Inflammatory Atherosclerosis Risk and Lipid Ratios Markers in Type 1 Diabetic Patients: The Role of Ketosis as a Metabolic State

Walid Hassene Hamri; Mustapha Diaf; Mohamed Hadj Habib

Walid Hassene Hamri Department of Biology, Faculty of Natural and Life Sciences, Djillali LIABES University, Sidi-Bel-Abbes, Algeria and Laboratory of Molecular Microbiology Proteomics and Health, Djillali LIABES University, Sidi-Bel-Abbes, Algeria
Mustapha Diaf Department of Biology, Faculty of Natural and Life Sciences, Djillali Liabes University, Sidi-bel-Abbes, Algeria
Mohamed Hadj Habib Department of Medicine, Faculty of Medicine Mourad TALEB, Djillali LIABES University, Sidi-Bel-Abbes, Algeria and Endocrinology-Diabetology Department, Abdelkader HASSANI University Hospital Center of Sidi-Bel-Abbès, Algeria

Keywords: Atherosclerosis risk, lipid ratios, ketosis, type 1 diabetes

Abstract

Background and aim: Epidemiological inquiries on subclinical atherosclerotic inflammatory disease in ketosis-onset type 1 diabetes (T1D) are scarce. Our objective was to evaluate the risk of developing atherosclerosis via lipid ratios by comparing two groups of patients according to their ketosis status. Subjects and methods: We performed a comparative retrospective study including 351 patients (13-74 years) with confirmed T1D divided into the following groups; patients with inaugural diabetic ketosis (IDK) vs. patients with diabetic ketosis (DK). Clinical, biological and pathophysiological patients' data were compared. Main lipid ratios have been assessed according to the patients’ ketosis status and gender. The multivariate logistic regression test was applied to evaluate the association of lipid ratios quartiles with the diabetic ketosis status. Results: Our study showed a slight predominance of males (50.43%), with an average age of 25.77 years. Comparing to IDK, DK patients had a higher body mass index. No significant differences were observed between fasting plasma glucose and HbA_1C and lipid levels. The results showed that the 3^rd (OR= 2.14 [0.81-5.61]; p=0.12) and the 4^th quartiles (OR= 0.9 [0.35-2.33]; p=0.83) of TC/HDL ratio were higher in both groups. We noticed higher concordant values on the last two quartiles (3^rdand 4^th) of LDL/HDL ratio with p values of 0.07 and 0.39, respectively. In both groups, TC/HDL and TG/HDL were slightly higher in males comparing to females T1D patients except for LDL/HDL ratio which showed a slight ascendant median in females compared to males with IDK. Conclusions: The prevalence and risk of atherosclerosis inflammatory disease were higher in newly and formerly diagnosed patients with ketosis-onset T1D. Thus, medical awareness initiatives and a routine thorough endothelial function are needed to reduce the prevalence of the risk of atherosclerotic inflammatory disease.