Prevalence, treatment rates and control of dyslipidemia among diabetes patients in northern Nigeria: A cross-sectional, multicenter study

Q: What are the key findings of this study?

Among 403 Nigerian diabetes patients, 59.6% had dyslipidemia (associated with female gender, OR 1.68, P=0.029, and proteinuria, OR 2.26, P=0.004), 51.3% took lipid-lowering therapy, and 17.1% achieved the LDL-C target.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Diabetes mellitus and dyslipidemia (n=403). Intervention: Routine diabetes care and lipid-lowering therapy (statins and clofibrate). Primary outcome: Prevalence of dyslipidemia, lipid-lowering treatment rate, and attainment of LDL-C target (<1.8 mmol/L) for primary prevention of cardiovascular disease (with logistic regression evaluating association of female gender with dyslipidemia) (OR 1.68, p=0.029).

Q: What does this research mean for the field?

Among Nigerian patients with diabetes, dyslipidemia is prevalent (59.6%) and significantly associated with female gender and proteinuria, while only 17.1% achieve recommended LDL-C targets despite approximately half receiving lipid-lowering treatment. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Nura H. Alkali; Andrew Uloko; Godwin Osaigbovo; AG Bakari; Mohammed Raji Bello; Maria Ahuoiza Garba; Garba Musa Fika; Abubakar Sahabi Muhammad; Muhammad Arabi Saad; Vandi Ghyi Zira; Umar Faruk Abdullahi; Ayuba Mugana; Ijuptil Chiroma; Ibrahim Abdullahi Haladu; Lumsami Shadrach; Usman Adamu Nuhu; Godiya Ishaya Dare

doi:10.1371/journal.pone.0346350

August 5, 2026PLoS ONEOpen Access

Prevalence, treatment rates and control of dyslipidemia among diabetes patients in northern Nigeria: A cross-sectional, multicenter study

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Key result

Female sex is linked to ~68% higher odds of dyslipidemia among patients with diabetes.

OR 1.68
P=0.029
n=403

Why the study?

What are the prevalence, treatment rates, and LDL-C target attainment rates of dyslipidemia among patients with diabetes mellitus receiving routine care in northern Nigeria?

Key Points

To determine the prevalence, treatment patterns, and control rates of dyslipidemia among patients with diabetes mellitus in northern Nigeria.
Conducted a multicenter cross-sectional study enrolling 403 participants with diabetes mellitus (58.8% females; 90.3% type 2 diabetes, 9.7% type 1 diabetes) across five sites in northern Nigeria.
Assessed cardiovascular disease risk factors, lipid-lowering drug usage, glycemic control (HbA1c), renal function, and attainment of the low-density lipoprotein cholesterol primary prevention target of < 1.8 mmol/L.
Identified factors associated with dyslipidemia using univariate analyses and multivariable binomial logistic regression evaluated with the Hosmer-Lemeshow goodness-of-fit test.
Dyslipidemia was present in 59.6% of participants (240/403) and was significantly associated with female gender (odds ratio = 1.68, P = 0.029) and proteinuria (odds ratio = 2.26, P = 0.004).
Among participants with dyslipidemia, 51.3% were receiving lipid-lowering treatment, which consisted of statins (50.8%) and clofibrate (2.9%), with none receiving non-statin therapies such as ezetimibe or PCSK9 inhibitors.
Only 17.1% of participants (69/403) attained the recommended low-density lipoprotein cholesterol target of < 1.8 mmol/L for the primary prevention of cardiovascular disease.

Study Design

Type

Cross-Sectional (n=403)

Multicenter

Yes

Structured PICO

What are the prevalence, treatment rates, and LDL-C target attainment rates of dyslipidemia among patients with diabetes mellitus receiving routine care in northern Nigeria?

P

Population

403 patients with diabetes mellitus (mean age 53.2 years, 58.8% female; 90.3% type 2 DM) attending five tertiary teaching hospital diabetes clinics in northern Nigeria between February and December 2023.

E

Exposure

Routine diabetes mellitus care and physician-prescribed lipid-lowering therapies (statins and/or clofibrate)

O

Outcome

Prevalence and patterns of dyslipidemia (defined as TC > 6.2 mmol/L, LDLC > 4.1 mmol/L, TG ≥ 2.3 mmol/L, or HDLC < 1.0 mmol/L in males or < 1.3 mmol/L in females), proportion of patients treated with lipid-lowering therapy, and proportion attaining the ESC/EAS primary prevention LDLC target of < 1.8 mmol/L at enrolmentsurrogate

Main Result

Odds Ratio: 1.68

Absolute Event Rate: 65.8% vs 50.6%

p-value: p=0.029

Limitations

Poor participant recall of previous pulmonary thrombo-embolism, which under-estimated the rate of previous cardiovascular disease.
Dyslipidemia was narrowly defined as abnormal serum lipoprotein levels tested during the study period regardless of current lipid-lowering treatment, which did not exclude wrong use of lipid-lowering therapy.
Missing data on body mass index and serum creatinine for a few participants.
Hospital clinic-based sampling rather than a community-based study, limiting generalizability to the broader population.
Poor participant recall of previous pulmonary thrombo-embolism, which under-estimated the rate of previous CVD
Narrow definition of dyslipidemia based solely on abnormal serum lipoproteins tested during the study period regardless of current treatment
Missing data on BMI and creatinine in a few participants
Clinic-based rather than community-based study design due to lack of financial resources

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Implication

In northern Nigeria, nearly 60% of diabetes clinic patients have dyslipidemia, yet only half receive lipid-lowering medications (exclusively statins and clofibrate) and only 17.1% achieve the guideline-recommended LDL-C target of <1.8 mmol/L, highlighting major gaps in guideline adherence and access to non-statin therapies.

Abstract

Objectives Dyslipidemia is prevalent among Nigerians with diabetes mellitus (DM), but its treatment has not been well-studied. The objective of this study was to determine the prevalence, treatment rates and control of dyslipidemia among DM patients in northern Nigeria. Methods We conducted a multicenter, cross-sectional study of dyslipidemia in DM patients, and noted cardiovascular disease (CVD) risk factors, lipid-lowering treatments, body mass index, blood pressure, HbA1c, lipid profile, glomerular filtration rate and proteinuria. Outcome measures were the rate and treatment of dyslipidemia and attainment of low density lipoprotein cholesterol target for primary prevention of CVD. Binomial logistic regression was used to analyze associations between participant characteristics and dyslipidemia. Hosmer-Lemeshow goodness-of-fit test was used to evaluate the model fit. Statistical analysis was performed with the SPSS version 25 program. Results The study enrolled 403 participants (58.8% females), of whom 59.6% had dyslipidemia. Besides DM and dyslipidemia, other risk factors for CVD were hypertension (56.8%), obesity (52.6%), chronic kidney disease (36.5%), atrial fibrillation (7.9%), heart failure (5.0%), cigarette smoking (4.7%), excess alcohol use (2.0%), and previous CVD (14.4%). Logistic regression analysis showed dyslipidemia was significantly associated with female gender (odds ratio = 1.68, P = 0.029) and proteinuria (odds ratio = 2.26, P = 0.004). Among those with dyslipidemia, 51.3% took lipid-lowering treatments comprising statins (50.8%) and clofibrate (2.9%). None took other lipid-lowering treatments, and only 17.1% attained the target for primary prevention of CVD. Conclusion Three-fifths of patients had dyslipidemia, but only a sixth attained the treatment target. Treatment for dyslipidemia included statins and fibrates, but not niacin, ezetimibe, bempedoic acid, icosapent ethyl, inclisiran or PCSK9 inhibitors recommended for those who failed intensive statin therapy. There is the need for better access to non-statin treatment and physician adherence to clinical practice guidelines.

Discussion

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Cite This Study

Alkali et al. (2026) conducted a cross-sectional in Diabetes mellitus and dyslipidemia (n=403). Routine diabetes care and lipid-lowering therapy (statins and clofibrate) was evaluated on Prevalence of dyslipidemia, lipid-lowering treatment rate, and attainment of LDL-C target (<1.8 mmol/L) for primary prevention of cardiovascular disease (with logistic regression evaluating association of female gender with dyslipidemia) (OR 1.68, p=0.029). Among 403 Nigerian diabetes patients, 59.6% had dyslipidemia (associated with female gender, OR 1.68, P=0.029, and proteinuria, OR 2.26, P=0.004), 51.3% took lipid-lowering therapy, and 17.1% achieved the LDL-C target.

synapsesocial.com/papers/6a758c4f847ab6d26c020490 https://doi.org/10.1371/journal.pone.0346350

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Prevalence, treatment rates and control of dyslipidemia among diabetes patients in northern Nigeria: A cross-sectional, multicenter study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Prevalence, treatment rates and control of dyslipidemia among diabetes patients in northern Nigeria: A cross-sectional, multicenter study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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