Hypertriglyceridemia and low HDL-cholesterol are the major lipid abnormalities in normal Pakistani adults: are these contributing to the high rates of coronary artery disease in this population?

Objective: Lipid abnormalities are related to enhanced risk of developing cardiovascular disease. The objective of the study was to investigate variability in lipid profile in Pakistani normal adults [from the personnel of 4 tertiary care hospitals] by age, gender, body mass index [BMI] and smoking, and to determine the prevalence of hypertriglyceridemia, hypercholesterolemia, low HDL-cholesterol and isolated low HDL-cholesterol in this population

Method: Serum samples from 323 normal healthy subjects [236 males and 87 females, age 30-70 years] from the personnel of the Aga Khan University, Civil Hospital, Karachi, Armed Forces Institute of Cardiology and Military Hospital, Rawalpindi were analyzed for total cholesterol, HDL-cholesterol and triglycerides using kit methods. LDL-cholesterol was determined using the Friedewald formula

Results: Mean +/- SD concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were found to be 165+/-37 mg/dl, 37+/-11.5 mg/dl, 98+/-34 mg/dl and 155 +/- 88 mg/dl, respectively. Mean levels of total cholesterol were found to be significantly higher in hypertriglyceridemia [>200mg/dl] than normotriglyceridemia [181+/-30 mg/dl vs 160+/-38 mg/dl; p=0.001]. Mean concentration of HDL-cholesterol in the younger age group [50 years] group [39.6+/-11.7 mg/dl vs 33.4+/-9.7 mg/dl; p=0.001]. Similarly, mean concentration of HDL-cholesterol in females was significantly higher compared to males [44.3+/-14 mg/dl vs 34.9+/-9.1 mg/dl; p=0.001]. In hypertriglyceridemia [>200 mg/dl], mean HDL-concentration was significantly lower compared to normotriglyceridemia [33.4+/-8.3 mg/dl vs 38.9+/-12 mg/dl; p=0.001]. The combined effect of age, gender and triglyceridemia was found to be significantly associated with HDL-cholesterol concentration [p25], triglyceride levels were significantly higher compared to those with BMI<25 [180+/-107 mg/dl vs 144+/-71 mg/dl; p=0.001]. Levels of triglycerides were, therefore, significantly associated with gender and BMI [p<0.001; R2 =0.076]. LDL-cholesterol levels were not found to be significant by age, gender, smoking, BMI and triglyceridemia. Smoking had no significant effect on lipid levels of male healthy subjects. Frequencies of hypercholesterolemia, hypertriglyceridemia, low HDL-cholesterol and isolated low HDL-cholesterol were found to be 17.6%, 26.9%, 45.8% and 29.4%, respectively. High prevalence values of low HDL-cholesterol and isolated low HDL-cholesterol are reported for the first time in Pakistani normal adults and require further studies at the community level

Conclusion: High levels of triglycerides and low levels of HDL-cholesterol are the most prominent abnormalities in Pakistani adults working in tertiary health care centers

Increased levels of erythrocyte glutathione in acute myocardial infarction: an antioxidant defence

Glutathione [GSH] has a central role in the defence against oxidative damage. This study was carried out to investigate any change in erythrocyte GSH levels in a population of patients with acute myocardial infarction [AMI] and compare them with levels in normal healthy subjects. Method: GSH levels were determined in erythrocytes of one hundred and seventy six patients with AMI [age: 30-70 years; 131 males and 45 females] admitted to the National Institute of Cardiovascular Diseases, Karachi. These levels were compared with eryrocyte GSH levels obtained from 95 normal healthy subjects [controls]. Mean ' SD erythrocyte GSH levels in AMI patients and controls were found to be 2.34 ' 0.62 micro mol/ml of packed cells and 2.08' 0.62 micro mol/ml of packed cells, respectively. The two values when compared with one way ANOVA were found to be significantly different [p=0.001]. Age had little effect on erythrocyte GSH levels in both AMI patients and normal healthy subjects. Increased production of reactive oxygen species is a feature of cardiovascular disease, such as AMI and cells can respond to mild oxidative stress by upregulating antioxidant defence in terms of increased production of GSH

Urinary N-acetyl-beta-D-glucosaminidase in rheumatoid arthritis

Excretion of urinary N-acetyl beta-D-glucosaminidase (NAG) and its isoenzyme patterns were studied in two groups of patients with rheumatoid arthritis (RA) and in normal control subjects. Urine samples were collected from 30 seropositive RA patients, 19 seronegative RA patients, and 15 normal healthy subjects. All the patients and normal subjects were assessed to have normal liver and kidney functions. A small portion of the urine sample was dialyzed against 0.01 M phosphate buffer, pH 7.0 and NAG activity was monitored. Mean +/- SD values of urinary NAG in seropositive RA patients, in seronegative RA patients and in normal healthy subjects were found to be 4.20 +/- 3.73 U/g creatinine, 2.96 +/- 2.11 U/gm creatinine, and 1.71 +/- 0.6 U/g creatinine, respectively. The mean urinary, NAG value in RA patients was found to be significantly higher (P < 0.05) in seropositive RA compared to the mean NAG value in normal healthy subjects and patients with seronegative RA when analyzed by one way ANOVA and Tukey-HSD test. The mean proportion of isoenzyme form B to isoenzyme form A in seropositive RA patients was also found to be significantly different (P < 0.05) from the mean proportion of these forms in normal healthy subjects and seronegative RA patients. There also appears to be a correlation between the concentration of urinary NAG and severity of the disease in seropositive RA.