Non-HDL-C and CRP: A Dual Approach to Unmask Hidden Cardiovascular Risk in Type 2 Diabetic Patients

Abstract

Type 2 diabetes mellitus (T2DM) is associated with atherogenic dyslipidemia and heightened cardiovascular risk, even when low-density lipoprotein cholesterol (LDL-C) appears within normal limits. Non-high-density lipoprotein cholesterol (non-HDL-C) and highly sensitive C-reactive protein (hs-CRP) have emerged as more comprehensive markers reflecting lipid-related and inflammatory risk, respectively. This study aimed to evaluate non-HDL-C as a superior marker over LDL-C for identifying atherogenic dyslipidemia in T2DM and to explore its correlation with systemic inflammation as indicated by hs-CRP. A cross-sectional study was conducted on 142 T2DM patients at Albadry Diabetic Clinic in Tripoli, Libya. Anthropometric data, lipid profiles, and hs-CRP levels were measured. Pearson correlation was used to assess relationships between lipid markers and hs-CRP. 56.3% of patients had elevated non-HDL-C, and 45.1% had elevated triglycerides. Non-HDL-C showed a stronger correlation with triglycerides (r = 0.82), HDL-C (r = -0.54), and hs-CRP (r = 0.44) compared to LDL-C (r = 0.41, -0.28, and 0.18, respectively; p < 0.01). These findings indicate that non-HDL-C better captures atherogenic lipid burden and inflammatory status. Conclusion: Non-HDL-C is a more robust marker of atherogenic dyslipidemia than LDL-C in T2DM and correlates more strongly with hs-CRP. Integrating non-HDL-C and hs-CRP into routine risk assessment may enhance cardiovascular risk prediction and guide targeted interventions.