Diabetes (T2DM) is a global public health concern (Bhowmik et al., 2018). This condition affects how the body uses glucose and alterations in lipid profiles are linked to this underutilization of glucose (Bhambhani et al., 2015). Abnormalities in lipids are typically linked to prediabetes and type 2 diabetes. Dyslipidemia is the term used to describe diabetic patients with abnormal lipid levels. High triglyce-rides (TG), high total cholesterol (T-Chol), and low levels of high-density lipoprotein cholesterol (HDL-C) & increased levels of LDL-C, or low-density lipoprotein cholesterol are the main indicators of diabetic dyslipidemia (Bhowmik et al., 2018). Dyslipidemia has a high correlation with obesity, diabetes, and hypertension (Joshi et al., 2014). Additionally connected to cardiovascular diseases (CVD) is dyslipidemia (Mangili, 2020). According to certain research, lipid parameters and prediabetes outcomes are related (Santos-Gallego & Rosenson, 2014; Wang et al., 2020). Hypercholesterolemia also causes diabetes (Aronow, 2002).  

Primary, hereditary or family causes or secondary, acquired reasons can also result in hypercholesterolemia (Wang et al., 2020). On the other hand, sex and age are significant risk factors for high levels of cholesterol (Al-Zahrani et al., 2021; Basulaiman et al., 2014; Al-Hassan & Fabella, 2017). According to the International Diabetes Federation, there were 425 million people with diabetes in 2017 and that figure is expected to rise to 625 million by 2045 (Abusaib et al., 2020). Diabetes is growing more common in Iraq as a result of both economic growth and urbanization (Onyango & Onyango, 2018). The most prevalent type of diabetes mellitus (DM) is T2 DM, which is spreading throughout all nations. 80% of those affected by DM live in low- and middle-income nations, both in rural and urban areas, and both genders are equally affected (Mbanya, 2009). Research indicates that the levels of lipoproteins follow a developmental pattern from childhood into young adulthood and adulthood (Lobstein et al., 2004). The main risk factors for type 2 diabetes are obesity, having an unhealthy lifestyle, and consuming packaged and processed foods that are high in sugar and saturated fats, which ultimately change the lipid profile (Kirti & Singh, 2022). Researchers have found evidence in the industrialized world linking adverse lipid profiles and adolescent obesity (Mangili, 2020). The current study was conducted on the lipid profile and its association with diabetes & each of their health effect based on sex & different ages among the people of Bangladesh & also people can know about lipid abnormalities diseases, causes of those diseases & the relation between diabetes and lipid abnormalities. 

Population studied

This study was conducted in the Savar area from March 2022 2to August 2022 (over 6 months) & enrolled with a total of 55 populations. For determine diabetes RBS was obtained in this study and sampling data were obtained from Sahara Modern Hospital (Bogabari, Ashulia), Happy General Hospital (Baipail), RM Diagnostic Center (Jamgora), and Gonosastho Medical (Nolam). Patients with thyroid disorder, chronic liver disease & fibrates were excluded from this study. The age range of patients was 25-80 years. Patients were then recorded for sociodemographic characteristics (age, sex, duration of disease, and hypertension status).

Biochemical laboratory evaluation

All lipid profile examinations were carried out following standard laboratory procedures and the data obtained were the results of the latest blood biochemical examination in the last six months. Current American Diabetes Association was used to classify lipoprotein concentrations into different cardiovascular disease risk categories those classifications are low, borderline, and high risk factors. For the range of LDL cholesterol was (130 mg/dl) and for HDL the range was (60 mg/dl) respectively. For triglycerides ranges were (400 mg/dl). For total cholesterol low, borderline & high were (200 mg/dl) respectively.

Statistical analysis

 Statistical analysis in this study uses SPSSS (version 22) for Windows. Data that are normally distributed will be displayed in the form of mean and standard deviation. Analysis of receiver operator characteristics ROC curves were used to make risk prediction of lipid profile parameters. Analysis of variance was used to determine differences in patient characteristics and analysis of covariance was used to test for differences in mean lipid levels. The chisquare (X2) test was used to test for differences in proportions. All tests were considered significant if the value of P<0.05.

General Features

55 patients were suffering from DM included in these study outcomes of several biochemical and clinical markers and how they relate to one another. Their age was distributed into five different groups & 30 were women (54.54%) and 25 were men (45.45%). The age & sex distribution of this study are shown in 

Table 1: Age and sex distribution.

The patients were divided into three groups based on RBS value (normal range <7.8 mmol/L, pre-diabetes=7.8-11 mmol/L & diabetes=>11 mmol/L). The control of diabetes degree is shown in Table 2 between males and females.

Table 2: Degree of control of diabetics.

Table 3 shows the mean values with a standard deviation of various lipid traction of diabetes between male & female patients. Blood sugar was higher than normal in both males & females (RBS=10.38±3.62 mmol/L, 10.74±2.84 respectively). However, the value of RBS was higher in females than in males. TG group is slightly more in females than males (191.47±111.97 mg/dl and 153.26±55.18 mg/dl respectively). 

Table 3: Various biochemical parameters of DM in males and females (Mean ± SD).

Total cholesterol and HDL were within normal levels in both groups where the level was higher in females than males (TC=184.7±35.45) & 180.25±36.79 mg/dl respectively). The HDL was higher in females than males (HDL=44.84±3.43 & 41.82±7.94) and finally, LDL was higher in males than females (LDL= 107. 80±31.71 & 101.60±34.44). The change in TG, TC, HDL & LDL was not significant (P>0.685, P>0.38, P>0.16 & P>0.489).

Table 4: Distribution of lipid profile according to duration of DM.

It was observed from Table 4 that cholesterol is slightly higher in females than males (3 females & 2 males), but the desired range is greater than the higher range in both males and females. High TG is higher in females than males (18.2% & 19.1%), HDL level is also higher in females, but LDL is higher in males than females. 

Diabetes is caused by lipid abnormalities, which are kinetic, qualitative, and quantitative in origin. The primary quantitative lipid abnormalities in diabetic dyslipidemia are low levels of HDL cholesterol and high levels of triglycerols (Verggès, 2005). Diabetes mellitus is linked to treating dyslipidemia and is one method of lowering the risk of cardiovascular disease, which is associated with a higher risk of cardiovascular diseases (Lobstein et al., 2004). Abnormalities in lipid profiles are linked to arterial disease (Taskinen, 2003). In people with diabetes mellitus, abnormal glucose results are one type of metabolic abnormality (Hachem et al., 2006). Fatty acids and cholesterol from dietary items are eventually transformed into chylomicrons in the intestine (Reaven et al., 1997; Lerchenmüller et al., 2018). The lipoprotein that initiates TG/fatty acids binds to these chylomicrons. Lipoprotein is reduced by insulin resistance which occurs as a result of an increase in TG & decrease in HDL (Reaven et al., 1997; Lerchenmüller et al., 2018; Aguilar et al., 2006). There is a correlation between hypertrophy-camera and insulin resistance (Cheal et al., 2004; Lee et al., 2003), and hyperglycemia is one of the factors contributing to higher mortality rates in T2DM patients (Moneta, 2010). 

In this study when applying current American Diabetes Association Guidelines to classify lipoprotein concentration, the proportion of male and female diabetes having desirable, borderline and high category total cholesterol (30.9%, 10.9%, 3.6%) & (41.8%,7.3%,5.5%); TG (25.5%,10.9%,19.1%) & (27.3%,9.1%,18.2%); HDL (52%,44%,4%) & (93. 3%,6.7%,0%) and LDL (44%,28%,28%) & (50%, 30%,20%) respectively. Many similar proportions of patients with DM were found to have high TG and LDL. In a study where they found the effect in black & white populations in Type 2 DM (Taskinen, 2003). Another study where their result was a high HDL of 32% (Firdous et al., 2007). Another study was done where LDL found 30% (Mooradian et al., 2006). In an Iranian report where they found high-risk LDL among urban dwellers (Sadeghi et al., 2004). Similar another study was done & their result was mostly the same (T. et al., 2003). In Chinese research, they showed that T2 DM is associated with TG/HDL ratio (Chen et al., 2020) & they marked TG/HDL ratio as biomarkers used to compute pre-diabetes & T2 DM (Jasim et al., 2022; Kanwal et al., 2022). 

In this study, hyperglyceridemia is prominent in female diabetes patients because high TG & LDL were present in females. Most diabetic patients have a high TG & combination of low HDL. Several reasons are why women are mostly affected by hyperglycemia. First women are not associated with any hard work like men. In Bangladesh most of the women are housewives so they do not have to do any outside jobs like men this is why they also become obese than men. Generally, women have higher levels of HDL cholesterol than men because of the female sex hormone estrogen that seems to boost good cholesterol but everything changes at menopause when they become old. At this stage many women experience a change in their childhood that might end in old adult life women have higher risk factors than young stages (Shiferaw et al., 2021). So women must be conscious about lipid abnormalities as well as diabetes.

Based on numerous investigations, there is currently overwhelming evidence that DM has a significant effect on lipid metabolism. This was supported by the discovery that, in comparison to healthy controls, all lipid fractions were higher in diabetes. The most common adverse effect of diabetes mellitus is hyperlipidemia.  Diabetic dyslipidemia is the most common complication of type 2 diabetes, is characterized by high cholesterol, TG, LDL, and low HDL levels in people in general. The highest correlation between high levels of TG and DM was found when combined with low levels of HDL-C. In this study, women had higher levels of TG than men. Comparatively more women than men are found to have dyslipidemia overall. Additional research is required to determine the relationship between lipid profile and diabetes mellitus (DM) as well as to identify the various lipid abnormalities diseases that can increase the publics awareness of lipid profile and diabetes is a major issue both in Bangladesh as well as globally.

R.A.: conceptualization, methodology, writing the manuscript. M.A.R.; K.T.K.P.; M.J.; M.K.H.; and M.E.U.: contributed to data analysis, investigation, supervision, and visualization. N.T.; M.T.A.; and M.K.H.: finally checked the manuscript and editing, Data Curation, Funding acquisition, and Formal Analysis. All authors who are involved in this research read and approved the manuscript for publication.

We are thankful to my honorable teachers, laboratory personnel, and clinicians who helped us during this research work.

There are no conflicts of interest.