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1. Assessment of Triglycerides to High Density
Lipoprotein Cholesterol Ratio and C -
reactive protein Among Type 2 Diabetic at
Somali Sudanese Hospital in Mogadishu
BY:
Names
Abdikafi Hassan Mohamud ID No. 4087
Kowthar Ali Abdi ID No.4336
Farah Muhidin Ahmed ID No. 4210

2. Introduction/Background
The prevalence of T2DM is steadily increasing everywhere, most
markedly in the world’s middle-income countries. China is experiencing
the world’s largest diabetes epidemic. The prevalence of T2DM in
Mainland China has risen from a low 0.67% in 1980 to an astounding
10.9% in 2013. International Diabetes Federation estimated the
number of Chinese people aged 20–79 years with diabetes to be at
114.4 million in 2017.3 identifying modifiable risk factors and reducing
the prevalence of these factors is essential for the prevention of T2DM.
Dyslipidemia such as elevated triglycerides (TGs) or decreased high-
density lipoprotein cholesterol (HDL-C) is a common feature
accompanying T2DM and prediabetic states.

3. Cont.…
There are several prospective studies that have demonstrated
elevated blood TG levels to increase the risk of diabetes,
impaired glucose tolerance11 and impaired fasting glucose.
Some studies have shown that HDL-C is inversely associated
with the incidence of T2DM.Insulin resistance (IR) is a key risk
factor for T2DM. The triglyceride to high-density lipoprotein
cholesterol (TG/HDL-C) ratio has been reported to be a
surrogate marker of IR.this might be a simple and reliable
method to assess IR. However, only few prospective studies
have evaluated the association between the TG/HDL-C ratio at
baseline and the incidence of T2DM. (Liu et al., 2021).

4. Problem Statement
• Diabetes mellitus type 2 (T2DM) is a disease that worsens over time and is
typified by persistent decrease of endogenous insulin production and insulin
resistance. In recent years, T2DM has affected an increasing number of people.
• According to reports, in 2013, the estimated prevalence of diabetes and
prediabetes in the adult Chinese population was 11.6% and 50.1%, respectively.
Over 90% of instances of diagnosed diabetes mellitus in China are T2DM cases,
making it the most frequent kind of the disease.
• Early identification of insulin resistance is beneficial since it plays a significant role
in the pathophysiology of type 2 diabetes. One straightforward indicator of
insulin resistance has been suggested: the ratio of triglycerides (TG) to high-
density lipoprotein cholesterol (HDL-C). TG/HDL-C's possible use in identifying
insulin resistance. There is insufficient data to suggest that in Chinese people, the
TG/HDL-C ratio serves as a proxy for insulin resistance.

5. Research Objectives
General objective
1. assessment of Triglycerides to High Density Lipoprotein Cholesterol
Ratio and C- reactive protein among Type 2 Diabetic at Somali
Sudanese hospital
Specific Objectives
1. To measure triglycerides, HDL and CRP among type 2 diabetic patient at
Somali Sudanese hospital
2. To find ratio between triglyceride and high-density Lipoprotein (HDL) at
Somali Sudanese hospital
3. To assess the relationship between triglyceride, HDL and C-reactive
protein with duration of type two diabetic patients at Somali Sudanese
hospital.

6. Research Question
1. What triglycerides and HDL, CRP among type 2 diabetic patient at Somali
Sudanese hospital?
2. What is ratio between triglyceride and high-density Lipoprotein (HDL) at
Somali Sudanese Hospital?
3. What is assess the relationship between triglyceride, HDL and CRP with
duration type two diabetic patients at Somali Sudanese hospital?

7. SCOPE OF THE STUDY
Content scope
The study was conduct Somali Sudanese hospital. This hospital is located in
Mogadishu, Somalia’s capital. The researchers was use this hospital because
it is the place to treat the Type 2 Diabetic. The study seeks to assess
Triglycerides to High Density Lipoprotein Cholesterol Ratio and C - reactive
protein among Type 2 Diabetic at Somali Sudanese hospital.
Geographical scope
The study was conduct Somali Sudanese hospital. This hospital is located in
Mogadishu, Somalia’s capital.
Time scope
The study was cover the information from September to December 2023.

8. Conceptual Frame Work
Ratio between triglyceride and
high-density Lipoprotein (HDL)
Relationship between triglyceride,
HDL and CRP with duration type
two diabetic
Triglycerides, HDL and CRP
among type 2 diabetic
C-reactive protein among Type 2
Diabetic

9. Research Design
Research Design
This study was be descriptive cross-sectional study because it’s easy to
use as the information collect from respondents and it’s not required to
make re-investigation over a period of the study.
Study area
This Study was conduct in Somalia Sudanese specialized hospital located
in Banadir region specially Hodan district Mogadishu-Somalia.
Target Population
The target population of this research was 70 of Somalia Sudanese
hospital staffs in Mogadishu Somalia. This is because the staff has the
right information and knowledge.

10. SAMPLING FRAME
No Name hospital Target
Population
Sample
Size
1 Somali sudanees
hospital
70 60

11. Sample Size Calculation
sample size from the target population. Stratified sampling method
used to classify the target population in to two strata. Using the
Slovene’s formulae, the sample size was 60 as shown below;

12. DATA COLLECTION TECHNIQUES
DATA COLLECTION TECHNIQUES
Primary data was collect using structured questionnaires. The structured
questionnaire was best suitable for its ability to easily collect data and it
was easily analyse Relevant questions about the variables of the study was
generate
DATA PROCESSING AND ANALYSIS
Data was use manually enter in a statistical package for social analysis (SPSS)
spreadsheet then tabulated using the programmer and analyzing. Statistical
package for social science analysis (SPSS) is computer application that
provides statistical analysis of a data. It allows in-depth data access and
preparation, analytical, reporting graphics and reporting tables.

13. Results/findings
• In terms of Age results it showed that the age of respondents.
Majority of the respondents 35(58%) were the age of 26-34 years
following by 15(25%) were 45-65 years while the rest 18-25 years
10(17%) were the age of respondents, comparing to the previous
study for this case which showed that many different ages like this
were find out that the demographic and clinical characteristics of
individuals diagnosed with pre-diabetes. the mean age of the
participants was 50 years, with (64.51%) of them being male. while
the median duration of follow-up was 2.95 years, during which
(41.91%) participants reverted to normoglycemia.

14. Results/findings
• In terms of gender, the respondent’s majority of the respondents 45(75%),
were male while the other 15(25%) who participated were female.
• The previous study indicated that, the incident of T2DM showed an upward
trend in terms of the gender who whose TG/HDL-C ratio (P for trend <
0.01). were male in the context of that the number of gender of female
were more than the males TG/HDL-C, we further reviewed the association
of TG/HDL-C ratio and T2DM in different subgroups (men and women)
followed the factors were also more different.
• The current study showed that the educational level the majority of the
respondents were primary level 20(33%) and the followed by 15 (25%)
were secondary level while the other of the 15(25%) were Bachelor’s
degree and the rest of 10 the respondents of educational level were No
formal education

15. Results/findings
• In accordance with the previous study the educational level were
mostly bachelor degree levels 48 (59%) p.values was 0.016 and the
remaining were secondary leves in terms of the educational level that
wast targeted by the study in 2021, in Ethiopia and sudan.
• Result Laboratory diagnosis were indicated that 35 (58%) were
abnormal for the density lipoprotein cholesterol tests from the blood
while the other rests of 25 (42%) were Normal with the Result of
Laboratory diagnosis tests during the hospital. Overall the baseline,
of other compared researches showed that 50% of men reported
history of type 2 diabetes, and 48% reported personal history of
hypertension; 2% had history family genetics.

16. Results/findings
• In terms of history of high triglycerides the respondents have indicated that
heart disease are the most number one from retrieving the target
populations of this study and the respondents 40 (66%) said yes when
asked them that the Family history of high triglycerides or heart disease
and followed by 20(34%) have said no for the asked questions during the
data collections on the other issues of triglyceride level the most recent
triglyceride level and they indicated that they are normal and followed by
25 (42%) responded that recent triglyceride level is Abnormal when asking
the measurement of protein levels and the last the respondents were
asked that the measurement of protein levels 30 (50%) said yes we
measure while the 25(41%) said no we don’t measure and the rest 5(9%)
said we have Never measure in terms of the findings.

17. Results/findings
• While comparing to the additional study that indicates a non-linear
correlation was found between TG/HDL-C ratio and the risk of T2DM,
and the slope of the curve decreased after the cutoff point of 2.54.
Subgroup analysis revealed a stronger positive correlation among
male individuals and those with body mass index <24 kg/m2, this
study which made in Sudan Khartoum in 2014.

18. Results/findings
• On the other hand there was previous study for this case triglyceride
level The high serum CRP concentration in diabetes reported in this
study and by other authors could be due to an increase in adipose
tissue mass that enhances cytokines production by adipocytes,
significant increase in the mean concentration of LDL-C in patients
than controls, being 137.71 ± 36.73 mg/dl and 122.47 ± 16.19 mg/dl
for patients and controls, (P-value 0.000). Also, a significant increase
in the mean of CRP concentration over the control value was seen,
being 7.38 ± 4.08 mg/dl and 4.13 ± 4.08 mg/dl for patients and
controls respectively, (P-value 0.000).

19. Conclusion
• Type 2 diabetes mellitus (T2DM) is characterized by dysregulation of
carbohydrate, lipid and protein metabolism, and results from
impaired insulin secretion, insulin resistance or a combination of
both. Of the three major types of diabetes, T2DM is far more
common (accounting for more than 90% of all cases) than either type
1 diabetes mellitus (T1DM) or gestational diabetes Over the past few
decades, our understanding of the development and progression of
T2DM has evolved rapidly. The TG–to–HDL cholesterol ratio may be
related to the processes involved pathophysiology and relevant with
regard to the risk of clinical vascular disease.

20. Recommendations
• TGs: HDLc ratio and CRP can be used routinely for type2 diabetic patients to
assess atherogenicindex to avoid the complications that may suddenly happen.
• The examine more sample size with different target population to get much more
reliable. Physical activity is an important part of managing your blood glucose
level and staying healthy.Being active has many health benefits.
• You may need to check your blood glucose level before, during, and right after
you are physicallyactive.
• It is needed to further research about on this Combining type 2 diabetes and
prediabetes with dyslipidemia, which is defined by elevated triglycerides (TGs) or
decreased HDL- C (high-density lipoprotein cholesterol), is common. Numerous
prospective studies have connected elevated blood TG levels to lower glucose
tolerance, poor fasting glucose, and an increased risk of diabetes.

21. Thanks For Your
Listening