Pattern of Individual Lipid Abnormalities Across Different Glycemic States among Adult Patients Attending a Tertiary Care Centre: A Retrospective Laboratory-Based Study

Abstract

Background: Abnormalities of lipid metabolism frequently accompany disturbances in glucose regulation and contribute to an increased cardiometabolic risk. Although dyslipidemia is well recognized in diabetes mellitus, lipid abnormalities may also be present during the prediabetic stage. Evaluation of individual lipid components across different glycemic states may provide a better understanding of the pattern of biochemical abnormalities encountered in routine tertiary-care practice.

Objective: To evaluate the pattern and distribution of individual lipid abnormalities across normal, prediabetic, and diabetic-range glycemic states among adult patients attending a tertiary care centre.

Methods: A retrospective laboratory-based observational study was conducted in the Department of Biochemistry using routinely generated laboratory records from January 2024 to September 2024. Records of 300 adults with complete fasting plasma glucose and lipid profile results were included. Patients were categorized into normal glycemic, prediabetic, and diabetic-range groups according to fasting plasma glucose values. Total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were evaluated. The prevalence of individual lipid abnormalities was compared across the three glycemic categories.

Results: Among 300 patients, 92 (30.7%) had normal glycemic status, 86 (28.7%) were in the prediabetic range, and 122 (40.7%) were in the diabetic range. Mean total cholesterol increased progressively from 167.0 ± 25.3 mg/dL in the normal group to 184.0 ± 26.6 mg/dL in the prediabetic group and 199.3 ± 33.4 mg/dL in the diabetic group (p<0.001). Triglycerides increased from 102.9 ± 31.2 mg/dL to 137.7 ± 43.5 mg/dL and 156.0 ± 67.2 mg/dL, respectively (p<0.001). LDL-C also increased progressively, while HDL-C demonstrated a declining pattern (all p<0.001). Elevated total cholesterol was present in 9.8%, 26.7%, and 49.2% of normal, prediabetic, and diabetic-range patients, respectively. Elevated triglycerides occurred in 6.5%, 38.4%, and 52.5%, while reduced HDL-C was observed in 15.2%, 26.7%, and 41.0%, respectively. Overall dyslipidemia was present in 70.0% of the study population.

Conclusion: Individual lipid abnormalities showed a progressive increase with worsening glycemic status, while HDL-C demonstrated an inverse pattern. Importantly, several lipid abnormalities were already evident among patients with prediabetes. Routine assessment of lipid parameters alongside glycemic evaluation may therefore assist in early recognition of unfavorable metabolic patterns.