Comparative Analysis of Dyslipidemia and Atherogenic Indices among Controlled and Uncontrolled Diabetes Mellitus Patients at a Tertiary Care Center

Objective: To compare the prevalence, patterns, and atherogenic indices associated with dyslipidemia among patients with controlled and uncontrolled diabetes mellitus. Study Design: Cross-sectional observational study. Place and Duration of Study: The study was conducted at the Punjab Institute of Cardiology, Lahore, from October 2 to December 29, 2025. Materials and Methods: Fasting blood samples of 503 eligible patients were analyzed for their lipid profiles and HbA1c levels. Participants were grouped into controlled and uncontrolled diabetes groups based on ADA criteria, while dyslipidemia classification was made using NCEP ATP III cutoffs. Clinical characteristics, lipid profile parameters, and atherogenic indices were compared between the two groups using independent t-test for parametric variables while Mann-Whitney U test was employed for non-parametric variables. Logistic regression analysis was used to assess the association of specific dyslipidemia phenotypes with glycemic control status. Results: The overall prevalence of dyslipidemia in the study population was 87.3%, which was significantly higher in the uncontrolled group (89.5% vs. 82.8%, χ²=4.510, p=0.034). Patients with uncontrolled diabetes showed significantly higher median values of HbA1c, triglycerides, duration of diabetes, Castelli Risk Index I and II, atherogenic coefficient, and cardiometabolic index, while HDL-C levels were lower. Uncontrolled diabetes was a strong, independent predictor of the combined dyslipidemia phenotype (OR: 3.43, 95% CI: 1.61–7.31, p=0.001), while LDL-C did not differ significantly between groups. Conclusion: Uncontrolled diabetes mellitus is strongly associated with a more atherogenic lipid profile. Atherogenic indices should be incorporated into routine lipid profile along with a detailed assessment of dyslipidemia patterns, especially in the diabetic population.