
LDL-c (mmol/L) | 2.85 ± 0.78 | 3.47 ± 0.74 | < 0.001* |
TyG Index | 8.72 ± 0.76 | 8.76 ± 0.76 | 0.817 |
Triglycerides (mmol/L) | 1.18 ± 0.59 | 1.19 ± 0.48 | 0.933 |
RC (mmol/L) | 0.54 ± 0.27 | 0.54 ± 0.21 | 0.833 |
Non-HDL (mmol/L) | 3.39 ± 0.81 | 4.02 ± 1.06 | 0.001* |
CVD Risk (%) | 13.05 ± 7.96 | 14.78 ± 8.90 | 0.279 |
Diastolic BP (mmHg) | 84.78 ± 9.93 | 88.93 ± 10.68 | 0.033* |
Systolic BP (mmHg) | 137.63 ± 15.93 | 143.45 ± 16.65 | 0.047* |
ALT (U/L) | 22.80 ± 6.87 | 23.81 ± 7.42 | 0.451 |
GGT (U/L) | 22.3 ± 7.10 | 22.68 ± 7.85 | 0.617 |
Adiponectin (µg/ml) | 9.14 ± 4.83 | 7.15 ± 4.58 | 0.021* |
Resistin (ng/mL) | 11.56 ± 3.89 | 14.20 ± 3.66 | < 0.001* |
hs-CRP | 1.27 ± 0.70 | 1.72 ± 0.87 | 0.004* |
Fat (%) | 23.58 ± 7.47 | 33.04 ± 8.03 | < 0.001* |
FPG = fasting plasma glucose; HDL-c = high-density lipoprotein cholesterol; LDL-c = low-density lipoprotein cholesterol; RC = remnant cholesterol; CVD = cardiovascular disease; hs-CRP = high sensitivity C-reactive protein; BP = blood pressure; BMI = body mass index; TC = total cholesterol; * = significant p-value.
When BMI-based data categorization was further disaggregated by sex, a similar trend was observed in terms of parameters that differed significantly in the two weight groups, but the specific indices differed according to sex (Tables 4a and 4b). In the female respondents, only total cholesterol, LDL-c, Non-HDL-c, hs-CRP and percentage body fat levels were significantly (P < 0.05; Table 4a) higher in the overweight/obese group. However, in the male respondents, total cholesterol, LDL-c, Non-HDL-c, hs-CRP, resistin, diastolic blood pressure and percentage body fat levels were higher but adiponectin level was lower (P < 0.05; Table 4b) in the overweight/obese group.
Table 4
a: Clinical and biochemical characteristics that differed significantly in females by weight category
Parameter | Underweight/Normal (18) | Overweight/Obese (73) | P-value |
---|
TC (mmol/L) | 4.54 ± 0.81 | 5.17 ± 0.97 | 0.012 |
LDL-c (mmol/L) | 2.78 ± 0.81 | 3.40 ± 0.96 | 0.013 |
Non-HDL-c (mmol/L) | 3.29 ± 0.84 | 3.96 ± 1.03 | 0.012 |
hs-CRP | 1.23 ± 0.64 | 1.68 ± 0.82 | 0.032 |
Fat (%) | 27.12 ± 6.61 | 34.66 ± 7.51 | < 0.001 |
LDL-c = low-density lipoprotein cholesterol; HDL-c = low-density lipoprotein cholesterol; hs-CRP = high sensitivity C-reactive protein; TC = total cholesterol; Non-HDL-c = non-HDL cholesterol; Fat (percentage body fat |
Table 4
b: Clinical and biochemical characteristics that differed significantly in males by weight category
Parameter | Underweight/Normal (16) | Overweight/Obese (47) | P-value |
---|
TC (mmol/L) | 4.51 ± 0.67 | 5.25 ± 1.03 | 0.01 |
LDL (mmol/L) | 2.82 ± 0.71 | 3.55 ± 1.00 | 0.009 |
Non-HDL-c (mmol/L) | 3.40 ± 0.80 | 4.05 ± 1.09 | 0.03 |
hs-CRP | 1.13 ± 0.68 | 1.79 ± 0.93 | 0.012 |
Adiponectin | 10.26 ± 4.93 | 6.33 ± 4.44 | 0.004 |
Resistin | 11.05 ± 2.76 | 14.18 ± 3.28 | 0.001 |
Systolic BP (mmHg) | 132.38 ± 9.93 | 143.55 ± 16.52 | 0.013 |
Fat (%) | 20.00 ± 7.44 | 29.17 ± 8.28 | < 0.001 |
FPG = fasting plasma glucose; HDL-c = high-density lipoprotein cholesterol; LDL-c = low-density lipoprotein cholesterol; RC = remnant cholesterol; CVD = cardiovascular disease; hs-CRP = high sensitivity C-reactive protein; BP = blood pressure; MAP = mean arterial pressure; BMI = body mass index; TG = triglycerides; WC = waist circumference; WHR = waist-to-hip ratio; ALT = alanine amino transferase; GGT = gamma-glutamyl transferase; TyG = triglyceride glucose index.; TC = total cholesterol |
Since the majority (75%) of respondents were hypertensive on appropriate treatment regimens, the various indices were compared between the hypertensive and normotensive groups regardless of gender and weight category to examine the effects of hypertension on the measured indices. As expected, the hypertensive group demonstrated significantly (P < 0.05; Table 5) higher levels of all the measured indices except adiponectin which was lower than their normotensive counterparts with FPG, HDL-c and WHR being comparable (P > 0.05; Table 5) in the two groups.
Table 5
Comparison of clinical and biochemical characteristics of respondents by hypertension status
Parameter | Normotensive (39) | Hypertensive (115) | P-value |
---|
FPG (mmol/L) | 7.90 ± 5.00 | 8.40 ± 4.70 | 0.58 |
TC (mmol/L) | 4.50 ± 0.10 | 5.20 ± 0.10 | < 0.001* |
HDL-c (mmol/L) | 1.20 ± 0.19 | 1.20 ± 0.21 | 0.29 |
TG (mmol/L) | 1.00 ± 0.50 | 1.30 ± 0.50 | 0.004* |
TyG index | 8.50 ± 0.80 | 8.80 ± 0.70 | 0.02* |
LDL-c (mmol/L) | 2.90 ± 0.80 | 3.50 ± 1.00 | 0.001* |
RC (mmol/L) | 0.50 ± 0.20 | 0.60 ± 0.20 | 0.004* |
Non-HDL (mmol/L) | 3.30 ± 0.10 | 4.00 ± 1.00 | 0.001* |
CVD risk (%) | 8.30 ± 5.80 | 16.40 ± 8.50 | < 0.001* |
hs-CRP (mg/dl) | 1.00 ± 0.57 | 1.80 ± 0.80 | < 0.001* |
Resistin (ng/ml) | 11.30 ± 2.80 | 14.30 ± 3.60 | < 0.001* |
Adiponectin(µg/ml) | 11.40 ± 4.00 | 6.40 ± 4.20 | < 0.001* |
BMI (kg/m2) | 24.60 ± 3.45 | 27.60 ± 4.10 | < 0.001* |
WHR | 0.86 ± 0.06 | 0.89 ± 0.05 | 0.416 |
WC (cm) | 87.40 ± 10.40 | 92.90 ± 8.40 | 0.001* |
ALT (U/L) | 22.20 ± 6.80 | 24.00 ± 7.40 | 0.17 |
GGT (U/L) | 23.20 ± 8.20 | 22.30 ± 7.50 | 0.55 |
Duration (years) | 2.80 ± 2.30 | 4.90 ± 3.30 | 0.002* |
Fat (%) | 24.43 ± 6.78 | 32.66 ± 8.58 | < 0.001 |
FPG = fasting plasma glucose; HDL-c = high-density lipoprotein cholesterol; LDL-c low-density lipoprotein cholesterol; RC = remnant cholesterol; CVD = cardiovascular disease; hs-CRP = high sensitivity C-reactive protein; BP = blood pressure; MAP = mean arterial pressure; BMI = body mass index; TG = triglycerides; WC = waist circumference; WHR = waist-to-hip ratio; ALT = alanine amino transferase; GGT = gamma-glutamyl transferase; TyG = triglyceride glucose index; TC = total cholesterol; * = significant p-value.
Although the mean levels of most of the measured indices appear to be within the acceptable reference ranges, the levels of biomarkers observed for a reasonable proportion of individuals in the entire sample and by BMI categorization fell outside the acceptable limits (Table 6). For instance, the prevalence of dyslipidaemia associated with the various components of the lipid profile in the entire respondents ranged from 18% for triglycerides to 74% for LDL-c (Table 6). In relation to weight groups, the overweight/obese group appear to consistently exhibit a relatively higher proportion of individuals with unfavourable levels of various cardiometabolic indices except for HDL-c, TyG and remnant cholesterol that the underweight/normal weight group seem to have a higher proportion of individuals with unfavourable levels. (Table 6).
Table 6
Prevalence of selected cardiometabolic risk factors among respondents
Parameter | underweight/normal weight (34) | Overweight/obese (120) | Entire respondents (154) |
---|
TC (≥ 5.2 mmol/l) | 6 (17.65%) | 56 (46.67%) | 62 (40.26%) |
HDL-c (< 1.0 in males, < 1.3 in females)/mmol/l | 14 (41.18%) | 45 (37.50%) | 59 (38.31%) |
LDL-c (> 2.6 mmol/L) | 22 (64.71%) | 92 (76.67%) | 114 (74.01%) |
Non-HDL (> 3.4 mmol/L) | 14 (41.18%) | 86 (71.67%) | 99 (64.29%) |
RC (> 0.6 mmol/L) | 15 (44.12%) | 49 (40.83%) | 64 (41.56%) |
TG (> 1.7mmol/l) | 5 (14.71%) | 23 (19.17%) | 28 (18.18%) |
BP (> 140/90mmHg) | 19 (53.44%) | 96 (80%) | 115 (74.68%) |
hs-CRP (> 1.0 mg/l) | 16 (47.06%) | 92 (76.67%) | 108 (70.13%) |
Adiponectin (< 8.0 µg/ml) | 18 (52.94%) | 78 (65%) | 96 (62.34%) |
Resistin > 14.8 ng/L | 5 (14.71%) | 58 (48.33%) | 63 (40.91%) |
CVD risk (> 10%) | 22 (64.71%) | 86 (71.67%) | 108 (70.13%) |
TyG > 8 | 126 (81.82%) | 28 (82.34%) | 98 (81.67%) |
HDL-c = high-density lipoprotein cholesterol; LDL-c low-density lipoprotein cholesterol; RC = remnant cholesterol; CVD = cardiovascular disease; hs-CRP = high sensitivity C-reactive protein; BP = blood pressure; TC = total cholesterol; TG = triglycerides; TyG = triglyceride glucose index.
In bivariate correlational analysis to examine linear relationships between biomarkers irrespective of gender and BMI in the entire sample, the usual expected linear relationships were observed among the measured indices. As indicated in Table 7, the duration of diabetic condition exhibited a positive correlation with TyG, hs-CRP, CVD risk, blood pressure, ALT, percentage fat and triglyceride levels but a negative correlation with adiponectin. FPG correlated positively with total cholesterol, TyG, LDL-c, remnant cholesterol, Non-HDL-c and GGT. Additionally, total cholesterol correlated negatively with adiponectin but positively with resistin, hs-CRP, ALT and GGT. Adiponectin continued to demonstrate a negative correlation with Non-HDL and LDL, even as TyG showed a positive correlation with hs-CRP, resistin, ALT and GGT. Expectedly, LDL-c correlated positively with resistin, hs-CRP, ALT and GGT, with Non-HDL correlating positively with resistin, hs-CRP, ALT and GGT. Interestingly, no correlation was observed among hs-CRP, adiponectin, resistin, ALT and GGT in the current study.
Table 7
Bivariate correlation among selected clinical and biochemical characteristics of respondents
Parameter | Correlation coefficient | P-value |
---|
Duration and TyG | 0.222 | 0.014 |
Duration and hs-CRP | 0.193 | 0.034 |
Duration and CVD risk | 0.417 | < 0.001 |
Duration and Adiponectin | -0.234 | 0.009 |
Duration and systolic | 0.25 | 0.005 |
Duration and diastolic | 0.273 | 0.002 |
Duration and ALT | 0.18 | 0.047 |
Duration and fat% | 0.248 | 0.006 |
Duration and TG | 0.179 | 0.048 |
FPG and cholesterol | 0.341 | < 0.001 |
FPG and TyG | 0.813 | < 0.001 |
FPG and LDL-c | 0.297 | < 0.001 |
FPG and RC, Non-HDL-c | 0.394,0.364 | < 0.001 |
FPG and GGT | 0.256 | 0.001 |
TC and HS-CRP, resistin | 0.596,0.558 | < 0.001 |
TC and adiponectin | -0.447 | < 0.001 |
TC and ALT, GGT | 0.234, 223 | 0.003, 0.005 |
TyG and hs-CRP, resistin | 0.318, 0.25 | < 0.001, 0.002 |
TyG and ALT, GGT | 0.171, 0.272 | 0.034, 0.001 |
LDL-c and hs-hs-CRP, resistin | 0.603, 0.558 | < 0.001 |
LDL-c and adiponectin | -0.459 | < 0.001 |
LDL-c and ALT, GGT | 0.212, 0.207 | 0.008, 0.01 |
Non-HDL-c and hs-CRP, resistin | 0.648, 0.577 | < 0.001 |
Non-HDL-c and adiponectin | -0.474 | < 0.001 |
Non-HDL-c and ALT, GGT | 0.237, 0.226 | 0.003, 0.005 |
FPG = fasting plasma glucose; HDL-c = high-density lipoprotein cholesterol; LDL-c = low-density lipoprotein cholesterol; RC = remnant cholesterol; CVD = cardiovascular disease; hs-hs-CRP = high sensitivity C-reactive protein; BP = blood pressure; MAP = mean arterial pressure; BMI = body mass index; TG = triglycerides; WC = waist circumference; WHR = waist-to-hip ratio; ALT = alanine amino transferase; GGT = gamma-glutamyl transferase;TC = total cholesterol; TyG = triglyceride glucose index.
In a stepwise linear regression analysis with TyG as dependent variable, remnant cholesterol, duration of diabetes ,and FPG were found to be independent predictors (R2 = 0.951; adjusted R2 = 0.951; P < 0.001) predictors of TyG with the model explaining about 95% of observed variation.
Table 8 presents predictors of cardiovascular disease risk, adiponectin, resistin, hs-CRP and hypertension in the studied sample by multivariate logistic regression analyses. On average, the cardiovascular disease risk decreased by 2.41 for females compared with males (P = 0.003; Table 8) but increased by 7.88 for ages 50–59 years and 14.45 for ages 60 years and above compared to ages 40–49 years (P < 0.001; Table 8). For a unit increase in non-HDL-c, the risk of having a cardiovascular disease increased by 4.31 on average.
Table 8
Predictors of selected clinical and biochemical outcome variables
Variable | AOR (95% CI) | P-value |
---|
CVD risk |
Sex | | |
Male | 1 | |
Female | -2.41 (-3.98, -0.85) | 0.003* |
Age | | |
40–49 | 1 | |
50–59 | 7.88 (6.14, 9.61) | < 0.001* |
≥ 60 | 14.45 (12.38, 16.52) | < 0.001* |
RC | 1.37 (-2.32, 5.06) | 0.464 |
Non-HDL-c | 4.31 (3.49, 5.13) | < 0.001* |
Adiponectin |
Sex | | |
Male | 1 | |
Female | 0.45 (-0.89, 1.79) | 0.508 |
Age | | |
40–49 | 1 | |
50–59 | -2.11 (-3.60, -0.63) | 0.006* |
≥ 60 | -0.99 (-2.76, 0.79) | 0.274 |
RC | -2.54 (-3.42, 2.91) | 0.874 |
Non-HDL | -2.24 (-2.94, -1.54) | < 0.001* |
Resistin |
Sex | | |
Male | 1 | |
Female | 0.47 (-4.8, 1.41) | 0.328 |
Age | | |
40–49 | 1 | |
50–59 | 0.58 (-0.46, 1.63) | 0.273 |
≥ 60 | -1.81 (-3.06, -0.56) | 0.005* |
RC | 0.29 (-1.94, 2.51) | 0.801 |
Non-HDL | 2.14 (1.64, 2.64) | < 0.001* |
Hs-hs-CRP |
Sex | | |
Male | 1 | |
Female | -0.04 (-0.25, 0.16) | 0.683 |
Age* | | |
40–49 | 1 | |
50–59 | 0.19 (-0.04, 0.41) | 0.106 |
≥ 60 | 0.41 (0.14, 0.68) | 0.003* |
RC | 0.53 (0.05, 1.02) | 0.030* |
Non-HDL | 0.48 (0.37, 0.59) | < 0.001* |
Hypertension |
Sex | | |
Male | 1 | |
Female | 1.27 (0.56, 2.87) | 0.571 |
Age | | |
40–49 | 1 | |
50–59 | 3.02 (1.24, 7.37) | 0.015* |
≥ 60 | 6.24 (1.59, 24.56) | 0.009* |
RC | 3.23 (0.43, 24.33) | 0.255 |
Non-HDL | 2.24 (1.35, 3.72) | 0.002* |
AOR = Adjusted odds ratio; RC = remnant cholesterol; HDL = low-density lipoprotein cholesterol; CVD = cardiovascular disease; hs-HS-CRP = high sensitivity C-reactive protein; * = significant p-value |
Adiponectin levels decreased with increased (P < 0.05; Table 8) Non-HDL levels and age 50–59 years only, whereas resistin levels decreased with increasing age at 60 years and above. With respect to hs-CRP, on average, participants showed decreased likelihood in its rise for a unit increase in Non-HDL, remnant cholesterol and age 60 years and above. The likelihood of hypertension in participants increased from 3-fold at age 50–59 years to about 6-fold at age 60 years and above compared to age 40–49 years (P < 0.05; Table 8). Above all, a unit rise in Non-HDL-c levels increased one’s risk of hypertension by approximately 2-fold (P = 0.002; Table 8).