Factors influencing atherogenic indices in type 2 diabetic women in northwestern Algeria


  • Mustapha Diaf Department of Biology, Faculty of Natural and Life Sciences, Djillali Liabes University, Sidi-bel-Abbes, Algeria
  • Boumediene Méghit Khaled Department of Biology, Faculty of Natural and Life Sciences, Djillali Liabes University, Sidi-bel-Abbes, Algeria




Type 2 diabetes, Atherogenic indices, Risk factors, Women, Anthropometric parameters


Background: Type 2 diabetic women are at higher risk of developing atherogenic dyslipidemia. The major possible risk factors are obesity, abdominal fat accumulation and poor glycaemic control. However, menopause-related changes could be another determinant. The aim of this study was to evaluate the interrelationships of these risk factors and their independent effects on atherogenic indices in type 2 diabetes women.

Methods: A prospective, cross-sectional study, which includes 160 women agreed to participate in this study. Anthropometrics, biochemical parameters and blood pressure were measured. Atherogenic indices - total cholesterol-to-high-density lipoprotein cholesterol ratio (TC/HDL) and apolipoprotein (apo) B-to-apo A1 ratio, were calculated. Individual risk factors were examined in relationship to these atherogenic indices using correlation tests and logistic regression.  

Results: 23.12% of the participants were normal weight and 76.87% were overweight/obese. The overall mean age was 57.70±11.16 years. Diabetes duration (˃5years), anthropometric parameters, poor glycaemic control, high apo B and high level of low-density lipoprotein (LDL) were found to be significant determinants of atherogenic indices changes. The TC/HDL ratio was weakly associated with both BMI and waist circumference. However, the apo B/apo A1 ratio provided positive correlations with anthropometric parameters, especially with waist circumference (p=0.185, r=0.108, r2=0.012), and this, in both pre and post-menopausal type 2 diabetic women.

Conclusions: The atherogenic risk, estimated by TC/HDL and apo B/apo A1 ratios, becomes more severe with higher anthropometric parameters (BMI and waist circumference), diabetes duration and poor glycaemic control in type 2 diabetes women and this during both premenopausal and postmenopausal periods. 


Metrics Loading ...


Bener A, Zirie M, Daghash MH, Al-Hamaq AO, Daradkeh G, Rikabi A. Lipids, lipoprotein (a) profile and HbA1c among Arabian Type 2 diabetic patients. Biomedical Research. 2007;18(2):97-102.

Habib SS. Cardiovascular disease in diabetes: An enigma of dyslipidemia, thrombosis and inflammation. Basic Research Journal of Medicine and Clinical Sciences. 2012;1(3):33-42.

Diaf M, Khaled BM, Sellam F. Impact of corpulence parameters and haemoglobin A1c on metabolic control in type 2 diabetic patients: comparison of apolipoprotein B/A-I ratio with fasting and postprandial conventional lipid ratios. Libyan J Med. 2015;10:27400.

Snijder MB, Van Dam RM, Visser M, Seidell JC. What aspects of body fat are particularly hazardous and how do we measure them?. Int J Epidemiol. 2006;35(1):83-92.

Von Der Lohe E. Coronary heart disease in women. Prevention. Diagnosis. Therapy. 1st ed. Berlin Heidelberg: Springer-Verlag; 2003: 17-21.

Wingard DL, Suarez L, Barrett-Connor E. The sex differential in mortality from all causes and ischemic heart disease. Am J Epidemiol. 1983;117(2):165-72.

Nwagha UI, Ikekpeazu EJ, Ejezie FE, Neboh EE, Maduka IC. Atherogenic index of plasma as useful predictor of cardiovascular risk among postmenopausal women in Enugu, Nigeria. Afr Health Sci. 2010;10(3):248-52.

World Health Organization (WHO). The WHO STEPwise approach to chronic disease risk factor surveillance. Switzerland; Geneva: World Health Organization; 2005.

Samanta B. Serum cholesterol in healthy postmenopausal women. Indian J Med Sci. 1998;52(5):191-5.

Pasquali R, Casimirri F, Pascal G, Tortelli O, Morselli Labate A, Bertazzo D, et al. Influence of menopause on blood cholesterol levels in women: the role of body composition, fat distribution and hormonal milieu. Virgilio Menopause Health Group. J Intern Med. 1997;241(3):195-203.

Lovejoy JC. The menopause and obesity. Prim Care. 2003;30(2):317-25.

Walldius G, Jungner I, Holme I, Aastveit AH, Kolar W, Steiner E. High apolipoprotein B, low apolipoprotein A-I, and improvement in the prediction of fatal myocardial infarction (AMORIS study): a prospective study. Lancet. 2001;358(9298):2026-33.

Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52.

Stępień A, Stępień M, Wlazeł RN, Paradowski M, Banach M, Rysz J. Assessment of the relationship between lipid parameters and obesity indices in non-diabetic obese patients: a preliminary report. Med Sci Monit. 2014;20:2683-8.

Diaf M, Khaled MB, Sellam F. Correlation between dietary fat intake and atherogenic indices in normal, overweight and obese adults with or without type 2 diabetes. Romanian Journal of Diabetes Nutrition and Metabolic Diseases. 2015;22(4):347-60.

Van Der Steeg WA, Boekholdt SM, Stein EA, El-Harchaoui K, Stroes ES, Sandhu MS, et al. Role of the apolipoprotein B-apolipoprotein A-I ratio in cardiovascular risk assessment: a case-control analysis in EPIC-Norfolk. Ann Intern Med. 2007;146(9):640-8.

Dunder K, Lind L, Zethelius B, Berglund L, Lithell H. Evaluation of a scoring scheme, including proinsulin and the apolipoprotein B/apolipoprotein A1 ratio, for the risk of acute coronary events in middle-aged men: Uppsala Longitudinal Study of Adult Men (ULSAM). Am Heart J. 2004;148(4):596-601.

Rohlfing CL, Wiedmeyer HM, Little RR, England JD, Tennill A, Goldstein DE. Defining the relationship between plasma glucose and HbA(1c): analysis of glucose profiles and HbA(1c) in the Diabetes Control and Complications Trial. Diabetes Care. 2002;25(2):275-8.

Elley CR, Kenealy T, Robinson E, Drury PL. Glycated haemoglobin and cardiovascular outcomes in people with Type 2 diabetes: a large prospective cohort study. Diabet Med. 2008;25(11):1295-301.

Chang CJ, Wu CH, Yao WJ, Yang YC, Wu JS, Lu FH. Relationships of age, menopause and central obesity on cardiovascular disease risk factors in Chinese women. Int J Obes Relat Metab Disord. 2000;24(12):1699-704.






Original Research Articles