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Abstract
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SUMMARY AND CONCLUSION
Although the association of diabetes mellitus with hyperlipidemia has been a long standing observation and
a subject for several studies, yet no definite clues seem so far to elucidate a relationship (Khachadurian and Uthman, 1971).
In an attempt to elucidate the effect of the severity of diabetes on the levels of the three parameters (serum total cholesterol, triglycerides, and free fatty acids)
the present work was conducted.
Eighty six adult persons were the subjects of this work. Fasting blood glucose, serum total cholesterol,
serum triglycerides and serum free fatty acids were measured in twenty three apparently healthy non-diabetic Egyptian subjects (reference), and in sixty three adult-onset diabetics. The diabetics were further subdivided into three subgroups according to the level of fasting blood glucose (Sosenko et al., 1980) :
a-Mild diabetics (20): < 8.3 m mo1/1
b-Moderate diabetics (21): 8.3-11.7 m mo1/1
c-Severe diabetics (22): >11.7 m mo1/1
The results obtained from this study can be summarized
as follows :
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1- The blood serum total cholesterol as estimated by ”Enzymatic colorimetric method” (Trinder, 1969), (Stahler, 1977) and (Siedel, 1981) showed :
-In the reference group, the mean value was found to be 5.19 + 0.57 m mo1/1 ranging from 4.3 to 6.4 m mo1/1.
-In mild diabetics, the mean value was 5.59 + 0.98 m mo1/1 ranging from 3.72 to 7.18 m mo1/1.
-In moderate diabetics, the mean value was 5.98 + 0.96 m mo1/1 ranging from 4.05 to 7.87 m mo1/1.
-In severe diabetics, the mean value was 6.42 + 1.16 m mo1/1 ranging from 3.82 to 8.72 m mo1/1.
There was no significant difference between the mild diabetics and the reference group, but there was a significant difference between both moderate and severe diabetic groups
as compared with the reference group (P < 0.001).
In other words, the total serum cholesterol in general was significantly elevated in both moderate and severe diabetics but not in the mild diabetics.
Among the diabetic patients there was no parallel correlation between fasting blood glucose and serum total cholesterol.
2- The blood serum triglycerides as estimated by ”Laurell method” (1966) showed:
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-In the reference group, the mean value was 1.19 + 0.32 m mo1/1 with a range from 0.72 to 1.8 m mol/1.
-In mild diabetics, the mean triglycerides level was 1.91 + 0.64 m mo1/1 ranging from 0.92 to 3.1 m mol/1.
-In moderate diabetics, the mean triglycerides was 2.56 + 1.01 m mo1/1 ranging from 1.32 to 5.63 m mo1/1.
-In severe diabetics, the mean triglycerides was 3.14 + 1.05 m mol/l.ranging from 1.82 to 5.6 m mo1/1.
There was a significant difference between the mild, the moderate, and the severe diabetic groups as compared with the reference group (P < 0.001).
In other words, the blood serum triglycerides were markedly and progressively elevated in all grades of the diabetic affections (mild, moderate and severe) as compared with the reference level.
In the diabetic patients the blood glucose elevations were also correlated and parallel to the blood serum triglycerides level.
3- The blood serum free fatty acids (NEFA) as determined by ”Duncombe method” (1963), showed a mean value 0.45 + 0.15 m mo1/1 ranging from 0.19 to 1.13 m mo1/1 in the
reference group.
- In mild diabetics, the mean value for serum free fatty acids was 0.54 + 0.23 m mo1/1 ranging from 0.23 to 0.93 m mo1/1.
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-In moderate diabetics, the mean value was 0.66 + 0.28 m mo1/1 ranging from 0.26 to 1.34 m mo1/1.
-In severe diabetics, the mean free fatty acids was 0.83 + 0.4-1 m mo1/1 ranging from 0.21 to 1.6 m mo1/1.
Thus, for the blood serum NEFA, while the difference between the mild diabetics and the reference group was insignificant, both the moderate and the severe diabetics showed significant elevations as compared with the reference (P < 0.001).
In other words, free fatty acids in general show high levels in serum of moderate and severe diabetics, but has
a similar serum level in the mild cases as the reference level.
In diabetic patients blood glucose levels were parallely correlated with the free fatty acids level.
In conclusion, this work showed that elevations in the blood serum triglyceride levels were most sensitive to diabetic affections, followed by the blood serum free fatty acids (NEFA), while the blood serum total cholesterol was only mild and moderately elevated in moderate and severe diabetic affections respectively.