A STUDY TO EVALUATE THE IMPORTANCE OF FASTING LIPID PROFILE ESTIMATION AS THE PART OF INITIAL EVALUATION OF HIV POSITIVE PATIENTS BEFORE STARTING HAART

BACKGROUND:-There is evidence that ART is associated with lipodystrophy syndrome, a disturbance of lipid metabolism characterised by insulin resistance, dyslipidaemia, and fat maldistribution, metabolic bone disease (osteopenia and/or osteoporosis), and lactic acidosis. ART- associated dyslipidaemia is characterized by elevated serum concentrations of total cholesterol, triglycerides, low density lipoprotein 2(LDL-c), very low-density lipoprotein (VLDL), and Apo lipoprotein B (apoB) and low levels of high density lipoprotein (HDL-c) constituting an atherogenic lipid 1pro?le . In this study 143 young patients who were attending the Antiretroviral Therapy Plus MATERIAL AND METHODS:- Centre & Medicine Wards, ACSR GMC NELLORE were included randomly. 5ml Sample preparation and Biochemical assay :- of venous blood sample was collected by venipuncture from 12 hours overnight fast and centrifuged at 3000 cycles per minute and serum was separated for lipid pro?le measurement within one hour of blood collection. The serum levels of TC, HDL-C, LDL-C, VLDL and TG were measured using AU480 BECKMANS random access fully automated auto analyzer at Biochemistry laboratory, ACSR GMC, NELLORE. TC, LDL and TC/HDL lipid pro?les are signi?cant. F-Signi?cant values are RESULTS;- <0.05, reject null hypothesis. It means that the difference among the lipid pro?les of TC, LDL and TC/HDL in the study group is statistically signi?cant with respect to regimen groups. HDL, TG and VLDL lipid pro?les are not signi?cant. F-Signi?cant values are >0.05, no evidence to reject null hypothesis. It means that the no signi?cant difference among the lipid pro?les of HDL, TG, and VLDL in the study group is not statistically signi?cant with respect to regimen groups. Signi?cant CONCLUSIONS:- metabolic and morphological alterations occur in HIV infected patients especially in patients on HAART. The patients on HAART had an elevated Castelli Index I, indicating an increased risk for atherosclerotic cardiovascular disease in this population. There is need to assess lipid pro?les at baseline before initiation of HAART treatment and lipid pro?le monitoring during therapy to monitor any rising trends. New medications with more lipid friendly pro?les within existing drugs such as darunavir (PI), etravirine (NNRTI), new classes of drugs such as integrase inhibitors (raltegravir) and CCR5 inhibitors (maraviroc) can be used to avoid dyslipidaemia

To Study the Association of Cerebrovascular Disease with Metabolic Syndrome in Western Uttar Pradesh

Objective: To Study the association of cerebrovascular disease with metabolic syndrome. Methods: A Total 104 patients were included in this study & investigated for cerebrovascular disease associated with metabolic syndrome or not. A study of presence or absence of metabolic syndrome in cerebrovascular disease was done. P value was calculated by using analysis of variance test (ANOVA) & P value <0.05 was considered as statistically significant. Results: Total 104 patients were included in this study in 72 patients (69.23%) were suffering from metabolic syndrome and 32 patient (30.77%) were not suffering from metabolic syndrome. Most of the patients suffering from cerebrovascular disease associated with metabolic syndrome were of older age groups (61.11%)>61 years. Second most common group was (22.22%) 51-60 years. Other patients of cerebrovascular disease not suffering from metabolic syndrome (56.25%) in 51-60 years followed by (31.25%) in 41-50 years. Amongst the patients suffering from cerebrovascular accident and metabolic syndrome males outnumbered females, although this data is not statistically significant p=0.4. Among the Cerebrovascular accident patient group prevalence was highest therefore raised fasting blood sugar (n=58) (80.55%) and low HDL values (75.2%), whereas it was highest for Hypertension (88.89%). In the cerebrovascular accident group out of total 104 patients 72%(n=72) were suffering from metabolic syndrome and 30.77%(n=32) were not suffering from metabolic syndrome there is positive correlation between metabolic syndrome and cerebrovascular accident .Using Test for equality for proportion (zscore) this data is found to be statistically significant. Conclusion: In cerebrovascular accident group (total patients =104) 67.5%(n=108) were having 3 risk factors, 50%(n=80) were having 4 risk factors and 11.25%(n=18) were having 5 risk factors of metabolic syndrome among the cases .Among the patients suffering from cerebrovascular accident (total patients =104) the prevalence of hypertension was 88.89%(n=64),of low HDL was 75.2%(n=54),of high TGs was 80.55%(n=58),of raised waist circumference was 58.32%(n=42) and of increased fasting blood sugar was 80.55%(n=58) in the case group.

Prevalence Of Dyslipidemia Among Master Health Check-Up Beneficiaries In A Rural Tertiary Care Hospital

Dyslipidemia is one of the major cause and risk factor for the development and progression of Cardiovascular Disease (CVD), many epidemiological study shows dyslipidemia is a major cause of morbidity and mortality in both developed and developing countries like India, Bangladesh , Pakistan and Nepal . Most of the studies have revealed the prevalence of dyslipidemia mostly in general population. The present study attempted to find out the prevalence of dyslipidemia among master health checkup beneficiaries who attended the master health checkup unit of our institution. MATERIAL AND METHODS:The aim of the study was to determine the prevalence of dyslipidemia among master health check-up beneficiaries by retrospective analysis of data from Master health check-up department of IRT- Perundurai Medical College and Hospital, Perundurai, Tamilnadu. RESULT: Among the study subjects, Overall 65.4% were found to have Dyslipidemia which was determined by considering all four lipid parameters (Total Cholesterol, LDL, HDLand Triglycerides) into consideration. DISCUSSION: The prevalence of dyslipidemia among the study population undergone master health checkup is 65.4%, comparative to study done by Karna.S.K et al(57.7% ) among individuals attending preventive health checkup in rural tertiary care hospital. CONCLUSION: The overall prevalence of dyslipidemia in our study is alarming and it highlights the extensive need for screening programs and appropriate intervention programs to reduce the risk factors

Metabolic syndrome in chronic obstructive pulmonary disease

Background: COPD (Chronic obstructive pulmonary disease) is considered as a systemic disease due to associated systemic inflammation which can manifest as metabolic syndrome or its component illnesses. This study was undertaken to determine the proportion of metabolic syndrome in patients with COPD.Methods: 51 patients with COPD were compared with equal number of age and gender matched controls. GOLD (Global Initiative for Chronic Obstructive Lung Disease) criteria were used for diagnosing COPD. Metabolic Syndrome (MS) was diagnosed based on modified NCEP:ATP III criteria (National cholesterol education Program Adult Treatment Panel III). Subjects were evaluated for hypertension, WC, FBS, and serum triglycerides and serum HDL (High-density lipoprotein) to diagnose MS.Results: Metabolic syndrome was diagnosed in 16 (31.4%) patients with COPD and in 8 (15.7%) controls. The proportion of individual parameters of MS in cases and controls was as follows: DM in 19 (37.3%) cases and 13 (25.5%) controls, hypertension in 21(41.2%) cases and 9 (17.6%) controls, low serum HDL in 31 (60.7%) cases and 22 (43.1%) controls increased WC in 14 (27.5%) cases and 7 (13.7%) controls and elevated serum TG in 12 (23.5%) cases and an equal number of controls.Conclusions: Metabolic syndrome and its parameters are more prevalent in COPD patients. Early detection and treatment of MS in COPD patients can prevent development of complications due to the combined effects of both diseases

Prevalence and Risk Factors of the Metabolic Syndrome as Defined by NCEP-ATP III

BACKGROUNDS: The Third Report of the Adult Treatment Panel (NCEP-ATP III) has newly introduced the clinical diagnosis guideline of the metabolic syndrome which is characterized by clustering of the CHD risk factors. The purpose of this study was to estimate the prevalence of the metabolic syndrome in Korean adults by the newly introduced guideline and to evaluate possible risk factors with the syndrome. METHODS: The subject of this study included 3,873 adults (males 2,144, females 1,729) aged 20 years or older who visited the Health Promotion Center of SNUH. Among the subjects, we excluded those who did not have records of physical parameters, blood test results and who were on current medications except antihypertensives and oral hypoglycemic agents. We estimated the prevalence of the metabolic syndrome in Korean adults according to the ATP III waist-circumference guideline, Asia-Pacific waist- circumference, and Body Mass Index (BMI), respectively, and calculated the age-adjusted prevalence of the metabolic syndrome using the direct standardized method. While applying the Asia-Pacific waist circumference, we estimated the prevalence of the metabolic syndrome by age group and the prevalence of the individual abnormalities of the metabolic syndrome. To identify variables associated with the metabolic syndrome, we used the multiple logistic regression method to estimate the prevalence odds ratios for the metabolic syndrome vs. the non-metabolic syndrome. RESULTS: The age-adjusted prevalence of the metabolic syndrome in Korean adults was 9.3% when ATP III waist-circumference was applied, 15.4% for Asia-Pacific waist-circumference, and 18.6% for body mass index (BMI). The highest prevalence of the individual criteria among the metabolic syndrome diagnostic criteria in men was hypertension, followed by hypertriglyceridemia, abdominal obesity, high fasting blood glucose, and low HDL-cholesterolemia. And in women, it was also hypertension, followed by abdominal obesity, low HDL- cholesterolemia, hypertriglyceridemia, and high fasting blood glucose. The prevalence increased from 3.8% among participants aged 20 through 29 years to 27.1% for ages 60 through 69 years and 31.6% for ages above 70 years. Females, increasing age, increased BMI, current smoking, physical inactivity were higher risk factors for the metabolic syndrome, but mild drinking was a lower risk factor for the metabolic syndrome. CONCLUSION: These results show that the metabolic syndrome is highly prevalent although less prevalent than in American adults. The family physician should focus on the screening and comprehensive management of the metabolic syndrome.

Prevalence of the metabolic syndrome as defined by NCEP-ATPIII among the urban Korean population / 대한내과학회지

BACKGROUND: The definition of metabolic syndrome was different in each studies and thus the results of each studies were variable. In 2001 years, the third report of the national cholesterol education program expert panel on detection, evaluation and treatment of high blood cholesterol in adults (NCEP-ATP III) emphasized the importance of treating patients with the metabolic syndrome to prevent cardiovascular disease. In year 2000, the criteria to define obesity in Asia-Pacific region was proposed. However, limited information is available about the prevalence of the metabolic syndrome according to NCEP-ATP III in Korea. We compared the prevalence of the metabolic syndrome in the urban Korean population by criteria of ATP III report and Asia-Pacific region and estimated the effect of age and sex on the development of metabolic syndrome. METHODS: Total 40,698 participants (26,528 men, 14,170 women) underwent medical check-up from Jan. to Dec. 2001, aged 20-82 years (mean+/-SD: 41.2+/-9.2), were included in this study. Age, sex, height, body weight, waist circumference, blood pressure, blood cholesterol, triglyceride, HDL cholesterol and fasting glucose levels were measured. RESULTS: By the definition of ATPIII, the age-adjusted prevalence of metabolic syndrome for Koreans was 6.8% in total, 5.2% in men, 9.0% in women. In Asia-Pacific definition with waist circumference, 10.9% in total, 9.8% in men, 12.4%. In Asia-Pacific definition with body mass index (BMI) instead of waist circumference, 13.1% in total, 13.2% in men, 13.1% in women. By the definition of ATP III, the prevalence among participants aged 20 through 29 years, 30 through 39 years, 40 through 49 years, 50 through 59 years, 60 through 69 years, and over 70 years were 1.4%, 2.5%, 5.2%, 11.5%, 19.5% and 22.2%, respectively. By the Asia-Pacific definition with waist circumference, 2.4%, 5.4%, 9.4%, 18.2%, 27.5% and 31.3%, respectively. By the Asia-Pacific definition with BMI instead of waist circumference, 3.2%, 8.4%, 13.0%, 21.0%, 29.0% and 30.6%, respectively. With BMI-adjusted logistic regression analysis, the odds ratio of participants with the metabolic syndrome aged over 70 years against aged 20 through 29 years was 13.8(95% CI 8.2~23.2). With age and BMI-adjusted logistic regression analysis, the odds ratio of women with the metabolic syndrome for men was 1.4(95% CI 1.2~1.5). CONCLUSION: The prevalence of the metabolic syndrome on NHANES III (The Third National Health and Nutrition Examination Survey) report in USA displayed much difference with our report. Therefore, adequate criteria of the metabolic syndrome for Koreans should be needed.

Prevalence of the metabolic syndrome as defined by NCEP-ATPIII among the urban Korean population / 대한내과학회지

BACKGROUND: The definition of metabolic syndrome was different in each studies and thus the results of each studies were variable. In 2001 years, the third report of the national cholesterol education program expert panel on detection, evaluation and treatment of high blood cholesterol in adults (NCEP-ATP III) emphasized the importance of treating patients with the metabolic syndrome to prevent cardiovascular disease. In year 2000, the criteria to define obesity in Asia-Pacific region was proposed. However, limited information is available about the prevalence of the metabolic syndrome according to NCEP-ATP III in Korea. We compared the prevalence of the metabolic syndrome in the urban Korean population by criteria of ATP III report and Asia-Pacific region and estimated the effect of age and sex on the development of metabolic syndrome. METHODS: Total 40,698 participants (26,528 men, 14,170 women) underwent medical check-up from Jan. to Dec. 2001, aged 20-82 years (mean+/-SD: 41.2+/-9.2), were included in this study. Age, sex, height, body weight, waist circumference, blood pressure, blood cholesterol, triglyceride, HDL cholesterol and fasting glucose levels were measured. RESULTS: By the definition of ATPIII, the age-adjusted prevalence of metabolic syndrome for Koreans was 6.8% in total, 5.2% in men, 9.0% in women. In Asia-Pacific definition with waist circumference, 10.9% in total, 9.8% in men, 12.4%. In Asia-Pacific definition with body mass index (BMI) instead of waist circumference, 13.1% in total, 13.2% in men, 13.1% in women. By the definition of ATP III, the prevalence among participants aged 20 through 29 years, 30 through 39 years, 40 through 49 years, 50 through 59 years, 60 through 69 years, and over 70 years were 1.4%, 2.5%, 5.2%, 11.5%, 19.5% and 22.2%, respectively. By the Asia-Pacific definition with waist circumference, 2.4%, 5.4%, 9.4%, 18.2%, 27.5% and 31.3%, respectively. By the Asia-Pacific definition with BMI instead of waist circumference, 3.2%, 8.4%, 13.0%, 21.0%, 29.0% and 30.6%, respectively. With BMI-adjusted logistic regression analysis, the odds ratio of participants with the metabolic syndrome aged over 70 years against aged 20 through 29 years was 13.8(95% CI 8.2~23.2). With age and BMI-adjusted logistic regression analysis, the odds ratio of women with the metabolic syndrome for men was 1.4(95% CI 1.2~1.5). CONCLUSION: The prevalence of the metabolic syndrome on NHANES III (The Third National Health and Nutrition Examination Survey) report in USA displayed much difference with our report. Therefore, adequate criteria of the metabolic syndrome for Koreans should be needed.