It is apparent that atherosclerosis manifested by coronary heart disease (CHD) is not only the single most common cause of death among middle-aged people in industrialized nations, but it is also the leading cause of morbidity and mortality among people suffering from diabetes mellitus. Coronary heart disease and diabetes mellitus (DM) are both chronic metabolic diseases whose pathophysiology remains extremely complex and multi-factorial. Yet of the many risk factors to blame, much attention has focused on the elevated lipid profile and its "atherogenic potential" as a very powerful risk factor for the aggravation of these diseases. In the recent report of the expert panel from the National Cholesterol Education Program (NCEP) on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III), they continued to recognize low-density lipoprotein cholesterol (LDL-C) as the primary target for cholesterol lowering therapy . This was of course based on the premise that keeping lipid parameters to their optimal levels would be certain to lessen the chances of developing coronary heart disease.
Emerging novel risk factors were nevertheless recognized by NCEP. One of them is the non-high density lipoprotein cholesterol (non-HDL-C), whose value can be calculated by subtracting HDL-cholesterol from the total cholesterol. While several trials from different populations have reported that non-HDL-C has more predictive power than LDL-C in detecting CHD [2,3], no such trials have so far been made in any Arab community whose propensity to develop coronary heart disease is high compared to other ethnicities . Hence, this study primarily aims to determine and compare the power and influence of the novel risk factor non-HDL- cholesterol versus other lipid parameters, in predicting coronary heart disease among diabetic versus non-diabetic adult Saudis. This study will also attempt to identify which among the lipid parameters makes a significant contribution in the development of coronary heart disease, diabetes mellitus, and metabolic syndrome in the same population.