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Relationship of HbA1c with plasma atherogenic index and non-HDL cholesterol in patients with type 2 diabetes mellitus

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript



Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular diseases (CVD). The plasma atherogenic index (PAI) has been suggested as a novel marker of atherosclerosis and coronary heart disease. The present study is conducted to investigate the relationship between glycated hemoglobin (HbA1c), non-HDL (high-density lipoprotein) cholesterol, and atherogenic index within patients with T2DM.

Materials and methods

A total of 4252 patients with T2DM were screened retrospectively and parameters including glucose, HbA1c, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride, TSH, age, and gender were recorded. Non-HDL cholesterol and PAI were calculated as follows:

$$ \mathrm{PAI}=\mathrm{TG}\div \mathrm{HDL}\ \mathrm{cholesterol} $$
$$ \mathrm{non}-\mathrm{HDL}=\mathrm{total}\ \mathrm{cholesterol}-\mathrm{HDL}\ \mathrm{cholesterol} $$


Mean age was 57.06 ± 11.39 years. Mean HbA1c was 8.49 ± 1.86%, PAI ratio was 4.12 ± 3.88 mg/dl, and mean non-HDL cholesterol was 156.50 ± 45.39 mg/dl. Non-HDL cholesterol (r = 0.427; p < 0.001), HbA1c (r = 0.163; p < 0.001), and glucose (r = 0.154; p < 0.001) showed a significantly positive correlation with PAI.


Although a respectable attention is drawn to non-HDL cholesterol based on the present data, PAI may have a stronger relationship with HbA1c in patients with T2DM. PAI may be beneficial in predicting patients who have high risk for CVD in clinical practice.

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Author information

Authors and Affiliations



EB has made substantial contributions to the conception and design. AE, OP, YSA, HP, SD, and IC have made contributions to the acquisition of data. YO has made contributions to analysis and interpretation of data. EB, MM, and IC have given final approval of the version to be published.

Corresponding author

Correspondence to Evin Bozkur.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the İstanbul SBU, Bakirkoy, Dr. Sadi Konuk SUAM Ethical Committee.

Additional information

The sample sizes are very limited in the previous studies that investigate the correlation between PAI and glucose and HbA1c levels. The data gained with this study show that the atherogenic index and non-HDL cholesterol values increase with the elevated levels of HbA1c. Although non-HDL cholesterol is paid more attention in clinical practice, PAI may have a stronger relationship with HbA1c in diabetic patients. Paying enough attention to PAI may be beneficial for long-term cardiovascular risk management in diabetic patients.

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Bozkur, E., Esen, A., Polat, O. et al. Relationship of HbA1c with plasma atherogenic index and non-HDL cholesterol in patients with type 2 diabetes mellitus. Int J Diabetes Dev Ctries 41, 302–306 (2021).

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