Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (<i>P</i> = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (<i>P</i> = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (<i>P</i> = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.
Jaffar, S. and Gill, G. (2017) The Crisis of Diabetes in Sub-Saharan Africa. The La n cet Diabetes & Endocrinology , 5, 574-575. https://doi.org/10.1016/S2213-8587(17)30219-X
International Diabetes Federation. Diabetes in Africa. https://www.idf.org/our-network/regions-members/africa/diabetes-in-africa.html
Wu, L. and Parhofer, K.G. (2014) Diabetic Dyslipidemia. Metabolism , 63, 1469-1479. https://doi.org/10.1016/j.metabol.2014.08.010
Mooradian, A.D. (2009) Dyslipidemia in Type 2 Diabetes Mellitus. Nature Reviews Endocrinology , 5, 150-159. https://doi.org/10.1038/ncpendmet1066
Pappan, N. and Rehman, A. (2022) Dyslipidemia. StatPearls Publishing, Treasure Island.
Angassa, D., Solomon, S. and Seid. A. (2022) Factors Associated with Dyslipidemia and Its Prevalence among Awash Wine Factory Employees, Addis Ababa, Ethiopia: A Cross-Sectional Study. BMC Cardiovascular Disorders , 22, Article No. 22. https://doi.org/10.1186/s12872-022-02465-4
Davidson, M.H. and Pulipati, V.P. (2023) Merck Manual, Professional Version: Dyslipidemia. Merck Sharp & Dohme Corp. https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/lipid-disorders/dyslipidemia
Warraich, H.J. and Rana, J.S. (2017) Dyslipidemia in Diabetes Mellitus and Cardiovascular Disease. Cardiovascular Endocrinology , 6, 27-32. https://doi.org/10.1097/XCE.0000000000000120
Masilela, C., Adeniyi, O.V. and Benjeddou, M. (2022) Prevalence, Patterns and Determinants of Dyslipidaemia among South African Adults with Comorbidities. Scientific Reports , 12, Article No. 337. https://doi.org/10.1038/s41598-021-04150-6
Wu, L. and Parhofer, K.G. (2014) Diabetic Dyslipidemia. Metabolism , 63, 1469-1479. https://doi.org/10.1016/j.metabol.2014.08.010
Vijayaraghavan, Krishnaswami. (2010) Treatment of Dyslipidemia in Patients with Type 2 Diabetes. Lipids in Health and Disease , 9, Article No. 144. https://doi.org/10.1186/1476-511X-9-144
Pappan, N. and Rehman, A. (2023) Dyslipidemia. StatPearls Publishing, Treasure Island.
Roth, G.A., Forouzanfar, M.H., Moran, A.E., Barber, R., Nguyen, G., Feigin, V.L., Naghavi, M., Mensah, G.A. and Murray, C.J. (2015) Demographic and Epidemiologic Drivers of Global Cardiovascular Mortality. The New England Journal of Medicine , 372, 1333-1341. https://doi.org/10.1056/NEJMoa1406656
22 University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
23 University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
24 University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
25 Department Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, New Orleans, USA
26 London School of Hygiene and Tropical Medicine, London, UK
Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J. and Lisheng, L. (2004) Effect of Potentially Modifiable Risk Factors Associated with Myocardial Infarction in 52 Countries (The Interheart Study): Case-Control Study. The Lancet , 364, 937-952. https://doi.org/10.1016/S0140-6736(04)17018-9
Bowry, A.D., Lewey, J., Dugani, S.B. and Choudhry, N.K. (2015) The Burden of Cardiovascular Disease in Low-and Middle-Income Countries: Epidemiology and Management. Canadian Journal of Cardiology , 31, 1151-1159. https://doi.org/10.1016/j.cjca.2015.06.028
Moran, A., Forouzanfar, M., Sampson, U., Chugh, S., Feigin, V. and Mensah, G. (2013) The Epidemiology of Cardiovascular Diseases in Sub-Saharan Africa: The Global Burden of Diseases, Injuries and Risk Factors 2010 Study. Progress in Ca r diovascular Diseases , 56, 234-239. https://doi.org/10.1016/j.pcad.2013.09.019
Leong, D.P., Joseph, P.G., McKee, M., Anand, S.S., Teo, K.K., Schwalm, J.D. and Yusuf, S. (2017) Reducing the Global Burden of Cardiovascular Disease, Part 2: Prevention and Treatment of Cardiovascular Disease. Circulation Research , 121, 695-710. https://doi.org/10.1161/CIRCRESAHA.117.311849
Marcus, M.E., Ebert, C., Geldsetzer, P., Theilmann, M., Bicaba, B.W., Andall-Brereton, G., Bovet, P., Farzadfar, F., Singh Gurung, M., Houehanou, C., Malekpour, M.R., Martins, J.S., Moghaddam, S.S., Mohammadi, E., Norov, B., Quesnel-Crooks, S., Wong-McClure, R., Davies, J.I., Hlatky, M.A., Atun, R., Bärnighausen, T.W., Jaacks, L.M., Manne-Goehler, J. and Vollmer, S. (2021) Unmet Need for Hypercholesterolemia Care in 35 Low-and Middle-Income Countries: A Cross-Sectional Study of Nationally Representative Surveys. PLOS Medicine , 18, e1003841. https://doi.org/10.1371/journal.pmed.1003841
Gebreegziabiher, G., Belachew, T., Mehari, K. and Tamiru, D. (2021) Prevalence of Dyslipidemia and Associated Risk Factors among Adult Residents of Mekelle City, Northern Ethiopia. PLOS ONE , 16, e0243103. https://doi.org/10.1371/journal.pone.0243103
Noubiap, J.J., Bigna, J.J., Nansseu, J.R., Nyaga, U.F., Balti, E.V., Echouffo-Tcheugui, J.B. and Kengne, A.P. (2018) Prevalence of Dyslipidaemia among Adults in Africa: A Systematic Review and Meta-Analysis. The Lancet Global Health , 6, e998-e1007. https://doi.org/10.1016/S2214-109X(18)30275-4
Abdissa, D. and Hirpa, D. (2022) Dyslipidemia and Its Associated Factors among Adult Diabetes Outpatients in West Shewa Zone Public Hospitals, Ethiopia. BMC Cardiovascular Disorders , 22, Article No. 39. https://doi.org/10.1186/s12872-022-02489-w
Omodanisi, E.I., Tomose, Y., Okeleye, B.I., Ntwampe, S K.O. and Aboua, Y.G. (2020) Prevalence of Dyslipidaemia among Type 2 Diabetes Mellitus Patients in the Western Cape, South Africa. International Journal of Environmental Research and Public Health , 17, Article 8735. https://doi.org/10.3390/ijerph17238735
Pitso, L., Mofokeng, T.R.P. and Nel, R. (2021) Dyslipidaemia Pattern and Prevalence among Type 2 Diabetes Mellitus Patients on Lipid-Lowering Therapy at a Tertiary Hospital in Central South Africa. BMC Endocrine Disorders , 21, Article No. 159. https://doi.org/10.1186/s12902-021-00813-7
Achila, O.O., Ghebretinsae, M., Kidane, A., Simon, M., Makonen, S. and Rezene, Y. (2020) Factors Associated with Poor Glycemic and Lipid Levels in Ambulatory Diabetes Mellitus Type 2 Patients in Asmara, Eritrea: A Cross-Sectional Study. Journal of Diabetes Research , 2020, Article ID: 5901569. https://doi.org/10.1155/2020/5901569
Oguejiofor, O.C., Onwukwe, C.H. and Odenigbo, C.U. (2012) Dyslipidemia in Nigeria: Prevalence and Pattern. Annals of African Medicine , 11, 197-202. https://doi.org/10.4103/1596-3519.102846
Maiga, Y., Diallo, S., dite Nènè Konipo, F., Sangho, O., Sangaré, M., Diallo, S.H., Mahamadou, S., Péréon, Y., Giumelli, B., Coulibaly, A., Daou, M., Traoré, Z., Sylla, D.S., Albakaye, M., Guinto, C.O., Ouologem, M., Sissoko, A.S., Traoré, H.A., Coulibaly, S.P., Damier, P., Attal, N. and Nizard, J. (2020) Diabetic Polyneuropathy with/out Neuropathic Pain in Mali: A Cross-Sectional Study in Two Reference Diabetes Treatment Centers in Bamako (Mali), Western Africa. PLOS ONE , 15, e0241387. https://doi.org/10.1371/journal.pone.0241387
International Diabetes Federation (2021) IDF Diabetes Atlas, 10th Edition. https://www.ncbi.nlm.nih.gov/books/NBK581934/#:~:text=In 2021, it is estimated,impaired glucose tolerance in 2021
American Diabetes Association (2020) 6. Glycemic Targets: Standards of Medical Care in Diabetes—2021. Diabetes Care , 44, S73-S84. https://doi.org/10.2337/dc21-S006
Raal, F.J., Blom, D.J., Naidoo, S., Bramlage, P. and Brudi, P. (2013) Prevalence of Dyslipidaemia in Statin-Treated Patients in South Africa: Results of the Dyslipidaemia International Study (Dysis). Cardiovascular Journal of Africa , 24, 330-338. https://doi.org/10.5830/CVJA-2013-071
Criqui, M.H., and Golomb, B.A. (1998) Epidemiologic Aspects of Lipid Abnormalities. The American Journal of Medicine , 105, 48s-57s. https://doi.org/10.1016/S0002-9343(98)00212-5
Noubiap, J.J., Mato, E.P.M., Guewo-Fokeng, M., Kaze, A.D., Boulenouar, H. and Wonkam, A. (2018) Genetic Determinants of Dyslipidemia in African-Based Populations: A Systematic Review. OMICS , 22, 749-758. https://doi.org/10.1089/omi.2018.0158
Catley, D., Puoane, T., Tsolekile, L., Resnicow, K., Fleming, K.K., Hurley, E.A., Smyth, J.M., Materia, F.T., Lambert, E.V., Vitolins, M.Z., Levitt, N.S. and Goggin, K. (2022) Evaluation of an Adapted Version of the Diabetes Prevention Program for Low-and Middle-Income Countries: A Cluster Randomized Trial to Evaluate “Lifestyle Africa” in South Africa. PLOS Medicine , 19, e1003964. https://doi.org/10.1371/journal.pmed.1003964
Mbanya, J.C., Motala, A.A., Sobngwi, E., Assah, F.K. and Enoru, S.T. (2010) Diabetes in Sub-Saharan Africa. The Lancet , 375, 2254-2266. https://doi.org/10.1016/S0140-6736(10)60550-8
Diawara, A., Coulibaly, D.M., Hussain, T.Y.A., Cisse, C., Li, J., Wele, M., Diakite, M., Traore, K., Doumbia, S.O. and Shaffer. J.G. (2023) Type 2 Diabetes Prevalence, Awareness, and Risk Factors in Rural Mali: A Cross-Sectional Study. Scientific R e ports , 13, Article No. 3718. https://doi.org/10.1038/s41598-023-29743-1
Tsimihodimos, V., Gonzalez-Villalpando, C., Meigs, J.B. and Ferrannini, E. (2018) Hypertension and Diabetes Mellitus. Hypertension , 71, 422-428. https://doi.org/10.1161/HYPERTENSIONAHA.117.10546
Kodaman, N., Aldrich, M.C., Sobota, R., Asselbergs, F.W., Poku, K.A., Brown, N.J., Moore, J.H. and Williams, S.M. (2016) Cardiovascular Disease Risk Factors in Ghana during the Rural-to-Urban Transition: A Cross-Sectional Study. PLOS ONE , 11, e0162753. https://doi.org/10.1371/journal.pone.0162753
Popkin, B.M., Adair, L.S. and Ng, S.W. (2012) Global Nutrition Transition and the Pandemic of Obesity in Developing Countries. Nutrition Reviews , 70, 3-21. https://doi.org/10.1111/j.1753-4887.2011.00456.x
Lopes, T., Zemlin, A.E., Erasmus, R.T., Madlala, S.S., Faber, M. and Kengne, A.P. (2022) Assessment of the Association between Plant-Based Dietary Exposures and Cardiovascular Disease Risk Profile in Sub-Saharan Africa: A Systematic Review. BMC Public Health , 22, Article No. 361. https://doi.org/10.1186/s12889-022-12724-w
Noubiap, J.J. (2021) Clustering of Cardiometabolic Risk Factors in Sub-Saharan Africans. The Pan African Medical Journal , 38, Article 112. https://doi.org/10.11604/pamj.2021.38.112.28180
Obsa, M.S., Ataro, G., Awoke, N., Jemal, B., Tilahun, T., Ayalew, N., Woldegeorgis, B.Z., Azeze, G.A. and Haji, Y. (2021) Determinants of Dyslipidemia in Africa: A Systematic Review and Meta-Analysis. Frontiers in Cardiovascular Medicine , 8, Article 778891. https://doi.org/10.3389/fcvm.2021.778891
Capparelli, R. and Iannelli, D. (2021) Role of Epigenetics in Type 2 Diabetes and Obesity. Biomedicines , 9, Article 977. https://doi.org/10.3390/biomedicines9080977
Kwak, S.H. and Park, K.S. (2016) Recent Progress in Genetic and Epigenetic Research on Type 2 Diabetes. Experimental & Molecular Medicine , 48, e220. https://doi.org/10.1038/emm.2016.7
Lazarte, J. and Hegele, R.A. (2020) Dyslipidemia Management in Adults with Diabetes. Canadian Journal of Diabetes , 44, 53-60. https://doi.org/10.1016/j.jcjd.2019.07.003
Berberich, A.J. and Hegele, R.A. (2019) The Complex Molecular Genetics of Familial Hypercholesterolaemia. Nature Reviews Cardiology , 16, 9-20. https://doi.org/10.1038/s41569-018-0052-6
Rader, D.J., Cohen, J. and Hobbs, H.H. (2003) Monogenic Hypercholesterolemia: New Insights in Pathogenesis and Treatment. Journal of Clinical Investigation , 111, 1795-1803. https://doi.org/10.1172/JCI200318925
Pisciotta, L., Oliva, C.P., Mario Pes, G., Di Scala, L., Bellocchio, A., Fresa, R., Cantafora, A., Arca, M., Calandra, S. and Bertolini, S. (2006) Autosomal Recessive Hypercholesterolemia (ARH) and Homozygous Familial Hypercholesterolemia (FH): A Phenotypic Comparison. Atherosclerosis , 188, 398-405. https://doi.org/10.1016/j.atherosclerosis.2005.11.016
Ober, C., Loisel, D.A. and Gilad, Y. (2008) Sex-Specific Genetic Architecture of Human Disease. Nature Reviews Genetics , 9, 911-922. https://doi.org/10.1038/nrg2415
Teslovich, T.M., Musunuru, K., Smith, A.V., Edmondson, A.C., et al . (2010) Biological, Clinical, and Population Relevance of 95 Loci for Blood Lipids. Nature , 466, 707-713. https://doi.org/10.1038/nature09270