Serum lipids and lipoproteins in chronic primary glomerular diseases

Chronic Primary Glomerular Diseases [CPGD] that are common in our country, are often neglected and not given due attention, leading rise in number of patients with renal failure. Hyperlipidemia and lipoprotein abnormalities may play role in development of glomerular atherosclerosis in renal disease. Study was designed to characterize the status of lipids and lipoproteins in patients with CPGD and to find their correlation with serum albumin and that correction of the hyperlipidemia would be favorable in solving the progress of the renal failure. Study was conducted at Biochemistry Department, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC] Karachi. Seventy uncomplicated nephrotic patients [44 males, 26 females; age range 18 - 51 rears] with biopsy-proven CPGD were collected from Nephrology Department, JPMC, Karachi and twenty age- matched control subjects were investigated for serum total protein, albumin, triacylglycerols, total cholesterol, high-density lipoprotein cholesterol [HDL- cholesterol] and low-density lipoprotein cholesterol [LDL- cholesterol]. A highly significant [P<0.001] increase levels of triacylglycerols, total cholesterol, LDL- cholesterol, and the ratio of LDL-cholesterol to HDL- cholesterol, whereas a highly significant [P<0.001] decrease levels of serum HDL-cholesterol, total protein and albumin were observed in all patients when compared to matched control subjects. The correlation coefficient between serum albumin vs. triacylglycerols and total cholesterol were negative but highly significant [r = -0.68 and r = -0.64] were observed in such patients. It was concluded that CPGD are accompanied invariably by alteration in lipids and lipoproteins, which have potential for accelerating the atherosclerosis and increasing the risk of renal failure

Association of lipoprotein [A] with myocardial infarction

To compare serum lipid profile i.e., lipoprotein [a] [Lp [a]], total cholesterol [TC], triglycerides [TG], high density lipoprotein cholesterol [HDL-C] and low density lipoprotein-cholesterol [LDL-C] levels of subjects with and without history of myocardial infarction [MI] and to find out the association of Lp[a] with the development of coronary artery disease [CAD]. All the subjects were studied prospectively. Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. Subjects and Thirty subjects aged less than 50 years with the history of proven myocardial infarction were randomly selected as group A, from hospital record and were matched with subjects having no history of myocardial infarction, group B, to serve as control. Fasting blood samples of both the groups were collected and analyzed on Humalyser 2000 to measure Lp[a] while lipids and Lp variables were analyzed enzymatically. Subjects with a history of myocardial infarction had a significantly higher level of serum Lp[a] [p<0.001] as compared to those without the history. The other lipoprotein variable which exhibited a significant difference between the two groups of subjects was HDL-C [P<0.001]. The subjects with early myocardial infarction have higher mean values of Lp[a] than control subjects suggesting that this lipid variable may strongly predispose to CAD. Although a possible influence of other factors may account for part of this result, a genetic predisposition to CAD is also likely to be involved since Lp[a] levels are strongly determined genetically

Comparison of plasma protein concentration and haematological parameters in type-1 and type-2 diabetics of short and long duration

Diabetes mellitus is the most common metabolic disorders, characterized primarily by relative or absolute insufficiency of insulin secretion and concomitant insensitivity or resistant to the metabolic action of insulin on target tissues leading to metabolic derangement. These metabolic derangements are translated into alteration in blood constituents, thus affecting the characteristic of blood. The purpose of this study was to evaluate hematological and biochemical parameters in blood of diabetics of short and long term duration. Hematocrit, ESR, serum sugar, fibrinogen, total serum protein, albumin, and globulin were determined in shortand long-term type-1 and type-2 diabetics, and in healthy control subjects. Hematocrit, ESR, serum sugar, fibrinogen, total serum protein, and albumin concentration of both short- and long-term type-1 diabetics were significantly greater than those of the non-diabetics controls. There were no significant differences between short- term type-2 diabetics and the controls in the parameters like hematocrit, ESR, fibrinogen and globulin. However, hematocrit, ESR, serum glucose, fibrinogen, total serum protein, and albumin of long-term type-2 diabetics were significantly elevated above those of the controls. Based on the reported association of these parameters with diabetic complications, our results suggest that there could be an earlier development of complications in type-1 than in type-2 diabetics

Role of glycemic control and blood pressure in the development of microalbuminuria in NIDDM patients

To assess the relationship of elevated urinary albumin excretion to glycated hemoglobin and increased blood pressure in non-insulin-dependent diabetic patients. Analysis of glycated hemoglobin, blood pressure, serum and urinary creatinine, body mass index in groups I, II and III, i.e., 21-120, 1 21-170 and 171-200 micro g/min, respectively, based on rate of albumin excretion in 24 hours urine samples of patients with NIDDM. Department of Biochemistry, Basic Medical Sciences Institute and Diabetic Clinic of Jinnah Postgraduate Medical Centre, Karachi. A total of one hundred patients having NIDDM diagnosed at least two years previously and 25 apparently healthy subjects as control with similar socioeconomic status were selected. Serum glycated hemoglobin, urinary albumin, albumin creatinine ratio and creatinine clearance were significantly increased in all groups when compared to controls, whereas systolic blood pressure of group-Ill was highly significant. The results of this study prove the effect of poor glycemic control and increased blood pressure on development of microalbuminuria in NIDDM patients

Apolipoprotein as an indicator of coronary artery disease risk in normolipidemic subjects after myocardial infarction

The study investigated whether apolipoprotein [apo] A-I and B could better identify patients than lipid lipoproteins in a male population with recent acute myocardial infarction which could differentiate normolipidemic subjects with an increased risk of myocardial infarction. Serum lipids, HDL-C, LDL-C and apo A-I and B were determined in 34 hyperlipidemic and 31 normolipidemic survivors of myocardial infarction and compared with matched control. A significant decreased level of HDL-C and apo A-I [P<0.01,P<0.05] and an increased level of LDL-C and apo B [P<0.001,P<0.05] was found in all the patients. The data supports the view that apo A-I and B as well as its ratio [X2 values 11.11,18.84 and 28.51 respectively, P<0.001] were better indicators of lipid derangement in normolipidemic survivors of myocardial infarction than the levels of LDL-C and HDL-C. Our findings also suggests that determination of apo A-I and B and its ratio are better predictors of coronary artery disease even in patients with normal plasma lipid level

Variation in serum cholesterol and triglycerides throughout gestation

To determine the metabolic changes of lipids mainly serum cholesterol and triglycerides throughout the pregnancy. Enrolled non-obese pregnant women in the Department of Gynaecology and Obstetric were included in the study. The pregnant women were seen four weekly from 20th to 28th week, biweekly until 36th week of gestation and then weekly until delivery. Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. Forty non-obese normal pregnant women and 30 matched non-pregnant women as control were included in the study. Serum cholesterol from 28th week and triglycerides from 24th week's of gestation increased significantly when compared to 20th week and remained steadily rise till the termination of pregnancy. While both were significantly increased after 30th week of gestation when compared with non-pregnant women as control. Serum level of triglycerides and cholesterol starts to increase during pregnancy particularly in third trimester probably from 28th week of gestation and this may help in prognostic of certain metabolic disorders in pregnancy

Iron binding capacity and transferrin saturation in pregnancy

To find changes in the iron status in relation to total iron binding capacity and% saturation of transferrin in pregnant women. Design: Comparative study of haemoglobin, serum iron, serum iron binding capacity [TIBC] and saturation of transferrin in 1st, llnd and lllrd trimester of pregnancy with age matched non-pregnant women. Setting: Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. Subjects: Ninety pregnant women, at various stages of pregnancy, all having haemoglobin values below 12 g%, were selected. Result: Values of Hb were found to be significantly lower as compared to the control in all the trimesters of pregnancy. Serum iron and% saturation of iron showed a significant decrease; while total iron binding capacity and unsaturated iron binding capacity showed a significant [P<0.001] increase in the second and third trimesters of pregnancy as comapred to matched control. Total serum iron binding capacity and% iron saturation of transferrin are more sensitive indices of iron stores of an iron deficient pregnant mother at an earlier date, thus preventing anaemia