Association of HbA1c with renal markers and lipid profile in Type 2 diabetic patients

Association of HbA1c with renal markers and lipid profile in Type 2 diabetic patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Association of HbA1c with renal markers and lipid profile in Type 2 diabetic patients sundaram Ramalingam, Nandhakumar Elumalai This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7175363/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract The current study was conducted to determine the relationship between HbA1c and renal markers (urea, creatinine and uric acid and lipid profile (Total cholesterol, triglycerides, HDL, LDL and VLDL cholesterol ) in patients with type 2 diabetes. Participants in this control trial were to be between the ages of 35 and 45, regardless of gender. Three groups were formed out of them. Group 1 consisted of fifty healthy, normal people who had no family history of diabetes. Fifty patients with prediabetes were in group 2. 50 individuals with diabetes from the same population were part of Group 3. Participants in all three groups were asked to fast peripheral venous blood samples, which were then examined for serum uric acid, fasting blood sugar, renal markers, lipid profile and HbA1c levels. A direct relationship with blood sugar and HbA1c was observed with serum urea, creatinine,, uric acid ,cholesterol, TGL, HDL, LDL and VLDL. The measurement of HbA1c levels is important not only for monitoring of diabetes but also renal failure, gout and dyslipidemia associated with cardiovascular disease because some parameters were not significantly increased with increasing HbA1c level. Therefore, this study proves that even poor glycemic control (even if HbA1c levels go beyond 14.8%) between the age group 35 and 45 years old would not cause any severe complications but uncontrolled diabetes which exists more than ten years after crossing 50 years of old might cause severe complications like amputation, cataract, renal failure, gout and cardiovascular disease etc. Uric acid HbA1c Blood glucose Diabetes mellitus: lipid profile renal markers Figures Figure 1 Introduction Diabetes is still one of the main concerns of human health in the world. According to the report of the International Diabetes Federation, the global prevalence of diabetes in people aged 20–79 in 2021 was estimated to be 10.5% (536.6 million people). This number is expected to reach 12.2% (783.2 million) in 2045 .Sun et al., 2021). In 2019, an estimated 4.2 million deaths among adults were attributable to diabetes (11.3% of deaths globally). Almost half of these deaths (1.9 million, 46.2%) occurred in people younger than 60 years (Mobasheri et al.,2023). India is the diabetes capital with 69.1 million people with Diabetes Mellitus, second highest number of cases after China in 2015(Mobasheri et al.2023). Prevalence of diabetes is higher in the Indian Subcontinent and it is rapidly rising at an alarming rate. Over the past 30 years, the status of Diabetes has changed from being considered as a mild disorder of the elderly to one of the major causes of morbidity and mortality affecting the youth and the middle-aged people (Jaspinder Kaur2022). Diabetes is a chronic disease mainly associated with an absolute or relative deficiency in insulin secretion and/or insulin resistance resulting in numerous co-morbidities and complications. Chronic uncontrolled hyperglycemia can lead to numerous microvascular and macrovascular complications including coronary artery disease and stroke, which constitutes 65% of all diabetic mortalities as well as diabetic nephropathy. Diabetic nephropathy is currently the number one cause of end-stage renal disease (ESRD) in the world today (Sarnak et al.,2003, Alemu et al.,2020) This study aims to compare lipid, kidney and uric acid profile along with co morbidities and management of diabetic patients based on glycemic control, hypothesizing that better glycemic control would lead to significant improvements in these metabolic parameters as well as result in a reduction in co morbidities. Material and Method This case control study was done on the subjects who attendedthe out patients department at Saveetha Medical College &Hospital between June 2022 and October 2022 to determine the Association of HbA1c with lipid, uric acid and renal profile in Type 2 diabetic patients. This study was approved by the Institutional Review Board, Saveetha Medical College & Hospital, Chennai-602105.Approval Number-SMC/IEC/2022/09/032. Informed consents were taken from all the subjects who were willing to participate in the study. Patients with chronic liver or kidney diseases, cancer, or taking diuretics were excluded from the study. The subjects who were included in this study were of the age group 35–45 years of either sex and were divided into 3 groups as follows: Group 1 included 50 normal healthy individuals whose HbA1C levels were ranging from 4.2 to 5.6%, without family history of Diabetes mellitus Group 2 included 50 diagnosed prediabetic patients whose HbA1C levels were ranging from 5.7 to 6.4% Group 3 included 50 diagnosed patients of Type 2 Non-Insulin Dependent Diabetes mellitus (NIDDM) and whose HbA1C levels were ranging from 10.2 to 18.5% A detailed history was taken from each patient and a thorough clinical examination was carried out. Morning blood samples were taken after an overnight fasting for generation of plasma and serum for biochemical parameters analysis. Serum uric acid, urea, creatinine, total cholesterol, triglycerides, HDL and blood sugar using Ortho-Clinical Diagnostic kits by Vitros 5600 fully automated analyzer and HbA1c was estimated by ion exchange HPLC with a glycosylated hemoglobin analyzer system (D10-Bio-Rad- America) in the Department of Biochemistry, Saveetha Medical College & Hospital. Serum low-density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were calculated using Friedewald's formula which states: VLDL cholesterol = Triglyceride/5 and LDL cholesterol = Total cholesterol- (VLDL + HDL cholesterol). Statistical analysis All the grouped data were statistically evaluated with SPSS\17.0 software. Hypothesis testing methods included one-way analysis of variance (ANOVA) followed by least significant difference (LSD) test; all the results were expressed as Mean ± STD for 50 subjects in each group P-value of less than 0.05 was considered to indicate statistical significance. All the results were expressed as the mean ± SD for 50 subjects in each group.. A p value is less than 0.05was considered to indicate statistical significance Results Distribution of male and female participants across the three study groups The distribution of male and female study participants across the three study groups is shown in the Figures from A to C. Figures show the distribution of males and females in the three study groups (Normal healthy control, Prediabetic and diabetic group) Comparison of HbA1c with fasting blood glucose and uric acid Table 1 shows mean & SD of HbA1c, uric acid and fasting blood glucose levels of all the three groups (Normal healthy control, Prediabetic and Diabetic group). Table 1 B show s the c omparison of various parameters analyzed among the three study groups by Post Hoc analysis. The statistical analysis showed the levels of blood glucose were increased with increasing HbA1c levels in all the groups but there was no linear correlation between the HbA1c and uric acid levels in all the three groups. The levels of uric acid did not rise significantly with increasing blood glucose concentration in the normal healthy control and prediabetic group whereas the levels of uric acid tend to decline with increasing blood glucose and HbA1c levels in diabetic patients Comparison of HbA1c with serum urea and serum creatinine Table 1 shows the levels of serum urea and serum creatinine among the three study groups those levels were compared with HbA1c. The serum urea and creatinine levels were not increased significantly with increasing HbA1c levels in both prediabetic and diabetic patients when compared to normal healthy patients Comparison of HbA1c with lipid profile The levels of serum total cholesterol, triglycerides HDL, VLDL and LDL among the three study groups and those levels were compared with HbA1c. Total cholesterol and triglycerides levels were significantly increased when HbA1c level increases in each of the three groups, but HDL levels were not significantly decreased in prediabetic and diabetic groups when compared to control whereas LDL and VLDL levels were not found marked increase in both prediabetic and diabetic groups when compared to control group but those levels show statistical significance in diabetic group when compared to control and prediabetic groups (Table 1 ) Table 1 Comparison of Fasting blood glucose Uric acid, Urea, Creatinine, Total cholesterol, Triglycerides, HDL,LDL and VLDL with HbA1c parameters Normal healthy control Prediabetic group Diabetic group P value HbA1c 5.16 ± 0.34 a 5.9 ± 0.22b 11.74 ± 1.42c < 0.000 FBS 95.82 ± 10.24 102.06 ± 13.03b 237.34 ± 59.83c < 0.385 Serum uric acid 5.11 ± 1.26 5.27 ± 0.94 3.99 ± 1.03c < 0.186 Serum urea 21.20 ± 6.19 20.56 ± 6.00 23.36 ± 7.52c < 0.629 Serum creatinine 0.79 ± 0.20 0.73 ± 0.17 0.64 ± 0.17 < 0.064 Total cholesterol 91.8 ± 3716 198.86 ± 43.51 206.44 ± 56.13c < 0.447 Triglycerides 139.56 ± 89.07 144.08 ± 61.76 171.68 ± 84.85c < 0.777 HDL 45.78 ± 12.64 43.50 ± 10.08 42.12 ± 10.87 < 0.312 LDL 134.55 ± 109.53 126.41 ± 39.15 129.94 ± 50.09c < 0.711 VLDL 28.10 ± 17.82a 28.86 ± 12.48b 34.34 ± 16.97c < 0.954 A statistical significance difference was noted in FBS,uric acid, urea, creatinine and lipid profile compared with HbA1c levels in all the three groups.Values are given as mean ± SD for fifty persons each group (n = 50).Values are considered significantly different at P < 0.05 with post hoc LSD test. Comparisons are made between: a Normal healthy control vs Prediabetic b Normal healthy control vs Diabetic c Prediabetic vs Diabetic Discussion The chronic hyperglycemia can damage several body organs due to microvascular and macrovascular complications. Macrovascular complications of diabetes include cardiovascular disease (CVD) such as stroke, which is the cause of death in 50% of diabetics. On the other hand, microvascular complications of diabetes include diabetic nephropathy, neuropathy, and retinopathy. (Ifeyinwa Dorothy Nnakenyi 2022 ] The glycosylated hemoglobin (HbA1c) widely accepted and used as the most reliable test for assessment of chronic glycaemia which reflects the overall blood glucose levels over a period of 3 months and may be used to assess changes in metabolic control that follow an alteration in treatment. Since, adequate glycemic control can delay development of diabetic complications (Saudek et al.,2006, Pfab et al.,2006) Serum uric acid (SUA), a degradation metabolite of purines which, have been extensively addressed in the past years as a possible risk factor for cardiovascular disease (Niskanen et al.,2004). In fact, hyperuricemia has been associated with higher mortality and higher rate of cardiovascular events, as it might promote atherosclerosis progression by inducing oxidative stress, endothelial dysfunction and smooth muscle cells proliferation (Verdoia 2014) . In our study, we observed that the serum uric acid level significantly decreased with increasing fasting blood glucose and HbA1c levels in diabetic group but many previous studies reported that high serum uric acid level is associated with increasing blood glucose with type 2 diabetes mellitus due to impaired glucose tolerance and insulin resistance [Gill et al., 2013 , Rusdiana et al., 2018, Qiu et al.,2015, Babikr et al.,2016). In addition, some studies reported that Uric acid levels rise with increasing blood glucose concentrations in the normal and prediabetic population (Gill et al., 2013 , Rusdiana et al., 2018). These reports are controversial to our findings but there are studies which revealed declining uric acid levels with increasing blood glucose and HbA1c levels in diabetic patients (Gill et al., 2013 , Herman and Goldbourt 1982 , Cook et al.,1986, Tuomilehto et al.,1988, Whitehead, 1992, Choi and Ford 2008 , Wei et al.,2016). These reports are corroborated to our findings. The reason for the inverse relationship between the HbA1c and uric acid in type 2 diabetic patients is still obscure. Since there is no discernible correlation between the study participants' HbA1c and uric acid levels, it can be inferred from the results that those with much higher HbA1c levels may be less likely to develop hyperuricemia and gout. Many studies have reported nephropathy as a complication due to the long standing duration of diabetes and correlated it with microalbuminuria, hypertension, but there are few studies which have correlated levels of serum creatinine and urea levels with the glycemic status (HbA1c levels) in diabetic population (Bamanikar et al.,2016, Hutani and Pande 2016). This study was undertaken to study the levels of serum creatinine and urea in Type 2 diabetes mellitus and further study their correlation with duration of diabetes and HbA1c levels. In the present study the serum urea and creatinine levels were not significantly increased in prediabetic and diabetic patients when compared to normal healthy patients. These results revealed that even poor glycemic control (even if HbA1c levels go beyond 14.8%) between the age group 35 and 45 years old do not cause any severe complications. This might be due to young age and onset of diabetes. Moreover patients with type 2 diabetes mellitus (T2DM) often exhibit an atherogenic lipid profile, characterized by high plasma levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), but low level of high-density lipoprotein cholesterol (HDL-C) as well as increased free fatty acids, increased small dense LDL (sdLDL), which greatly increases their risk for CVD via the process of atherosclerosis. Although hyperglycaemia was associated with atherosclerotic lesion initiation, addition of increasing amounts of cholesterol led to dyslipidaemia which was the major factor in atherosclerosis progression. However, this risk can be reduced by good management and control of both hyperglycemia and dyslipidemia (Ozder 2014 ). In the present study, total cholesterol and triglycerides levels were significantly increased with increasing HbA1c level increases in each of the three groups, but HDL levels were not significantly decreased in prediabetic and diabetic groups when compared to control whereas LDL and VLDL levels were not found marked increase in both prediabetic and diabetic groups when compared to control group but those levels show statistical significance in diabetic group when compared to control and prediabetic groups. These results are agreement with previous study [Hussain et al.,2017, Alzahrani et al.,2019, Sharahili et al.,2023). Conclusion This study highlights the importance of HbA1c, serum uric acid, renal profile and lipid profile measurement for guiding the treatment of type 2 diabetes mellitus and its complications related with s renal failure, gout and cardiovascular diseases. The measurement of HbA1c levels is important not only for monitoring of diabetes but also renal failure, gout and dyslipidemia associated with cardiovascular disease. Based on the results obtained from this study, it can be concluded that even poor glycemic control (even if HbA1c levels go beyond 14.8%) between the age group 35 and 45 years old would not cause any severe complications but uncontrolled diabetes which exists more than ten years after crossing 50 years of old might cause severe complications like amputation, cataract, renal failure, gout and cardiovascular disease etc. Declarations Compliance with Ethical Standards Disclosure of potential conflicts of interest The authors declare that there is no potential conflict of interest Research involving human participants Informed consent Informed consents were taken from all the subjects who were willing to participate in the study. Funding This study received no funding Author Contribution RS , Writing – original draft. EN, review & editing Acknowledgement nil References Alemu H, Hailu W, Adane A. 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1","display":"","copyAsset":false,"role":"figure","size":37423,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7175363/v1/79fc07b4c4818eac39fac5b6.png"},{"id":93022076,"identity":"26ed1e9b-f75c-4418-ba4d-b2559e9acd54","added_by":"auto","created_at":"2025-10-08 08:58:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":539804,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7175363/v1/ce57ca63-986e-454b-ae33-98e5030bee53.pdf"},{"id":93020377,"identity":"4aa561d4-cf1c-4d10-89d0-c1460040aa22","added_by":"auto","created_at":"2025-10-08 08:42:18","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":1713866,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementarymaterials.docx","url":"https://assets-eu.researchsquare.com/files/rs-7175363/v1/0b78b536f7d0783032859343.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Association of HbA1c with renal markers and lipid profile in Type 2 diabetic patients ","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDiabetes is still one of the main concerns of human health in the world. According to the report of the International Diabetes Federation, the global prevalence of diabetes in people aged 20–79 in 2021 was estimated to be 10.5% (536.6\u0026nbsp;million people). This number is expected to reach 12.2% (783.2\u0026nbsp;million) in 2045 .Sun et al., 2021). In 2019, an estimated 4.2\u0026nbsp;million deaths among adults were attributable to diabetes (11.3% of deaths globally). Almost half of these deaths (1.9\u0026nbsp;million, 46.2%) occurred in people younger than 60 years (Mobasheri et al.,2023). India is the diabetes capital with 69.1\u0026nbsp;million people with Diabetes Mellitus, second highest number of cases after China in 2015(Mobasheri et al.2023). Prevalence of diabetes is higher in the Indian Subcontinent and it is rapidly rising at an alarming rate. Over the past 30 years, the status of Diabetes has changed from being considered as a mild disorder of the elderly to one of the major causes of morbidity and mortality affecting the youth and the middle-aged people (Jaspinder Kaur2022).\u003c/p\u003e\u003cp\u003eDiabetes is a chronic disease mainly associated with an absolute or relative deficiency in insulin secretion and/or insulin resistance resulting in numerous co-morbidities and complications. Chronic uncontrolled hyperglycemia can lead to numerous microvascular and macrovascular complications including coronary artery disease and stroke, which constitutes 65% of all diabetic mortalities as well as diabetic nephropathy. Diabetic nephropathy is currently the number one cause of end-stage renal disease (ESRD) in the world today (Sarnak et al.,2003, Alemu et al.,2020)\u003c/p\u003e\u003cp\u003eThis study aims to compare lipid, kidney and uric acid profile along with co morbidities and management of diabetic patients based on glycemic control, hypothesizing that better glycemic control would lead to significant improvements in these metabolic parameters as well as result in a reduction in co morbidities.\u003c/p\u003e"},{"header":"Material and Method","content":"\u003cp\u003eThis case control study was done on the subjects who attendedthe out patients department at Saveetha Medical College \u0026amp;Hospital between June 2022 and October 2022 to determine the Association of HbA1c with lipid, uric acid and renal profile in Type 2 diabetic patients. This study was approved by the Institutional Review Board, Saveetha Medical College \u0026amp; Hospital, Chennai-602105.Approval Number-SMC/IEC/2022/09/032. Informed consents were taken from all the subjects who were willing to participate in the study. Patients with chronic liver or kidney diseases, cancer, or taking diuretics were excluded from the study. The subjects who were included in this study were of the age group 35–45 years of either sex and were divided into 3 groups as follows:\u003c/p\u003e\u003cp\u003eGroup 1 included 50 normal healthy individuals whose HbA1C levels were ranging from 4.2 to 5.6%, without family history of Diabetes mellitus\u003c/p\u003e\u003cp\u003eGroup 2 included 50 diagnosed prediabetic patients whose HbA1C levels were ranging from 5.7 to 6.4%\u003c/p\u003e\u003cp\u003eGroup 3 included 50 diagnosed patients of Type 2 Non-Insulin Dependent Diabetes mellitus (NIDDM) and whose HbA1C levels were ranging from 10.2 to 18.5%\u003c/p\u003e\u003cp\u003eA detailed history was taken from each patient and a thorough clinical examination was carried out. Morning blood samples were taken after an overnight fasting for generation of plasma and serum for biochemical parameters analysis. Serum uric acid, urea, creatinine, total cholesterol, triglycerides, HDL and blood sugar using Ortho-Clinical Diagnostic kits by Vitros 5600 fully automated analyzer and HbA1c was estimated by ion exchange HPLC with a glycosylated hemoglobin analyzer system (D10-Bio-Rad- America) in the Department of Biochemistry, Saveetha Medical College \u0026amp; Hospital. Serum low-density lipoprotein cholesterol (LDL-C) and very low density lipoprotein cholesterol (VLDL-C) were calculated using Friedewald's formula which states:\u003c/p\u003e\u003cp\u003eVLDL cholesterol = Triglyceride/5 and LDL cholesterol = Total cholesterol- (VLDL + HDL cholesterol).\u003c/p\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eAll the grouped data were statistically evaluated with SPSS\\17.0 software. Hypothesis testing methods included one-way analysis of variance (ANOVA) followed by least significant difference (LSD) test; all the results were expressed as Mean ± STD for 50 subjects in each group P-value of less than 0.05 was considered to indicate statistical significance. All the results were expressed as the mean ± SD for 50 subjects in each group.. A p value is less than 0.05was considered to indicate statistical significance\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cb\u003eDistribution of male and female participants across the three study groups\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe distribution of male and female study participants across the three study groups is shown in the Figures from A to C. Figures show the distribution of males and females in the three study groups (Normal healthy control, Prediabetic and diabetic group)\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison of HbA1c with fasting blood glucose and uric acid\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows mean \u0026amp; SD of HbA1c, uric acid and fasting blood glucose levels of all the three groups (Normal healthy control, Prediabetic and Diabetic group). Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB show\u003cb\u003es\u003c/b\u003e the \u003cb\u003ec\u003c/b\u003eomparison of various parameters analyzed among the three study groups by Post Hoc analysis. The statistical analysis showed the levels of blood glucose were increased with increasing HbA1c levels in all the groups but there was no linear correlation between the HbA1c and uric acid levels in all the three groups. The levels of uric acid did not rise significantly with increasing blood glucose concentration in the normal healthy control and prediabetic group whereas the levels of uric acid tend to decline with increasing blood glucose and HbA1c levels in diabetic patients\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison of HbA1c with serum urea and serum creatinine\u003c/b\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the levels of serum urea and serum creatinine among the three study groups those levels were compared with HbA1c. The serum urea and creatinine levels were not increased significantly with increasing HbA1c levels in both prediabetic and diabetic patients when compared to normal healthy patients\u003c/p\u003e\u003cp\u003e\u003cb\u003eComparison of HbA1c with lipid profile\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe levels of serum total cholesterol, triglycerides HDL, VLDL and LDL among the three study groups and those levels were compared with HbA1c. Total cholesterol and triglycerides levels were significantly increased when HbA1c level increases in each of the three groups, but HDL levels were not significantly decreased in prediabetic and diabetic groups when compared to control whereas LDL and VLDL levels were not found marked increase in both prediabetic and diabetic groups when compared to control group but those levels show statistical significance in diabetic group when compared to control and prediabetic groups (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Fasting blood glucose Uric acid, Urea, Creatinine, Total cholesterol, Triglycerides, HDL,LDL and VLDL with HbA1c\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eparameters\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNormal healthy control\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePrediabetic group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDiabetic group\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHbA1c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.16\u0026thinsp;\u0026plusmn;\u0026thinsp;0.34 a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.9\u0026thinsp;\u0026plusmn;\u0026thinsp;0.22b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11.74\u0026thinsp;\u0026plusmn;\u0026thinsp;1.42c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFBS\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e95.82\u0026thinsp;\u0026plusmn;\u0026thinsp;10.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e102.06\u0026thinsp;\u0026plusmn;\u0026thinsp;13.03b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e237.34\u0026thinsp;\u0026plusmn;\u0026thinsp;59.83c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.385\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSerum uric acid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.11\u0026thinsp;\u0026plusmn;\u0026thinsp;1.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.27\u0026thinsp;\u0026plusmn;\u0026thinsp;0.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.99\u0026thinsp;\u0026plusmn;\u0026thinsp;1.03c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.186\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSerum urea\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21.20\u0026thinsp;\u0026plusmn;\u0026thinsp;6.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20.56\u0026thinsp;\u0026plusmn;\u0026thinsp;6.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23.36\u0026thinsp;\u0026plusmn;\u0026thinsp;7.52c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.629\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSerum creatinine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.79\u0026thinsp;\u0026plusmn;\u0026thinsp;0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.73\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.64\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.064\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal cholesterol\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e91.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3716\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e198.86\u0026thinsp;\u0026plusmn;\u0026thinsp;43.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e206.44\u0026thinsp;\u0026plusmn;\u0026thinsp;56.13c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.447\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTriglycerides\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e139.56\u0026thinsp;\u0026plusmn;\u0026thinsp;89.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e144.08\u0026thinsp;\u0026plusmn;\u0026thinsp;61.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e171.68\u0026thinsp;\u0026plusmn;\u0026thinsp;84.85c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.777\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHDL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e45.78\u0026thinsp;\u0026plusmn;\u0026thinsp;12.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43.50\u0026thinsp;\u0026plusmn;\u0026thinsp;10.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42.12\u0026thinsp;\u0026plusmn;\u0026thinsp;10.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.312\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLDL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e134.55\u0026thinsp;\u0026plusmn;\u0026thinsp;109.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e126.41\u0026thinsp;\u0026plusmn;\u0026thinsp;39.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e129.94\u0026thinsp;\u0026plusmn;\u0026thinsp;50.09c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.711\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVLDL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e28.10\u0026thinsp;\u0026plusmn;\u0026thinsp;17.82a\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e28.86\u0026thinsp;\u0026plusmn;\u0026thinsp;12.48b\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e34.34\u0026thinsp;\u0026plusmn;\u0026thinsp;16.97c\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.954\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eA statistical significance difference was noted in FBS,uric acid, urea, creatinine and lipid profile compared with HbA1c levels in all the three groups.Values are given as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD for fifty persons each group (n\u0026thinsp;=\u0026thinsp;50).Values are considered significantly different at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 with post hoc LSD test. Comparisons are made between:\u003c/p\u003e\u003cp\u003ea Normal healthy control vs Prediabetic\u003c/p\u003e\u003cp\u003eb Normal healthy control vs Diabetic\u003c/p\u003e\u003cp\u003ec Prediabetic vs Diabetic\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe chronic hyperglycemia can damage several body organs due to microvascular and macrovascular complications. Macrovascular complications of diabetes include cardiovascular disease (CVD) such as stroke, which is the cause of death in 50% of diabetics. On the other hand, microvascular complications of diabetes include diabetic nephropathy, neuropathy, and retinopathy. (Ifeyinwa Dorothy Nnakenyi \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2022\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eThe glycosylated hemoglobin (HbA1c) widely accepted and used as the most reliable test for assessment of chronic glycaemia which reflects the overall blood glucose levels over a period of 3 months and may be used to assess changes in metabolic control that follow an alteration in treatment. Since, adequate glycemic control can delay development of diabetic complications (Saudek et al.,2006, Pfab et al.,2006)\u003c/p\u003e\u003cp\u003eSerum uric acid (SUA), a degradation metabolite of purines which, have been extensively addressed in the past years as a possible risk factor for cardiovascular disease (Niskanen et al.,2004). In fact, hyperuricemia has been associated with higher mortality and higher rate of cardiovascular events, as it might promote atherosclerosis progression by inducing oxidative stress, endothelial dysfunction and smooth muscle cells proliferation (Verdoia 2014)\u003c/p\u003e\u003cp\u003e. In our study, we observed that the serum uric acid level significantly decreased with increasing fasting blood glucose and HbA1c levels in diabetic group but many previous studies reported that high serum uric acid level is associated with increasing blood glucose with type 2 diabetes mellitus due to impaired glucose tolerance and insulin resistance [Gill et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2013\u003c/span\u003e, Rusdiana et al., 2018, Qiu et al.,2015, Babikr et al.,2016). In addition, some studies reported that Uric acid levels rise with increasing blood glucose concentrations in the normal and prediabetic population (Gill et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2013\u003c/span\u003e, Rusdiana et al., 2018). These reports are controversial to our findings but there are studies which revealed declining uric acid levels with increasing blood glucose and HbA1c levels in diabetic patients (Gill et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2013\u003c/span\u003e, Herman and Goldbourt \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e1982\u003c/span\u003e, Cook et al.,1986, Tuomilehto et al.,1988, Whitehead, 1992, Choi and Ford \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2008\u003c/span\u003e, Wei et al.,2016). These reports are corroborated to our findings. The reason for the inverse relationship between the HbA1c and uric acid in type 2 diabetic patients is still obscure. Since there is no discernible correlation between the study participants' HbA1c and uric acid levels, it can be inferred from the results that those with much higher HbA1c levels may be less likely to develop hyperuricemia and gout.\u003c/p\u003e\u003cp\u003eMany studies have reported nephropathy as a complication due to the long standing duration of diabetes and correlated it with microalbuminuria, hypertension, but there are few studies which have correlated levels of serum creatinine and urea levels with the glycemic status (HbA1c levels) in diabetic population (Bamanikar et al.,2016, Hutani and Pande 2016). This study was undertaken to study the levels of serum creatinine and urea in Type 2 diabetes mellitus and further study their correlation with duration of diabetes and HbA1c levels. In the present study the serum urea and creatinine levels were not significantly increased in prediabetic and diabetic patients when compared to normal healthy patients. These results revealed that even poor glycemic control (even if HbA1c levels go beyond 14.8%) between the age group 35 and 45 years old do not cause any severe complications. This might be due to young age and onset of diabetes.\u003c/p\u003e\u003cp\u003eMoreover patients with type 2 diabetes mellitus (T2DM) often exhibit an atherogenic lipid profile, characterized by high plasma levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), but low level of high-density lipoprotein cholesterol (HDL-C) as well as increased free fatty acids, increased small dense LDL (sdLDL), which greatly increases their risk for CVD via the process of atherosclerosis. Although hyperglycaemia was associated with atherosclerotic lesion initiation, addition of increasing amounts of cholesterol led to dyslipidaemia which was the major factor in atherosclerosis progression. However, this risk can be reduced by good management and control of both hyperglycemia and dyslipidemia (Ozder \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn the present study, total cholesterol and triglycerides levels were significantly increased with increasing HbA1c level increases in each of the three groups, but HDL levels were not significantly decreased in prediabetic and diabetic groups when compared to control whereas LDL and VLDL levels were not found marked increase in both prediabetic and diabetic groups when compared to control group but those levels show statistical significance in diabetic group when compared to control and prediabetic groups. These results are agreement with previous study [Hussain et al.,2017, Alzahrani et al.,2019, Sharahili et al.,2023).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the importance of HbA1c, serum uric acid, renal profile and lipid profile measurement for guiding the treatment of type 2 diabetes mellitus and its complications related with s renal failure, gout and cardiovascular diseases. The measurement of HbA1c levels is important not only for monitoring of diabetes but also renal failure, gout and dyslipidemia associated with cardiovascular disease. Based on the results obtained from this study, it can be concluded that even poor glycemic control (even if HbA1c levels go beyond 14.8%) between the age group 35 and 45 years old would not cause any severe complications but uncontrolled diabetes which exists more than ten years after crossing 50 years of old might cause severe complications like amputation, cataract, renal failure, gout and cardiovascular disease etc.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cu\u003eCompliance with Ethical Standards\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure of potential conflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that there is no potential conflict of interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch involving human participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent\u003c/p\u003e\n\u003cp\u003eInformed consents were taken from all the subjects who were willing to participate in the study.\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThis study received no funding\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eRS , Writing \u0026ndash; original draft. EN, review \u0026amp; editing\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003enil\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlemu H, Hailu W, Adane A. Prevalence of Chronic Kidney Disease and Associated Factors among Patients with Diabetes in Northwest Ethiopia: A Hospital-Based Cross-Sectional Study. Curr Ther Res Clin Exp. 2020, 26; 92:100578.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlzahrani SH, Baig M, Aashi MM, Al-Shaibi FK, Alqarni DA, Bakhamees WH. Association between glycated hemoglobin (HbA1c) and the lipid profile in patients with type 2 diabetes mellitus at a tertiary care hospital: a retrospective study. Diabetes Metab Syndr Obes. 2019;12:1639\u0026ndash;1644.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBabikr WG, Elhussein AB, Abdelraheem A, Magzoub A, Mohamed H, Alasmary M. The Correlation of Uric Acid Levels with Glycemic Control in Type II Diabetic Patients. 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Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American heart association councils on kidney in cardiovascular disease, high blood pressure research, clinical cardiology, and epidemiology and prevention. Circulation. 2003;108:2154\u0026ndash;69.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSaudek CD, Derr RL and Kalvani RR. Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c. JAMA. 2006; 295:1688\u0026ndash;1697.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSharahili, A.Y.; Mir, S.A.; ALDosari, S.; Manzar, M.D.; Alshehri, B.; Al Othaim, A.; Alghofaili, F.; Madkhali, Y.; Albenasy, K.S.; Alotaibi, J.S. Correlation of HbA1c Level with Lipid Profile in Type 2 Diabetes Mellitus Patients Visiting a Primary Healthcare Center in Jeddah City, Saudi Arabia: A Retrospective Cross-Sectional Study. Diseases 2023, 11, 154\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, Stein C, Basit A, Chan JCN, Mbanya JC, Pavkov ME, Ramachandaran A, Wild SH, James S, Herman WH, Zhang P, Bommer C, Kuo S, Boyko EJ, Magliano DJ. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTuomilehto J, Zimmet P, Wolf E, Taylor R, Ram P, King H. Plasma uric acid level and its association with diabetes mellitus and some biologic parameters in a biracial population of Fiji. Am J Epidemiol 1988;127:321\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVerdoia M, Barbieri L, Schaffer A, Cassetti E, Nardin M, Bellomo G, Aimaretti G, Marino P, Sinigaglia F, De Luca G; Novara Atherosclerosis Study Group (NAS). Impact of diabetes on uric acid and its relationship with the extent of coronary artery disease and platelet aggregation: a single-centre cohort study. Metabolism. 2014;63(5):640\u0026ndash;6\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWei F, Chang B, Yang X, Wang Y, Chen L, Li WD. Serum Uric Acid Levels were Dynamically Coupled with Hemoglobin A1c in the Development of Type 2 Diabetes. Sci Rep. 2016; 6:28549.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWhitehead TP, Jungner I, Robinson D, Kolar W, Pearl A, Hale A. Serum urate, serum glucose and diabetes. Ann Clin Biochem 1992;29:159\u0026ndash;161\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"comparative-clinical-pathology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Comparative Clinical Pathology](https://link.springer.com/journal/580)","snPcode":"580","submissionUrl":"https://submission.springernature.com/new-submission/580/3","title":"Comparative Clinical Pathology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Uric acid, HbA1c, Blood glucose, Diabetes mellitus: lipid profile, renal markers","lastPublishedDoi":"10.21203/rs.3.rs-7175363/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7175363/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe current study was conducted to determine the relationship between HbA1c and renal markers (urea, creatinine and uric acid and lipid profile (Total cholesterol, triglycerides, HDL, LDL and VLDL cholesterol\u003cb\u003e)\u003c/b\u003e in patients with type 2 diabetes. Participants in this control trial were to be between the ages of 35 and 45, regardless of gender. Three groups were formed out of them. Group 1 consisted of fifty healthy, normal people who had no family history of diabetes. Fifty patients with prediabetes were in group 2. 50 individuals with diabetes from the same population were part of Group 3. Participants in all three groups were asked to fast peripheral venous blood samples, which were then examined for serum uric acid, fasting blood sugar, renal markers, lipid profile and HbA1c levels. A direct relationship with blood sugar and HbA1c was observed with serum urea, creatinine,, uric acid ,cholesterol, TGL, HDL, LDL and VLDL. The measurement of HbA1c levels is important not only for monitoring of diabetes but also renal failure, gout and dyslipidemia associated with cardiovascular disease because some parameters were not significantly increased with increasing HbA1c level. Therefore, this study proves that even poor glycemic control (even if HbA1c levels go beyond 14.8%) between the age group 35 and 45 years old would not cause any severe complications but uncontrolled diabetes which exists more than ten years after crossing 50 years of old might cause severe complications like amputation, cataract, renal failure, gout and cardiovascular disease etc.\u003c/p\u003e","manuscriptTitle":"Association of HbA1c with renal markers and lipid profile in Type 2 diabetic patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-08 08:42:13","doi":"10.21203/rs.3.rs-7175363/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-13T14:54:01+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-07T19:02:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"172018967539018644006597280654915205644","date":"2025-09-27T10:05:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"232032302923634772615260332551404280579","date":"2025-09-25T09:52:09+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-25T09:38:21+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-19T23:38:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-19T23:37:53+00:00","index":"","fulltext":""},{"type":"submitted","content":"Comparative Clinical Pathology","date":"2025-07-21T08:55:13+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"comparative-clinical-pathology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Comparative Clinical Pathology](https://link.springer.com/journal/580)","snPcode":"580","submissionUrl":"https://submission.springernature.com/new-submission/580/3","title":"Comparative Clinical Pathology","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"5227fbda-5394-4ec1-bc96-779ec72f9d86","owner":[],"postedDate":"October 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-02-18T15:24:39+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-08 08:42:13","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7175363","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7175363","identity":"rs-7175363","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}