Prevalence of dyslipidemia and its associated factors among university academic staff and students in Bangladesh.

BACKGROUND: Dyslipidemia is one of the important contributors to cardiovascular disease and type 2 diabetes. There is little or no information on dyslipidemia among academic staff and students in Bangladesh. Therefore, this study aimed to investigate the prevalence and factors related to dyslipidemia among university academic staff and students in Bangladesh. METHODS: A total of 533 participants (302 academic staff and 231 students) were enrolled in this cross-sectional study. A simple random sampling technique was used to enrol the participants. Fasting blood samples were obtained from the participants, and serum levels of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured using the standard methods. Dyslipidemia was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III) model guideline. Multivariable logistic regression was conducted to identify the factors related to lipid marker abnormalities. RESULTS: Overall, the prevalence of dyslipidemia was 81.5%, of which 85% was in staff and 76.5% in students. A significant difference was found in the prevalence of dyslipidemia between males and females only in the student group (p < 0.01). Among staff, hypertriglyceridemia prevalence was 49.7%, hypercholesterolemia 23%, high LDL-C 24.7% and low HDL-C 77.3%. On the other hand, hypertriglyceridemia prevalence was 39%, hypercholesterolemia 25.6%, high LDL-C 26.5% and low HDL-C 69.3% among students. The most common lipid abnormality was low HDL-C in both groups. The prevalence of mixed dyslipidemia was 14.2% and 14.1% in staff and students, respectively. According to the regression analysis, increased age, obesity, diabetes, and inadequate physical activity were significantly associated with dyslipidemia. CONCLUSIONS: Dyslipidemia was prevalent among the majority of the study participants. Increased age, obesity, diabetes, and inadequate physical activity were significantly associated with dyslipidemia. The study's results highlight the importance of implementing interventions to address the associated risk factors of dyslipidemia among academic staff and students in Bangladesh.

Prevalence and factors associated with dyslipidemia in Bangladeshi adults.

BACKGROUND: Dyslipidemia is one of the modifiable risk factors for cardiovascular disease and a leading cause of morbidity and mortality worldwide. This study was designed to estimate the prevalence and factors associated with dyslipidemia in Bangladeshi adults. METHODS: A total of 603 participants aged ≥ 18 years were recruited in the study. Serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) were analyzed using enzymatic colorimetric methods. Dyslipidemia was defined based on serum lipids levels following the standard guidelines by National Cholesterol Education Program Adult Treatment Panel III. Multivariate logistic regression analysis was applied to evaluate risk factors associated with dyslipidemia. RESULTS: The overall prevalence of dyslipidemia was 89% with no significant difference between male (90.1%) and female (85.7) subjects. The prevalence of hypertriglyceridemia was 51.7%, hypercholesterolemia 41.6%, high LDL 43.9% and low HDL 78.8%. When participants were classified into healthy control, hypertensive and diabetic groups, the lipid levels and prevalence of lipid abnormalities were higher in hypertensive and diabetic groups compared to the control group. Low HDL level was the main prevalent dyslipidemia among study subjects. The prevalence of isolated hypertriglyceridemia, isolated hypercholesterolemia, and isolated low HDL-C was 24.7%, 14.7%, and 25.5%, respectively. Mixed hyperlipidemia was prevalent in 26.9% of the participants. According to the logistic regression analysis, significant associated factors of dyslipidemia were increased age, overweight, general and abdominal obesity, hypertension, diabetes and inadequate physical activity. CONCLUSIONS: This study shows a high prevalence of dyslipidemia in Bangladeshi adults. Important risk factors of dyslipidemia are increased age, overweight, general and abdominal obesity, diabetes, hypertension and low physical activity. Our results suggest that awareness-raising programs are required to prevent and control dyslipidemia among Bangladeshi adults.

The association between elevated lipid profile and liver enzymes: a study on Bangladeshi adults.

Dyslipidemia, a major contributor to cardiovascular diseases, is rapidly increasing in Asian countries including Bangladesh. In addition to the cardiovascular system, abnormal lipid levels are also known to cause complications in renal and hepatic systems. The data regarding dyslipidemia and its relationship with liver enzymes are scarce for the Bangladeshi population. Therefore, this study was conducted to estimate the prevalence of dyslipidemia and determine the relationship between lipid profile and liver enzymes in Bangladeshi adults. A total of 405 participants (318 males and 87 females) were enrolled in the study. Serum levels of TG, TC, LDL, HDL and liver enzymes including ALT, AST, GGT and ALP were analyzed using standard methods. Dyslipidemia and liver function tests abnormalities were defined according to the international standard guidelines. The association between elevated lipid profile markers and liver enzyme abnormalities was assessed by logistic regression analysis. Overall, the prevalence of elevated TG, TC, LDL and low HDL were 30.9%, 23.7%, 26.2% and 78.8%, respectively. On the other hand, the prevalence of elevated liver enzymes ALT, AST, GGT and ALP were 18.8%, 21.6%, 12.9% and 21.9%, respectively. Dyslipidemia and liver enzyme abnormalities were higher in diabetic and hypertensive participants than in the healthy participants. About 61% of participants with dyslipidemia had at least one or more elevated liver enzymes. In regression analysis, an independent association was observed between serum GGT and all lipid components. In conclusion, a high prevalence of dyslipidemia and liver enzyme abnormalities were observed among the study participants. Of the four liver enzymes, the serum levels of GGT showed an independent association with all lipid components. Moreover, this study indicates that subjects with dyslipidemia often have a higher chance of having liver diseases than subjects with no dyslipidemia. However, large-scale prospective studies are needed to understand the underlying mechanisms of lipid-induced hepatic dysfunction in the Bangladeshi population.

Assessment of the relationship between serum uric acid levels and liver enzymes activity in Bangladeshi adults.

Serum uric acid (SUA) level has been suggested to be associated with cardiovascular disease, diabetes and metabolic syndrome. However, little is known about the relationship between SUA and liver enzymes activity in the general population. The present study aimed to assess the relationship between SUA and serum liver enzymes in an adult population in Bangladesh. In this cross-sectional study, a total of 410 blood samples were collected from apparently healthy adults aged > 18 years. SUA, liver enzymes, lipid profile and other biochemical markers were measured in the collected samples by using standard methods. Multinomial logistic regression model was used to assess the relationship between SUA and elevated levels of liver enzymes among the participants. Overall, the prevalence of hyperuricemia was 30.1% with 32.2% in male and 18.6% in female participants. About 33% of the participants had at least one or more elevated levels of liver enzymes. The mean level of SUA was significantly higher in males (389.3 ± 96.9 µmol/L) than in the female (290.4 ± 89.8 µmol/L) subjects (p < 0.001). There was a significant difference in the mean levels of serum ALT and GGT between the male (34.5 ± 16.0 U/L and 26.7 ± 19.5 U/L, respectively) and female (25.0 ± 13.0 U/L and 19.5 ± 13.2 U/L, respectively) participants (p < 0.001 and p < 0.01, respectively). An increasing trend was observed in the mean levels of serum ALT and GGT across the SUA quartile groups (p < 0.001 and p < 0.01, respectively). SUA showed a positive and significant correlation with serum ALT (p < 0.001) and GGT (p < 0.01). In further statistical analysis after adjustment for potential confounders, SUA showed an independent and significant association with serum ALT and GGT in all regression models. In conclusion, SUA was strongly associated with serum levels of ALT and GGT after adjustment for potential confounders. More prospective studies are needed to clarify the complex relationship between SUA and liver enzymes in the general population.

The Presence of Aflatoxin M1 in Milk and Milk Products in Bangladesh.

As milk provides both micro- and macronutrients, it is an important component in the diet. However, the presence of aflatoxin B1 (AFB1) in the feed of dairy cattle results in contamination of milk and dairy products with aflatoxin M1 (AFM1), a toxic metabolite of the carcinogenic mycotoxin. With the aim to determine AFM1 concentrations in milk and milk products consumed in Bangladesh, in total, 145 samples were collected in four divisional regions (Sylhet, Dhaka, Chittagong, and Rajshahi). The samples comprised these categories: raw milk (n = 105), pasteurized milk (n = 15), ultra-high temperature (UHT)-treated milk (n = 15), fermented milk products such as yogurt (n = 5), and milk powder (n = 5). AFM1 levels in these samples were determined through competitive enzyme-linked immunosorbent assay (ELISA). Overall, AFM1 was present in 78.6% of milk and milk products in the range of 5.0 to 198.7 ng/L. AFM1 was detected in 71.4% of raw milk (mean 41.1, range 5.0-198.7 ng/L), and in all pasteurized milk (mean 106, range 17.2-187.7 ng/L) and UHT milk (mean 73, range 12.2-146.9 ng/L) samples. Lower AFM1 levels were found in yogurt (mean 16.9, range 8.3-41.1 ng/L) and milk powder samples (mean 6.6, range 5.9-7.0 ng/L). About one-third of the raw, pasteurized, and UHT milk samples exceeded the EU regulatory limit (50 ng/L) for AFM1 in milk, while AFM1 levels in yogurt and milk powder samples were well below this limit. Regarding regions, lower AFM1 contamination was observed in Chittagong (mean 6.6, max 10.6 ng/L), compared to Sylhet (mean 53.7, max 198.7 ng/L), Dhaka (mean 37.8, max 97.2 ng/L), and Rajshahi (mean 34.8, max 131.4 ng/L). Yet, no significant difference was observed in AFM1 levels between summer and winter season. In conclusion, the observed frequency and levels of aflatoxin contamination raise concern and must encourage further monitoring of AFM1 in milk and milk products in Bangladesh.

Assessment of the relationship of serum liver enzymes activity with general and abdominal obesity in an urban Bangladeshi population.

Obesity is a global health concern because of its increasing trend both in developed and developing countries. A limited number of studies have evaluated the association of liver enzymes with both general and abdominal obesity in the general population; data for the Bangladeshi population are not available yet. This study aimed to assess the relationship of serum liver enzymes activity with both general and abdominal obesity in Bangladeshi adults. In total, 540 blood samples were obtained from the participants (388 males and 152 females) and analyzed for serum levels of ALT, AST, GGT, and ALP using standard methods. General obesity was defined as body mass index (BMI) ≥ 27.5 kg/m2 and abdominal obesity was defined as waist circumference (WC) ≥ 90 cm in males and ≥ 80 cm in females. The relationship between liver enzymes and obesity was evaluated by multivariate logistic regression models. Overall, 58% of participants in the general obesity group and 55% of the participants in the abdominal obesity group had at least one or more elevated levels of liver enzymes. The prevalence of elevated liver enzymes was significantly higher in the obesity group compared to the normal BMI and WC groups (p < 0.05 for all cases). The mean level of serum ALT, AST and GGT were significantly higher in the obesity group than the normal BMI group (p < 0.05). In the WC groups, mean AST and GGT were significantly higher in the obesity group compared to the normal group (p < 0.05). In regression analysis, serum levels of ALT showed an independent and significant association with general obesity, whereas, serum GGT showed a significant association with both general and abdominal obesity. In conclusion, a high prevalence of elevated liver enzymes was observed among participants included in the present study. Of the four enzymes, serum GGT was independently associated with both general and abdominal obesity. Further studies are required to understand the complex relationship between liver enzymes and obesity in the general population.

Prevalence and associated risk factors of general and abdominal obesity in rural and urban women in Bangladesh.

BACKGROUND: Obesity is a major public health concern worldwide including Bangladesh. This study aimed to assess the prevalence and associated risk factors of general and abdominal obesity in rural and urban women in Bangladesh. METHODS: A total of 450 adult women aged ≥ 18 years were recruited from rural (n = 210) and urban (n = 240) areas of four administrative regions (Chattagram, Dhaka and Rajshahi and Sylhet) of Bangladesh. Both socio-demographic and anthropometric data were recorded in this study. WHO proposed cut-off values were used for the Asian population for defining general and abdominal obesity. Multinomial logistic regression analysis was applied to evaluate the risk factors of general and abdominal obesity for Bangladeshi women. RESULTS: Overall, the prevalence of general and abdominal obesity was 28% and 49%, respectively. Urban women had a significantly higher prevalence of both general and abdominal obesity (30.9% and 58.6%, respectively) than in the rural women (26.6% and 38.1%, respectively) (p<0.05 and p<0.01, respectively). As region comparison, the prevalence of general obesity was higher in the Dhaka region (39.3%) compared to the Chattragram (23.3%), Rajshahi (23.9%) and Sylhet (3.5%) regions. On the other hand, abdominal obesity was more frequent among participants in Sylhet (72.4%) and Dhaka regions (61.5%), compared to the Chattagram (27.4%) and Rajshahi (37.3%) regions. A wide variation has been observed on the prevalence of general and abdominal obesity in the different age groups of the four regions. In regression analysis, a high socioeconomic status (ref: low socioeconomic level), low education level (ref: higher education), low physical activity (ref: adequate physical activity) and middle age (ref: ≥ 30 years of age) were significant risk factors for general and abdominal obesity. CONCLUSIONS: The prevalence of general and abdominal obesity was higher among participants living in urban areas. Physical inactivity, middle age, high socioeconomic status and low education level were associated with the increased prevalence of general and abdominal obesity. Such a high prevalence of general and abdominal obesity is a health concern for Bangladeshi women; therefore, public awareness and effective health intervention strategies are needed to address these conditions.

Association between serum liver enzymes and hypertension: a cross-sectional study in Bangladeshi adults.

BACKGROUND: Hypertension is a major contributing factor to cardiovascular disease and is a leading cause of death in the world. The association between hepatic enzymes and hypertension has been reported in limited studies and the findings are inconsistent; data from Bangladeshi adults are not available yet. This study was conducted to estimate the prevalence of elevated liver enzymes and evaluate the association of elevated liver enzymes with hypertension in Bangladeshi adults. METHODS: In this cross-sectional study, 302 blood samples were collected from adult participants and analyzed the serum concentrations of alanine and aspartate aminotransferase (ALT, AST), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT) and other markers related to hypertension. Hypertension was defined as resting SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. Associations between elevated liver enzymes and hypertension were evaluated by multinomial logistic regression. RESULTS: The mean concentrations of serum ALT, AST and GGT were significantly higher in the hypertensive group compared to the normotensive group (p < 0.01, p < 0.01 and p < 0.001, respectively). Overall, 49.2% of subjects in the hypertensive group and 38.1% of individuals in the normotensive group had at least one or more elevated liver enzymes. The prevalence of elevated ALT, AST, and GGT was significantly higher among participants in the hypertensive group compared to the normotensive group (p < 0.01, p < 0.01 and p < 0.001, respectively). An increasing trend for elevated liver enzymes was observed with increasing blood pressure. Serum ALT and GGT showed an independent relationship with hypertension. CONCLUSIONS: The prevalence of elevated liver enzymes was higher in hypertensive individuals. Increased serum ALT and GGT activities were positively associated with hypertension in Bangladeshi adults.

The relationship between serum uric acid and lipid profile in Bangladeshi adults.

BACKGROUND: Although the link between elevated uric acid and metabolic syndrome has been reported in some studies; the relationship of serum uric acid (SUA) with lipid profile has not well studied or little is known so far. This study was conducted to assess the relationship between SUA and lipid profile among the general adults in Bangladesh. METHODS: In total, 280 blood samples were collected from general adult participants (male, n = 150 and female, n = 130) and analyzed for serum lipid profile (TC, TG, HDL and LDL) and SUA levels. The study subjects were divided by quartiles based on SUA levels (Q1: ≤225 µmol/L, Q2: 226-285 µmol/L, Q3: 286-340 µmol/L and Q4: > 340 µmol/L). Linear regression modeling was used to evaluate the relationship between SUA and lipid levels. RESULTS: The prevalence of hyperuricemia was 9.2% in males and 10.4% in females. The mean level of SUA was significantly higher in male (317 ± 90 µmol/L) than in the female (255 ± 65 µmol/L) subjects (p < 0.001). An increasing trend for elevated lipid profile was observed in both gender with increasing levels of SUA in the quartiles (p < 0.05). In regression analysis, a significant positive correlation was found between SUA and TG, TC and LDL (p < 0.01) while an inverse correlation was observed between SUA and HDL (p < 0.01). After adjusting for potential confounders, lipid profile was linearly associated with SUA levels (p < 0.01 for trend). CONCLUSIONS: Present study showed a significant positive relationship for SUA with TG, TC and LDL levels, and an inverse relationship for SUA with HDL. Early prevention of hyperuricemia and dyslipidemia may be helpful to reduce the incidence of associated cardiovascular diseases.

Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: A study on Bangladeshi adults.

BACKGROUND AND OBJECTIVES: Recent studies have shown that hyperuricemia is commonly associated with dyslipidemia, cardiovascular diseases, hypertension and metabolic syndrome. Elevated serum uric acid has been demonstrated to be associated with obesity in the adult population in many countries; however, there is still a lack of evidence for the Bangladeshi population. The aims of this study were to evaluate the prevalence of hyperuricemia and determine the relationship between serum uric acid (SUA) and obesity among the Bangladeshi adults. METHODS: In this cross-sectional study, blood samples were collected from 260 adults (142 males and 118 females) and analyzed for SUA and lipid profile. All participants were categorized as underweight (n = 11), normal (n = 66), overweight (n = 120) and obese (n = 63) according to the body mass index (BMI) scale for the Asian population. Based on SUA concentration the participants were stratified into four quartiles (Q1: < 232 µmol/L, Q2: 232-291 µmol/L, Q3: 292-345 µmol/L and Q4: > 345 µmol/L). RESULTS: The mean age and BMI of the participants were 32.5 ± 13.3 years and 24.9 ± 3.8 kg/m2, respectively. The average level of SUA was 294 ± 90 µmol/L with a significant difference between males and females (p < 0.001). Overall, the estimated prevalence of hyperuricemia was 9.3% with 8.4% in male and 10.2% in female participants. There were significant increases in the prevalence of obesity (17.4%, 22.2%, 28.6% and 31.8%, respectively, p < 0.01 for trend) across the SUA quartiles. A multiple logistic regression analysis revealed that SUA quartiles were independently associated with the presence of obesity (p < 0.01). CONCLUSION: Present study indicates a significant positive relationship between SUA and obesity among the Bangladeshi adults. Therefore, routine measurement of SUA is recommended in obese individuals to prevent hyperuricemia and its related complications.