Objectives Dyslipidemia is prevalent among Nigerians living with diabetes, but the rate and extent of treatment have not been well-studied. The objective of this study was to determine the prevalence, treatment rates and control of dyslipidemia among diabetes patients in northern Nigeria.
Methods We conducted a multicenter, cross-sectional study of diabetes clinic patients. We noted cardiovascular risk factors, lipid-lowering treatments and examination findings, including body mass index, blood pressure, glycated hemoglobin, lipid profile, glomerular filtration rate and urinalysis. Outcome measures were the rate of dyslipidemia, the proportion of patients treated for dyslipidemia, and the proportion of patients with low density lipoprotein cholesterol goal and target for primary prevention of cardiovascular disease.
Results The study enrolled 403 participants (58.8% females), of whom 59.6% had dyslipidemia. Female gender and proteinuria were independently associated with dyslipidemia, with odds ratios of 1.74 and 2.26, respectively. Other cardiovascular risk factors of participants were hypertension (56.8%), obesity (52.6%), chronic kidney disease (36.5%), atrial fibrillation (7.9%), heart failure (5.0%), cigarette smoking (4.7%), excess alcohol use (2.0%), and previous cardiovascular disease (14.4%). In those with dyslipidemia, 51.3% took lipid-lowering treatments comprising statins (49.6%), clofibrate (1.7%) and statins combined with clofibrate (1.2%). None took other lipid-lowering treatments beside dietary control, probably due to high costs compared to statins. Only 17.1% of all participants attained the target for primary prevention of cardiovascular disease in people with diabetes.
Conclusion Most patients had dyslipidemia, which was more prevalent in females. Only a sixth of all patients had attained the treatment target. Treatment for dyslipidemia was limited to statins and fibrates, contrary to guideline recommendations for the use of ezetimibe, bempedoic acid, icosapent ethyl, or PCSK9 inhibitors for those who failed intensive statin therapy. There is a need for physician adherence to practice guidelines for the treatment of dyslipidemia, and improved access to treatment in northern Nigeria.
Competing Interest StatementThe authors have declared no competing interest.
Funding StatementThe author(s) received no specific funding for this work.
Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Approval for the study was granted by the Health Research Ethics Committees of Abubakar Tafawa Balewa University Teaching Hospital Bauchi, Ahmadu Bello University Teaching Hospital Zaria, Aminu Kano Teaching Hospital Kano, Modibbo Adama University Teaching Hospital Yola, and the University of Maiduguri Teaching Hospital Maiduguri, Nigeria, during January to March, 2023.
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
Yes
Data availability statementData are available from the corresponding author upon reasonable request.
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