Lipids-risk categories in omani type 2 diabetics: Impact of the national cholesterol educational program

Objective: To evaluate the impact of the National Cholesterol Educational Program Adult Treatment Panel III (ATP III) and the Framingham Offspring Study on Omani diabetic subjects. Methods: 221 subjects with type 2 diabetes (86 females and 135 males) and 156 non-diabetic subjects (70 females and 86 males) aged 30-70 years attending Sultan Qaboos University Hospital between 1999-2002 were recruited. Lipid profile, glucose, %HbA_1c, apoproteinA-1 and apoproteinB were measured. Low density lipoprotein was calculated using the Friedwald formula. ATP-III and Framingham Offspring Study guidelines were used to classify lipid parameters into coronary heart disease-risk categories. Results: Diabetic compared to non-diabetic subjects had significantly higher triglycerides of >1.7 mmol/L (p=0.01) and lower low density lipoprotein cholesterol of >4.2 mmol/L (p=0.012) and, in female subjects only, lower high density lipoprotein cholesterol of <1.15 mmo/L for (p<0.0001). In addition, 57% of diabetic subjects had abnormal aplipoproteinB of >1.2 g/L compared to 49% of non-diabetic subjects. Combined raised levels of triglycerides, apolipoproteinB and low levels of high density lipoprotein were found in 42% of diabetic compared to 26% of the non-diabetic subjects (p=0.05). Diabetic subjects had significantly higher (p=0.008) NCEP risk-score for coronary artery disease, however, only 34% conformed to a NCEP 10-year-risk score of >10%. Conclusion: A substantial proportion of the Omani diabetic subjects were dyslipidaemic according to the ATP III guidelines. This study recommends the implementation of a lower cut-off threshold for starting lipid-modifying agents for Omani diabetics when using the 10-year Framingham Risk Scoring equation.