Effectiveness of interventions to reduce coronary heart disease risk.

BACKGROUND: Coronary heart disease (CHD) is an important cause of morbidity and mortality in industrialized countries, and its incidence is increasing in the developing world. The effectiveness of interventions in developing countries has been questioned in view of the overwhelming burden of other health problems in such environments. OBJECTIVE: To determine the effectiveness of coronary heart disease risk reduction interventions. METHODS: The effects of lipid lowering interventions as well as dietary and lifestyle modifications on some risk factors of CHD were studied retrospectively in 47 males and 53 female patients [aged 33 to 61 years; mean age 47.20 ±14.17 years] attending a lipid clinic in Saudi Arabia. The main outcome measures were reductions in the values of the body mass index (BMI), blood pressure, blood glucose and lipid levels, as well as absolute reductions of risk category. RESULTS: The interventions were associated with reduced BMI by 2.75 percent (p<0.05), systolic pressure by 3.05% (p=0.12), diastolic pressure by 5.13% (p<0.05), blood glucose by 6.51% (p<0.05), total cholesterol by 16.35% (p<0.05), LDL-cholesterol by 4.81% (p<0.05) and triglyceride by 35.01% (p<0.05). HDL-cholesterol remained within the normal range before and after the interventions in all patients. Following the interventions, the absolute risk reductions in category 1 were 45.51% and 53.35%, for males and females, respectively. In category 2, the absolute risk reductions were 30.05% and 45.67%, for males and females, respectively. In category 3, the absolute risk reductions were 100% for both sexes. For the entire study population, the absolute risk reductions were 48.65% in category 1 and 38.10% in category 2, while the percentage of patients with one or no risk factor (category 3) increased by 62%. CONCLUSION: Lipid-lowering interventions appear to be as effective in reducing CHD risk in Bisha patients as in other populations. Appreciable absolute risk reductions can be achieved within a short period of time in all patients, irrespective of their initial risk status.

Interrelationship of growth hormone; glucose and lipid metabolism

BACKGROUND:The relationship between Growth hormone (GH) and the metabolism of glucose and lipid is not completely understood. OBJECTIVE:The present study is to obtain further information that will clarify the relationships between growth hormone and the metabolism of glucose and lipid.METHODS:The subjects were randomly selected 25 male (11) and female (14) healthy individuals aged 35.96 +/- 8.05 years. After an overnight fast (10-12 hours), blood was taken from the subjects into heparinised tubes, centrifuged at 5,000 rpm for 5 minutes and the plasma separated. Fasting plasma glucose (FBS) was determined by glucose oxidase method,, total cholesterol, LDL, HDL and, Triglyceride were determined by enzymatic methods. Hormone sensitive lipase was determined by, using dilaural-glycero-glutaric acid methyresoruffin as substrate and Cobas Integra 800 Auto-analyser. Growth Hormone was determined by Enzyme linked immunoassay method by using monoclonal antibodies and Access 2 Immunoassay system. All reagents were supplied by Roche Company.RESULT:The results showedpositive correlations between GH vs age and GH vs BMI. On the contrary, negative correlations were shown between GH vs the fasting levels of glucose,GH vs lipid and GH vs HSL.CONCLUSION:). GH caused the reduction of the blood levels of glucose and, lipid using HSL as mediator, by inhibiting gluconeogenesis and stimulating lipolysis, respectively

Diet, alcohol consumption, smoking and exercise as determinants of blood lipid levels of Nigerians.

Diet, alcohol consumption, smoking and exercise habits of randomly chosen 250 Nigerians were investigated by questionnaires. Most of the subjects, 67% were on carbohydrate diets, 50% were teetotal, 87.5% were non-smokers and 69% were not involved in exercise. The mean blood lipid levels of the Nigerians were within normal range, but much lower than the lipid levels of caucasians. It was concluded that the lifestyle of these Nigerians was largely responsible for the low levels of plasma lipids observed.

The plasma lipid concentrations of healthy Nigerians.

A cross-sectional survey was carried out to investigate the pattern of plasma lipid concentrations of healthy Nigerians living in the urban area of Lagos. Generally, the levels of plasma total cholesterol, triglyceride and lipoproteins of Africans were lower than those of Caucasians. The subjects were on high carbohydrate and low fat diets, and most of them were involved in some form of physical activity. These factors might contribute to their low plasma lipid levels. The plasma lipid concentrations (except HDL-cholesterol) increased with age. However, the HDL-cholesterol values remained very high within the protective limits, in older individuals as well as younger subjects. There were no significant differences in the cholesterol and triglyceride values for male and female subjects. Finally, the overweight subjects had higher concentrations of plasma lipids than subjects with normal weights.

Origin of non-dialysable urinary glucoconjugates.

A Gel exclusion chromatographic method was used to determine the molecular weight distribution, and therefore, the origin, of non-dialysable urinary glucoconjugates in normal men. The results showed a mixture of glucoconjugates with molecular weight ranges of 1605 to 141,000. It is suggested that the high molecular weight forms originally constitute the glucoconjugates, and that they are probably post-glomerular in origin. These may be degraded in vivo by glucosylhydrolases to produce the low molecular weight forms. The activities of the urinary enzymes may be reduced in male type 1 diabetic patients, and this may be responsible for the reported increase in their excretion of non-dialysable urinary glucoconjugates.

Structural analysis of the non-dialysable urinary glucoconjugates of normal men.

Enzymic methods were employed to analyse the structure of the non-dialysable urinary glucoconjugates of ten healthy males. The excretion of the urinary glucoconjugates was determined from the glucosyl:galactosyl ratio after acid hydrolysis, and a mean value of 0.27 was obtained. The results of the specific actions of alpha- and beta-glucosidases showed that the non-dialysable urinary glucoconjugates contain a branched alpha-glucan fraction with 1,4- and 1,6-glucosidic bonds, and a beta-glucan fraction containing 1,4-glucosidic bonds.

Plasma lipids in Nigerian hypertensives.

In this study, the plasma lipids in 50 Nigerian hypertensives and 50 control subjects, matched for age and sex, were estimated by enzymatic colorimetric methods. Generally, the levels of plasma lipids for both controls and subjects were within the normal range. However, there were elevations of plasma total cholesterol (after correcting for the effect of weight), low density lipoproteins and triglycerides in the hypertensives. There was some decrease in the levels of high density lipoproteins (HDL) and cholesterol concentration in hypertensives but this was not statistically significant.