Journal of AI and Integrative Medicine (JAIIM) Volume 1 | Issue 1 | May-July 2026 | Pages 16-22 DOI: https://doi.org/10.5281/zenodo.21874755 CASE REPORTS OPEN ACCESS https://journals.novadexpub.com/index.php/jaiim/index Copyright © 2026 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, adaptation, and reproduction in any medium, provided the original author(s) and the source are properly credited. 1 Evaluation of Lipid Profile in Newly Diagnosed Diabetic Patients with Nephropathy Complications Attending Federal Teaching Hospital, Owerri Edward Ukamaka 1 and Osuji Casmir Izuchukwu 2 1,2 Department of Medical Laboratory Science, Imo State University, Owerri Corresponding Author: * Edward Ukamaka, ( amakaprof77@gmail.com) Received: 15 June, 2026 | Revised: 04 August 2026 | Accepted: 10 August 2026 Abstract— Diabetes mellitus is a chronic metabolic condition that is characterised by persistent hyperglycemia due to defects in insulin production, insulin action, or both. Diabetic nephropathy is a common consequence of diabetes and is associated with profound metabolic alterations, including lipid metabolism abnormalities, which may further raise cardiovascular disease risk. Therefore, assessment of lipid profile in newly diabetic patients with nephropathy is critical for early detection of dyslipidaemia and timely management. The study assessed the lipid profile of newly diagnosed diabetes patients with nephropathy problems attending the Federal Teaching Hospital, Owerri and compared the results with seemingly healthy persons. Case-control research design was adopted. Sixty volunteers were recruited; 30 newly diagnosed diabetic patients with nephropathy problems and 30 apparently healthy controls. Serum total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were measured with standard enzymatic spectrophotometric techniques. Data were analysed by Student's t test. Statistical significance was defined at p < 0.05 . The mean TC concentration was substantially greater in diabetic patients with nephropathy (221.38 ± 21.97 mg/dL) compared to controls (138.40 ± 29.28 mg/dL; p = 0.0001). In diabetic group mean TG was also substantially higher (171.88 ± 43.61 mg/dL) than control group (110.00 ± 8.82 mg/dL; p = 0.001). Mean HDL-C was substantially lower in diabetic patients (35.63 ± 8.63 mg/dL) than controls (57.60 ± 18.30 mg/dL; p = 0.01). In contrast, LDL-C was significantly higher in the diabetic group (142.13 ± 46.55 mg/dL) than in controls (87.00 ± 21.95 mg/dL; p = 0.030). There were no significant differences between genders in the lipid parameters of the diabetes individuals (p>0.05). diabetes individuals with nephropathy problems had severe dyslipidaemia with increased TC, TG and LDL-C and decreased HDL-C values among the newly diagnosed diabetes patients. These findings emphasise the need for an early assessment of lipid profiles and adequate therapy in newly diagnosed diabetic patients with nephropathy for the prevention of cardiovascular and other metabolic problems. Key words : lipid profile,newly diagnosed diabetic patients, nephropathy, complications, owerri INTRODUCTION Diabetes mellitus (DM) is a chronic metabolic condition characterised by hyperglycemia resulting from problems in insulin secretion, insulin action, or both. Prolonged hyperglycemia leads to progressive structural and functional damage to the many organs especially kidney, eye, neurone, heart and blood vessel[1]. Diabetic nephropathy is one of the microvascular complications of diabetes and is a leading cause of chronic kidney disease and a significant contributor to morbidity and mortality in people with diabetes. Many metabolic and vascular problems including anomalies of lipid metabolism influence the development and progression of diabetic nephropathy. Diabetic dyslipidaemia is a common metabolic derangement in diabetes mellitus, especially in type 2 diabetes. It is usually accompanied by excessive triglycerides, low high-density lipoprotein cholesterol (HDL-C), and aberrant low-density lipoprotein cholesterol (LDL-C), with a greater incidence of atherogenic LDL particles [2] These lipoprotein abnormalities are also associated with endothelial dysfunction, atherosclerosis and other vascular alterations leading to increased risk for cardiovascular disease (CVD). Cardiovascular disease is a primary source of morbidity and mortality in people with diabetes [3] The clinical significance of the association of diabetes and dyslipidaemia with renal impairment. Endothelial damage and vascular dysfunction may be contributed to by aberrant lipid

Johnkennedy Nnodim(2026) 2 metabolism. Renal impairment may further modify lipid metabolism, which can establish a vicious cycle of metabolic and vascular problems. Total cholesterol (TC), triglycerides (TG) and LDL-C are elevated while HDL-C is lowered and may thus be particularly relevant in diabetic patients with indications of nephropathy. Dyslipidaemia may also contribute to the course of renal damage and raise the overall cardiovascular risk of the affected patients [4]. Assessment of lipid profile in newly diagnosed diabetes patients is significant as metabolic problems may be already manifested at the time of diagnosis. Early detection of dyslipidaemia provides a chance for adequate lifestyle adjustment, clinical surveillance and timely treatment intervention. This is particularly important in patients with nephropathy at diagnosis of diabetes, as coexistence of renal and lipid abnormalities may suggest higher risk of future complications[5]. The global burden of diabetes mellitus is increasing, and there is a notable increase in the prevalence of diabetes in sub- Saharan Africa. More than 24 million persons in Africa were living with diabetes in 2021, according to estimates from the International Diabetes Federation, and this figure is anticipated to climb significantly by 2045 [6] A significant proportion of people with diabetes are undiagnosed or diagnosed after complications have occurred. This may lead to presentation of individuals to healthcare facilities with established microvascular or macrovascular problems such diabetic nephropathy[7]. Dyslipidaemia is an essential modifiable risk factor in the pathogenesis of diabetes-related vascular problems. Increased TC, TG, and LDL-C and decreased HDL-C may induce atherogenesis, impair endothelial function, and cause vascular damage [8]. Such abnormalities may be of particular relevance in diabetic patients with nephropathy since renal failure may further affect lipid metabolism and raise cardiovascular risk. Therefore, the assessment of lipid parameters in this population is relevant to complete clinical evaluation and risk stratification [9]. In Nigeria, the increasing incidence of diabetes is accompanied by issues of early diagnosis, routine monitoring and access to quality healthcare. While blood glucose testing is essential for the diagnosis and management of diabetes, lipid profile may not be given sufficient attention in the first assessment of newly diagnosed patients, especially in resource-limited settings. Early detection and treatment of dyslipidaemia can increase the risk of progression of cardiovascular and renal disease[10]. While the link of diabetes with dyslipidaemia and renal problems is well recognised, there is little local evidence detailing the lipid profiles of newly diagnosed diabetic individuals presenting with nephropathy. Most of the information available deals with general diabetic populations or people with established long-term problems. Therefore, context-specific evidence on lipid abnormalities in newly diagnosed diabetes worsened by nephropathy is still needed. The generation of such evidence is vital to improve the full assessment of newly diagnosed diabetes patients and to promote early risk-reduction efforts. The lipid profile of this high-risk population can provide clinicians with information that helps them to identify individuals who require closer monitoring and adequate lipid therapy combined with assessment of glycaemic and renal parameters[11]. This study therefore determined the lipid profile of newly diagnosed diabetes patients with nephropathy complication attending Federal Teaching Hospital, Owerri and compared the lipid parameters with that of seemingly healthy persons. The aim of the study was to evaluate the serum levels of TC, TG, HDL-C and LDL-C and the gender differences of the lipid parameters in the diabetes patients. The findings may contribute to the available evidence on diabetic dyslipidaemia in Nigeria and support the inclusion of lipid evaluation in the comprehensive therapy of newly diagnosed diabetic patients with nephropathy. MATERIALS AND METHODS Study Area The study was conducted at the Federal University Teaching Hospital, Owerri, Imo State, Nigeria. Imo State shares its northern boundary with Anambra State for approximately 84 km and its eastern boundary with Abia State for approximately 104 km, partly along the Imo River. To the south and west, it is bounded by Rivers State for approximately 122 km. Geographically, Imo State lies between latitudes 4°45′N and 7°15′N and longitudes 6°50′E and 7°25′E, covering an estimated land area of approximately 5,100 km². Ethical Consideration The ethical approval for the study was obtained from Ethics Committee of the Federal University Teaching Hospital, Owerri. Participants were adequately informed about the objectives and procedures of the study, and confidentiality of the information obtained was assured. Written informed consent was obtained from all participants before their inclusion in the study. Study Population A total of 60 participants aged 25 years and above were recruited for the study. The study population comprised 30 diabetic patients with nephropathy complications who had been confirmed and had attended the diabetic clinic for at least three months, and 30 apparently healthy midwives who served as controls. Sample Size Determination The sample size was determined using the formula.Thus, the minimum sample size was approximately 30 participants. Selection Criteria Inclusion Criteria Participants were included if they met the following criteria: 1. Patients attending the Federal University Teaching Hospital, Owerri, for more than three months who had been confirmed to have diabetes mellitus with nephropathy complications according to the criteria stated in the study. 2. Patients aged 25 years and above.

Johnkennedy Nnodim(2026) 3 3. Participants who were willing to provide informed consent for participation in the study. Diagnostic Criteria for Diabetes Mellitus Diabetes mellitus was defined using the following criteria: 1. Fasting plasma glucose (FPG) ≥126 mg/dL (7.0 mmol/L). 2. Random plasma glucose ≥200 mg/dL (11.1 mmol/L). 3. Glycated haemoglobin (HbA1c) ≥6.5% (48 mmol/mol). Criteria for Nephropathy Nephropathy was defined based on the following criteria: 1. Albumin level >300 mg/g. 2. Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² for three months. Exclusion Criteria Participants were excluded if they: 1. Were younger than 25 years. 2. Had a history of other chronic diseases or other diabetic complications. 3. Were unwilling or unable to provide informed consent. Study Design A case-control study design was employed among patients with confirmed diabetic nephropathy attending the Federal University Teaching Hospital, Owerri. The study involved 30 individuals with newly confirmed diabetic nephropathy. Data were collected on demographic characteristics, medical history, diabetic status, and laboratory parameters. Sample Collection Each participant was seated comfortably, and a tourniquet was applied to the upper forearm. The selected venipuncture site was disinfected with 70% alcohol. Five millilitres (5 mL) of venous blood was collected using minimal venous stasis and transferred into an appropriate vacutainer tube. Each sample was properly labelled with the participant's identification, sample number, and date of collection. The blood samples were allowed to clot at room temperature and were subsequently centrifuged at 3,000 rpm for five minutes. The serum was carefully separated and transferred into clean, dry, appropriately labelled sample containers. The serum samples were stored at −20°C until laboratory analysis. Laboratory Procedures All laboratory reagents were commercially obtained, and the manufacturers' standard operating procedures were followed throughout the analyses. Determination of Total Cholesterol Total cholesterol (TC) was determined using a spectrophotometric method based on the Randox cholesterol assay kit (Randox Laboratories Ltd., USA; Catalogue No. CH8310), Determination of Triglycerides Triglyceride (TG) concentration was determined using an enzymatic method with the Randox triglyceride assay kit (Randox Laboratories Ltd., USA; Catalogue No. TR210), Determination of High-Density Lipoprotein Cholesterol High-density lipoprotein cholesterol (HDL-C) was determined spectrophotometrically using the Randox HDL- Cholesterol Assay Kit (Randox Laboratories Ltd., Crumlin, UK; Catalogue No. CH203). The method combines phosphotungstate precipitation with enzymatic determination. Determination of Low-Density Lipoprotein Cholesterol Low-density lipoprotein cholesterol (LDL-C) was determined spectrophotometrically using the Randox LDL-Cholesterol Assay Kit (Randox Laboratories Ltd., Crumlin, UK; Catalogue No. CH2361). The method involves polyvinyl sulphate precipitation followed by enzymatic determination. LDL-C (mg/dL) = Total cholesterol − (Triglycerides/5) + HDL-C Statistical Analysis Data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 23.0. Results were expressed as mean ± standard deviation (SD). Student's t-test was used to compare the study variables between groups. A p-value <0.05 was considered statistically significant. RESULTS Comparison of Lipid Profile Parameters between Newly Diagnosed Diabetic Patients with Nephropathy and Control Subjects Table 1: Mean ± Standard Deviation Values of Lipid Profile Parameters among Newly Diagnosed Diabetic Patients with Nephropathy and Apparently Healthy Controls Table 4.1 presents the comparison of mean ± standard deviation (SD) values of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low- density lipoprotein cholesterol (LDL-C) between newly diagnosed diabetic patients with nephropathy complications and apparently healthy control subjects. The mean TC concentration was significantly higher among the diabetic patients with nephropathy (221.38 ± 21.97 mg/dL) than among the control subjects (138.40 ± 29.28 mg/dL), with a statistically significant difference between the groups (t = 5.850, p = 0.0001). Similarly, the mean TG concentration was significantly higher among the diabetic patients with nephropathy (171.88 ± 43.61 mg/dL) compared with the control group (110.00 ± 8.82 mg/dL) (t = 3.075, p = 0.001). In contrast, the mean HDL-C concentration was significantly lower among the diabetic patients with nephropathy (35.63 ± 8.63 mg/dL) than among the control subjects (57.60 ± 18.30 mg/dL) (t = −2.964, p = 0.01). The mean LDL-C concentration was also significantly higher among the diabetic patients with nephropathy (142.13 ± 46.55

Johnkennedy Nnodim(2026) 4 mg/dL) than among the control subjects (87.00 ± 21.95 mg/dL) (t = 2.453, p = 0.030). . Table 1. Mean ± Standard Deviation Values of Lipid Profile Parameters among Newly Diagnosed Diabetic Patients with Nephropathy and Apparently Healthy Controls Parameters (mg/dL) Newly Diagnosed Diabetic Patients with Nephropathy (n = 30) Control Subjects (n = 30) t-value p- value Total cholesterol 221.38 ± 21.97 138.40 ± 29.28 5.850 0.0001 Triglycerides 171.88 ± 43.61 110.00 ± 8.82 3.075 0.001 HDL-C 35.63 ± 8.63 57.60 ± 18.30 −2.964 0.010 LDL-C 142.13 ± 46.55 87.00 ± 21.95 2.453 0.030 Note: p < 0.05 was considered statistically significant. HDL-C: High-density lipoprotein cholesterol; LDL-C: Low- density lipoprotein cholesterol. Comparison of Lipid Profile Parameters according to Sex among Newly Diagnosed Diabetic Patients with Nephropathy Table 2: Mean ± Standard Deviation Values of Lipid Profile Parameters among Newly Diagnosed Diabetic Patients with Nephropathy according to Sex Table 2 presents the comparison of mean ± SD values of lipid profile parameters among newly diagnosed diabetic patients with nephropathy according to sex. The mean TC concentration was 220.50 ± 16.66 mg/dL among female participants and 222.25 ± 29.10 mg/dL among male participants. Although the mean value was slightly higher among males, the difference was not statistically significant (t = −0.104, p = 0.92). The mean TG concentration was 163.25 ± 23.36 mg/dL among females and 180.50 ± 60.78 mg/dL among males. Although males had a higher mean TG concentration, the difference was not statistically significant (t = −0.530, p = 0.61). The mean HDL-C concentration was 33.75 ± 11.09 mg/dL among females and 37.50 ± 6.45 mg/dL among males. The difference was not statistically significant (t = −0.585, p = 0.58). For LDL-C, females had a higher mean concentration (154.00 ± 21.77 mg/dL) than males (130.25 ± 64.85 mg/dL); however, the difference was not statistically significant (t = 0.694, p = 0.51). Thus, although some numerical differences in lipid profile parameters were observed between male and female participants, none of the differences reached statistical significance (p > 0.05). Table 2. Mean ± Standard Deviation Values of Lipid Profile Parameters among Newly Diagnosed Diabetic Patients with Nephropathy according to Sex Parameters (mg/dL) Female (n = 15) Male (n = 15) t-value p- value Total cholesterol 220.50 ± 16.66 222.25 ± 29.10 −0.104 0.92 Triglycerides 163.25 ± 23.36 180.50 ± 60.78 −0.530 0.61 HDL-C 33.75 ± 11.09 37.50 ± 6.45 −0.585 0.58 LDL-C 154.00 ± 21.77 130.25 ± 64.85 0.694 0.51 Note: p < 0.05 was considered statistically significant. HDL-C: High-density lipoprotein cholesterol; LDL-C: Low- density lipoprotein cholesterol. Discussion The lipid profile of newly diagnosed diabetic patients with nephropathy problems attending the Federal University Teaching Hospital, Owerri was studied and the findings compared with those of seemingly healthy control participants. The results indicated that lipid metabolism was significantly changed in diabetes patients with increased TC, TG, LDL-C and decreased HDL-C. This pattern is consistent with diabetic dyslipidaemia, which is usually seen in association with insulin resistance and the metabolic abnormalities that characterise diabetes mellitus. The mean TC concentration was substantially greater in diabetic individuals with nephropathy compared to controls. This is in line with the findings of [12] who observed considerably higher levels of TC in diabetic patients with nephropathy than in non-diabetic controls. The increased TC in the present study may be attributed to abnormalities in hepatic cholesterol production and clearance in association with insulin insufficiency or resistance. Such metabolic changes can influence cholesterol homeostasis and the regulation of HMG-CoA reductase and LDL receptor function [13] It was also reported that dysregulated lipid metabolism may be involved in the advancement of renal impairment in diabetic subjects. Hypercholesterolaemia can induce glomerular damage via endothelial dysfunction and lipid deposition in renal tissues[14]. The study also showed considerably higher mean TG levels in diabetic individuals with nephropathy compared to controls. This conclusion is consistent with the report of [15] who found increased TG concentrations in patients with diabetic renal disease. Increased hepatic synthesis of very-low-density lipoprotein (VLDL) and decreased lipoprotein lipase activity can cause hypertriglyceridemia in diabetes resulting in impaired clearance of triglyceride-rich lipoproteins from the circulation [16]. The continuing rise of triglyceride-rich lipoproteins may be involved in metabolic and circulatory derangements in the kidney. Such anomalies have been documented to be related with mesangial growth, increased oxidative stress and advancement of renal fibrosis [ 17 ].

Johnkennedy Nnodim(2026) 5 However, mean HDL-C concentration was considerably lower in patients with diabetes and nephropathy than in apparently healthy controls. Reduced HDL-C is a well-known characteristic of diabetic dyslipidaemia and is related with increased risk of cardiovascular disease. This is in line with the prior findings of [18] who showed decreased HDL concentrations in diabetic patients with nephropathy. The reduced HDL-C concentration found in the present study could be attributed to changes in apolipoprotein metabolism, poorer reverse cholesterol transport and enhanced modification and catabolism of HDL particles associated with chronic metabolic disorders. These alterations in diabetic nephropathy may lead to endothelial dysfunction and increased atherogenic risk [ 19 ] Mean LDL-C concentration was also considerably greater in diabetic patients with nephropathy compared to controls. Elevated LDL-C is a major atherogenic risk factor and has been connected with macrovascular and microvascular consequences of diabetes. The current conclusion is comparable with the reports of [20] who reported increased concentration of LDL in diabetic nephropathy patients than non-diabetic individuals. Impaired LDL receptor-mediated clearance and other changes in lipoprotein metabolism can lead to elevated LDL-C. The accumulation and alteration of LDL particles, especially by oxidation, may stimulate inflammatory responses and cellular changes in the renal microvasculature and glomeruli, and this may cause renal damage [21] The comparison of lipid parameters according to sex showed no statistically significant variations in the concentrations of TC, TG, HDL-C or LDL-C between male and female diabetic patients with nephropathy. The mean TG and HDL-C concentrations were somewhat higher in males, whereas the mean LDL-C concentration was greater in females, but these differences were not statistically significant. These results show that sex was not an important factor for the dyslipidemic pattern found in this investigation. This finding is consistent with the observations of [22] who found no significant difference in lipid parameters between genders in diabetic nephropathy patients. However, some data suggest that lipid profiles may be different in some subgroups of women, especially after menopause when hormonal changes can affect TC and LDL-C concentrations . Such changes may consequently be age-dependent, hormonal status, disease duration and other clinical features[23]. The results show a specific dyslipidaemia pattern in newly diagnosed diabetic patients with nephropathy with considerably higher TC, TG and LDL-C and lower HDL-C than seemingly healthy controls. This trend might suggest abnormalities in lipoprotein metabolism linked with insulin resistance and hyperglycemia. The co-existence of dyslipidaemia and nephropathy is of clinical significance since both disorders may add to the elevated cardiovascular and renal risk. Thus, the results underscore the necessity of early evaluation of lipid profile in newly diagnosed diabetic patients, particularly in those with nephropathy, for timely risk assessment and appropriate therapy. Pathophysiologically, the findings are consistent with the suggested involvement of lipotoxicity in the formation and progression of diabetic nephropathy. Lipotoxicity is described as accumulation of excess lipid molecules in non- adipose tissues and may lead to cellular harm through oxidative stress, inflammation and apoptosis [24] Lipid deposition in renal cells such as podocytes and mesangial cells may result in cellular malfunction and renal damage [25, 26] Moreover, disturbances in TG and LDL metabolism may contribute to inflammatory and fibrotic processes implicated in the evolution of glomerular damage and renal dysfunction [27,28]. These data demonstrate that there are considerable lipid derangements in people with newly diagnosed diabetes aggravated by nephropathy. Early detection of these anomalies could therefore be relevant for holistic care and reduction of cardiovascular and renal risks. However, the findings of this study should be interpreted according to the circumstances surrounding the study population due to the relatively small sample size and case-control design and should not be generalised to similar clinical contexts without further investigation[29]. CONCLUSION The outcomes of this study showed considerable lipid abnormalities in newly diagnosed diabetic patients with nephropathy problems visiting the Federal University Teaching Hospital, Owerri. The diabetic nephropathy group showed significantly higher amounts of total cholesterol, triglycerides and LDL-C and significantly lower HDL-C concentrations when compared with seemingly healthy controls. These data demonstrate that dyslipidaemia might be present even at the early stage of diagnosed diabetes when nephropathy is already established. The lipid abnormalities identified may play a role in the elevated cardiovascular and renal risks in diabetic nephropathy. Therefore, routine screening of lipid profile is crucial as part of complete assessment of newly diagnosed diabetes patients especially those presenting with nephropathy. Early identification and adequate care of dyslipidaemia may help reduce the risk of future metabolic, cardiovascular and renal problems. Funding: This research received no external funding. Institutional Review Board Statement: Not applicable. Informed Consent Statement: Not applicable. Data Availability Statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request. Conflicts of Interest: The author declares no conflict of interest REFERENCES [1.]Yachmaneni Jr, A., Jajoo, S., Mahakalkar, C., Kshirsagar, S. and Dhole, S. (2023) ‘A comprehensive review of the vascular consequences of diabetes in the lower extremities: current approaches to management and evaluation of clinical outcomes’, Cureus, 15(10). 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