Lipid clinic service in Kuwait: Preliminary observations

ABSTRACT

Despite a dramatic increase in the prevalence of coronary heart disease [CHD] within the Kuwaiti population, hyperlipidemia, which is an important risk factor for CHD, is inadequately characterized. Since over half of all patients seen at Kuwait's Mubrarak Teaching Hospital had elevated plasma cholesterol and/or triglyceride levels, the hospital opened a Lipid Clinic Service [LCS]. The LCS provides a specialized diagnostic and therapeutic service to patients with primary hyperlipidemia. This report presents our preliminary observations on the first 150 patients seen at this clinic during the first 6 months of operation [March-September 1995]. A nationality survey of the clinic attendess revealed that 46.7% were Kuwaitis, 4.0% other Gulf Arabs, 34.0% other Arabs [predominantly Egyptians] and 15.3% South Asians [predominantly Indians]. Patient referrals came to the clinic from neighboring polyclinics [38.7%], hospital outpatient clinics [25.3%], clinical biochemistry laboratory [16.7%], hospital dietetic service [5.3%] as well as other sources [14.0%]. Of the 117 patients with primary hyperlipidemia, 48.7% had predominant hypercholesterolemia, 23.9% were classified as mixed hyperlipidemia, and 27.4% had predominant hypertriglyceridemia. Over 75% of the men, and 22% of the women smoked regularly. About a third of women were postmenopausal. The pattern of observations in the 28 patients with diabetes, incidentally seen in the clinic, was similar to that in the nondiabetic subjects with primary hyperlipidemia. The constellation of biochemical risk factors for CHD [higher triglyceride and uric acid and lower high density lipoprotein levels, coupled with a tendency towards central obesity and cigarette smoking] was more common in the men than in the in the women. This may account for a higher risk of CHD in men. Lipid and metabolic profiles did not differ between Kuwaitis and other nationals, suggesting that similar factors underlie the disorder in all patients. These features, similarly, did not differ between the pre- and postmenopausal women. This preliminary report on the first 150 patients seen in the LCS in Kuwait demonstrates a need for this type of specialized service in the country