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Aishwarya J, Bobby Z, Nair PP, Sunitha VC, Menon V, Thalapalliyil K. Increased vascular risk factors, atherosclerosis, and psychological distress among Indian adults with refractory epilepsy in comparison to well-controlled epilepsy. Epilepsy Behav 2023; 145:109326. [PMID: 37392602 DOI: 10.1016/j.yebeh.2023.109326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 07/03/2023]
Abstract
OBJECTIVE Comparison of cardiovascular risk factors, atherosclerosis, and psychological distress among adults with refractory versus well-controlled epilepsy. METHODS The cross-sectional study consisted of two groups of 40 people each: Group I - People with well-controlled epilepsy, Group II - People with refractory epilepsy. Age- and gender-matched people of 20-50 years were recruited. People who were diabetic, smokers, hypertensive, alcoholic, pregnant, with infections, and lactating women were excluded from the study. Biochemical parameters, fasting glucose, lipid profile, fasting insulin, leptin, adiponectin, Lp[a], hsCRP, TyG INDEX, HOMA1-%S, HOMA1-IR, HOMA1-%B, QUICKI, FIRI, AIP, AC, CLTI, MLTI, CRI-I, CRI-II, and CIMT were estimated. Stress levels [PSS-10, GAD-7 & PHQ-9] were assessed based on the scoring system from the questionnaires. RESULTS The existence of metabolic syndrome, levels of triglycerides, TyG index, MDA, OSI, CIMT, AIP, and stress scores [PSS-10, GAD-7 & PHQ-9] were significantly higher in the refractory-epilepsy group in comparison to the well-controlled group. There were associations between LDL -C and CIMT as well as between GAD-7 and CIMT among all the study subjects. There were no significant differences in the levels of glucose homeostasis parameters, hsCRP, leptin, adiponectin, and Lp[a] between the two groups. Based on the ROC analysis, MDA [AUC = 0.853] and GAD-7 [AUC = 0.900] are useful in the differential diagnosis of the study groups. CONCLUSION People with refractory epilepsy had increased levels of vascular risk factors, atherosclerosis, and stress levels compared to people with well-controlled epilepsy. Suitable disease management and therapeutic approaches to address cardiovascular and psychological distress could be planned out among people with refractory epilepsy to improve their quality of life.
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Affiliation(s)
- J Aishwarya
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Puducherry, India
| | - Zachariah Bobby
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Puducherry, India.
| | - Pradeep P Nair
- Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Puducherry, India
| | - V C Sunitha
- Department of Radiodiagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Puducherry, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Puducherry, India
| | - Kamila Thalapalliyil
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research [JIPMER], Puducherry, India
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Bansal SK, Suri A, Suryan V, Singh NK, Barman S. Level of non-conventional lipid parameters and its comparative analysis with TSH in subclinical hypothyroidism. Horm Mol Biol Clin Investig 2022; 44:61-65. [PMID: 36049016 DOI: 10.1515/hmbci-2022-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objective of this study is to estimate lipid parameters in subclinical hypothyroidism and correlate it with TSH. METHODS Forty newly diagnosed cases of subclinical hypothyroidism and Forty age and gender-matched healthy controls were recruited for the study. Blood samples were collected from them and serum lipid profile (i.e. HDL, LDL, TG, serum total cholesterol) of the subjects was estimated by standard photometric methods in a fully auto-analyzer (MINDRAY BS-300) using commercially available kits and VLDL cholesterol was calculated using the Friedewald's formula. While serum Ox-LDL, Lipoprotein A, Apolipoprotein A1 and Apo B were estimated by using commercial kit based on enzyme-linked immmunosorbent assay. RESULTS The parameters such as Oxidized low-density lipoprotein (Ox-LDL), lipoprotein (a), apolipoprotein A1, apolipoprotein B and small dense lipoprotein (sd LDL) were significantly increased in subclinical hypothyroid cases when compared with the control subjects (p<0.0001). In present study results showed significant positive correlations of serum thyroid stimulating hormone (TSH) with Ox-LDL (r=0.85, p<0.01), sd LDL (r=0.71, p<0.01). CONCLUSIONS The present study focuses on the role of Ox-LDL, sd-LDL Lipoprotein A, Apolipoprotein A1 and Apo B that are sensitive indicators of atherogenic dyslipidemia in subclinical hypothyroidism and can serve as a better & novel risk factor for CAD.
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Affiliation(s)
- Sanjiv Kumar Bansal
- Department of Biochemistry, Faculty of Medicine & Health Sciences, SGT University, Gurugram, Haryana, India
| | - Arpita Suri
- Department of Biochemistry, Faculty of Medicine & Health Sciences, SGT University, Gurugram, Haryana, India
| | - Varsha Suryan
- Department of Biochemistry, Faculty of Medicine & Health Sciences, SGT University, Gurugram, Haryana, India
| | - Naveen Kumar Singh
- Department of Biochemistry, Faculty of Medicine & Health Sciences, SGT University, Gurugram, Haryana, India
| | - Smita Barman
- Department of Biochemistry, Faculty of Medicine & Health Sciences, SGT University, Gurugram, Haryana, India
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Bustanji Y, Barham N, Abu-Rish EY, Alhyari A, Albustanji B, Alnajjar M, Abu-Irmaileh B, El-Huneidi W, Abu-Gharbieh E, Mohammad M, Fararjeh M, Issa A, Semreen M, Bajes H. Clinical investigation of lipoprotein (a) levels in type 2 diabetics for cariovascular diseases prediction and prognosis. Horm Mol Biol Clin Investig 2022; 43:263-271. [PMID: 35427448 DOI: 10.1515/hmbci-2021-0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/13/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES We aimed to evaluate the levels of serum lipoprotein a, LP (a), in Jordanian patients with type 2 diabetes mellitus (DM); and to examine its relation to glycemic control, metabolic syndrome (MS) and duration of DM. The LP (a) is considered one of the independent risk factors for coronary artery disease (CAD) in the general population. METHODS Fasting blood samples were drawn from 51 diabetic patients with type 2 DM and 31 non-diabetic age and sex control subjects. Serum LP (a) was measured along with other parameters, including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c) and glycosylated haemoglobin (HbA1c). Correlation analyses were performed between LP (a) and the various variables measured. RESULTS LP (a) measurement showed a skewed distribution towards the lower levels in both groups. Mean LP (a) levels showed a statistically insignificant difference between the two groups. No correlations of LP (a) were observed with age, sex or body mass index (BMI). No correlations of LP (a) with LDL-c, HDL-c, TG, TC, MS, DM duration or HbA1c were observed. The LP (a) serum levels were significantly higher in type 2 diabetic patients with retinopathy. CONCLUSIONS LP (a) serum levels are not increased in type 2 diabetic patients; so, LP (a) may not be a reliable marker for early therapeutic interventions in DM patients, even in high-risk for thrombosis groups.
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Affiliation(s)
- Yasser Bustanji
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE.,School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Noor Barham
- School of Pharmacy, The University of Jordan, Amman, Jordan
| | | | | | | | - Majd Alnajjar
- Hamdi Mango Center for Scientific Research, The University of Jordan, Amman, Jordan
| | - Bashaer Abu-Irmaileh
- Hamdi Mango Center for Scientific Research, The University of Jordan, Amman, Jordan
| | - Waseem El-Huneidi
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
| | - Eman Abu-Gharbieh
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
| | | | | | - Ala Issa
- School of Pharmacy, The University of Jordan, Amman, Jordan
| | | | - Hana Bajes
- School of Pharmacy, The University of Jordan, Amman, Jordan.,Science Department, Atlantic Cape Community College, Mays Landing, NJ 08330, USA
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Wadhwa D, Mahajan VK, Mehta KS, Chauhan PS, Yadav RS, Bhushan S, Sharma V, Sharma A, Sharma A, Chauhan S. Malondialdehyde, lipoprotein-a, lipoprotein ratios, comprehensive lipid tetrad index and atherogenic index as surrogate markers for cardiovascular disease in patients with psoriasis: a case–control study. Arch Dermatol Res 2019; 311:287-297. [PMID: 30830310 DOI: 10.1007/s00403-019-01896-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Dhaarna Wadhwa
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India.
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Rajinder S Yadav
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Satya Bhushan
- Department of Biochemistry, Dr. R. P. Govt. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Anuj Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Aditi Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
| | - Shailja Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. GovKangrat. Medical College, Kangra, (Tanda), Himachal Pradesh, 176001, India
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Bansal SK, Agarwal S, Daga MK. Advanced Atherogenic Index for the Assessment of Consolidated Lipid Risk in Premature Coronary Artery Disease Patients in India. J Lab Physicians 2016; 8:77-84. [PMID: 27365915 PMCID: PMC4866388 DOI: 10.4103/0974-2727.180786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: The high prevalence, severity, and prematurity of coronary artery disease (CAD) in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices. Aims and Objectives: To calculate newly defined advanced atherogenic index (AAI) in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices. Material and Methods: One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL), small dense LDL (SD LDL), lipoprotein (a) apolipoprotein B (Apo B), and apolipoprotein A1 (Apo A1) were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI) and lipid pentad index (LPI). Results: The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20) as compared to controls (305.84 ± 21.80). AAI has shown better statistical significance and correlation (P < 0.0001, r = 0.737) as compared to the earlier indices such as AI (P < 0.01, r = 0.52), LTI (P < 0.001, r = 0.677) and LPI (P < 0.001, r = 0.622) in premature CAD. Kolmogorov D statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices. Conclusion: Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices.
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Affiliation(s)
- Sanjiv Kumar Bansal
- Department of Biochemistry, SGT Medical College, Hospital and Research Institute, Budhera, Gurgaon, Haryana, India
| | - Sarita Agarwal
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
| | - Mridul Kumar Daga
- Department of Medicine, Maulana Azad Medical College, New Delhi, India
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Ikkruthi S, Rajappa M, Nandeesha H, Satheesh S, Sundar I, Ananthanarayanan PH, Harichandrakumar KT. Hyperhomocysteinemia and hyperlipoproteinemia (a) in obese South Indian men: an indication for increased cardiovascular risk. ACTA ACUST UNITED AC 2014; 101:13-20. [PMID: 24311227 DOI: 10.1556/aphysiol.100.2013.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Obesity is a pathological condition which increases the risk for cardiovascular disease. The present study was designed to evaluate homocysteine, lipoprotein (a) [Lp(a)], apolipoprotein-B (apo-B), apolipoprotein-A-I (apo-A-I) and lipid indices and their association if any in obese South Indian men. Thirty obese men and thirty age-matched males with normal body weight (controls) were recruited in the study. Plasma homocysteine, Lp(a), lipid profile, apo-A-I and apo-B were estimated in all the subjects. Lipid indices such as lipid pentad index (LPI), lipid tetrad index (LTI), atherogenic index of plasma (AIP), non-high density lipoprotein (non-HDL)/high density lipoprotein (HDL) ratio and apo-B/apo-A-I ratio were calculated in all study subjects. Homocysteine, Lp(a), apo-B, apo-B/apo-A-I ratio and lipid indices were significantly increased in obese men, compared to controls. Both homocysteine and Lp(a) were positively correlated with BMI, waist, hip circumference and apo-B and negatively correlated with apo-A-I. Also we found highly significant positive correlation between homocysteine and Lp(a) levels. The data from the present study concludes that non-conventional risk factors like homocysteine, Lp (a), apo-B/apo-A-I ratio, LTI, LPI, non-HDL/HDL ratio and AIP were significantly elevated in obese Indian men, suggesting they are more prone to develop cardiovascular disease, than the age-matched men with normal body weight.
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Affiliation(s)
- S Ikkruthi
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Biochemistry Puducherry 605006 India
| | - Medha Rajappa
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Biochemistry Puducherry 605006 India
| | - H Nandeesha
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Biochemistry Puducherry 605006 India
| | - S Satheesh
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Cardiology Puducherry India
| | - I Sundar
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Biochemistry Puducherry 605006 India
| | - P H Ananthanarayanan
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Biochemistry Puducherry 605006 India
| | - K T Harichandrakumar
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Department of Biometrics Puducherry India
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Rajappa M, Sridhar MG, Balachander J, Sethuraman KR, Rajendiran KS. Lipoprotein ratios as surrogate markers for insulin resistance in South indians with normoglycemic nondiabetic acute coronary syndrome. ISRN ENDOCRINOLOGY 2014; 2014:981524. [PMID: 24959351 PMCID: PMC4052181 DOI: 10.1155/2014/981524] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 04/08/2014] [Indexed: 11/17/2022]
Abstract
Background. Insulin resistance has been associated with dyslipidemia and cardiovascular disease. Even though homeostasis model assessment of insulin resistance (HOMA-IR) is a well-known insulin resistance predictor, estimation of serum lipoprotein ratios has been recently suggested as a surrogate marker for insulin resistance. Here, we evaluated the relationship between lipoprotein ratios and insulin resistance in normoglycemic nondiabetic south Indians with acute coronary syndrome. Methods. 100 normoglycemic nondiabetic ACS patients and 140 controls were enrolled in the study. Levels of fasting glucose, fasting insulin, and lipid profile [total cholesterol (TC), triglycerides (TG), and high density lipoprotein cholesterol (HDL-C)], lipoprotein(a) [Lp(a)] levels were measured and lipoprotein ratios were computed. HOMA-IR was used to calculate the insulin resistance. Receiver operating characteristic curves (ROC) analysis was used to compare the power of these lipoprotein ratios to predict insulin resistance. Results. Lipoprotein ratios were significantly higher in normoglycemic nondiabetic ACS patients, as compared to healthy controls, and were significantly correlated with HOMA-IR by Spearman's rank correlation analysis. ROC curve showed that Lp(a)/HDL-C and TG/HDL-C ratios were the best surrogate predictors of insulin resistance in normoglycemic nondiabetic ACS. Conclusion. This study demonstrates that serum lipoprotein ratios significantly correlate with insulin resistance in normoglycemic nondiabetic ACS. Lp(a)/HDL-C and TG/HDL-C ratios could be used as surrogate markers of insulin resistance in atherosclerosis-prone south Indians with normoglycemic nondiabetic ACS.
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Affiliation(s)
- Medha Rajappa
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605 006, India
| | - M. G. Sridhar
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605 006, India
| | - J. Balachander
- Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605 006, India
| | - K. R. Sethuraman
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605 006, India
| | - Kalai Selvi Rajendiran
- Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605 006, India
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Goswami B, Rajappa M, Chakraborty B, Patra SK, Kumar S, Mallika V. Comparison of the various lipid ratios and indices for risk assessment in patients of myocardial infarction. Clin Biochem 2012; 45:445-9. [PMID: 22318009 DOI: 10.1016/j.clinbiochem.2012.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 01/20/2012] [Accepted: 01/21/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Coronary artery disease (CAD) has emerged as the major cause of morbidity and mortality among Asian Indians in the recent past. The following study was undertaken to assess the predictive value of novel biomarkers of dyslipidemia for risk assessment for CAD in the Indian population. DESIGN AND METHODS The study group comprised of 100 clinically assessed patients of myocardial infarction and 100 age and sex matched healthy controls. Apolipoprotein-A (Apo-AI) and Apolipoprotein-B (Apo-B) were estimated and small dense LDL was derived mathematically. RESULTS The cases showed significantly high levels of total serum cholesterol, triglycerides, LDL cholesterol, Apo-B, sdLDL, and non-HDL cholesterol. On carrying out multivariate regression analysis, Lp(a)/HDL ratio emerged as the best determinant of CAD risk CONCLUSION The above data clearly underlines the role of these novel biomarkers in the risk assessment for CAD in the Indian context.
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Affiliation(s)
- Binita Goswami
- Department of Biochemistry, Lady Hardinge Medical College & Associated hospitals, New Delhi-110001, India.
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Prasad DS, Kabir Z, Dash AK, Das BC. Childhood cardiovascular risk factors in South Asians: A cause of concern for adult cardiovascular disease epidemic. Ann Pediatr Cardiol 2011; 4:166-71. [PMID: 21976880 PMCID: PMC3180978 DOI: 10.4103/0974-2069.84663] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Cardiovascular risk factors in children are increasing at an alarming rate in the western world. However, there is limited information regarding these in the South Asian children. This review attempts at summarizing such evidence. South Asians are remarkable for the earlier onset of adult cardiovascular disease (CVD) by almost a decade compared to the Caucasians. We identified published literature, mainly on PubMed, Embase and Cochrane library using specific search terms such as lipid abnormalities, high blood pressure, hyperglycemia, tobacco use, obesity, physical inactivity, and unhealthy dietary practices. Atherosclerotic CVD processes begin early in childhood and are influenced over the life course by genetic and potentially modifiable risk factors and environmental exposure. 80% of adult CVD burden will fall on the developing nations by 2020. The concept of primordial prevention is fast emerging as a necessary prevention tool to curb adult CVD epidemic. Established guidelines and proven preventive strategies on cardiovascular health exist; however, are always implemented half-heartedly. Composite screening and prediction tools for adults can be adapted and validated in children tailored to South Asian population. South Asian children could be at a greater risk of developing cardiovascular risk factors at an earlier stage, thus, timely interventions are imperative.
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Affiliation(s)
| | - Zubair Kabir
- Epidemiologist, Research Institute for a Tobacco Free Society, The Digital Depot, Thomas Street, Dublin, Ireland, India
| | - Ashok Kumar Dash
- Department of Pathology, M.K.C.G. Medical College, Berhampur, Orissa, India
| | - Bhagabati Charan Das
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneshwar, Orissa, India
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Goswami B, Rajappa M, Mallika V, Shukla DK, Kumar S. TNF-alpha/IL-10 ratio and C-reactive protein as markers of the inflammatory response in CAD-prone North Indian patients with acute myocardial infarction. Clin Chim Acta 2009; 408:14-8. [PMID: 19576194 DOI: 10.1016/j.cca.2009.06.029] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Revised: 06/23/2009] [Accepted: 06/23/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Cytokines are responsible for the modulation of immunological and inflammatory processes and play a significant role in the pathogenesis of coronary artery disease (CAD). Tumor necrosis factor (TNF)-alpha is the major pro-inflammatory cytokine while interleukin-10 (IL-10) is the major anti-inflammatory cytokine in patients with CAD. We determined the significance of the TNF/IL-10 ratio and C-reactive protein (CRP) in patients of acute myocardial infarction as a marker for CAD in the atherosclerosis-prone North Indian population. METHODS The study group comprised of 100 patients of acute myocardial infarction (AMI) and 100 age and sex matched healthy controls. Lipid profile, apolipoprotein-A (Apo-A), apolipoprotein-B (Apo-B) and CRP concentrations were estimated using commercially available kits in all patients and control subjects. TNF-alpha, lipoprotein (a) (Lp(a)) and IL-10 concentrations were assayed by using commercially available ELISA kits. RESULTS The TNF-alpha concentrations were significantly higher in patients with acute myocardial infarction (86.9+/-4.7 pg/ml), as compared to control subjects (7.1+/-0.67 g/ml). AMI patients also exhibited higher serum concentrations of IL-10 (5.74+/-0.82 pg/ml), in comparison to the controls (1.22+/-0.06 pg/ml). The ratio of TNF-alpha to IL-10 was significantly increased in cases (15.2+/-1.13), in comparison to healthy subjects (5.8+/-0.64). CONCLUSIONS These cytokines underline the role of the immune processes during unstable atherosclerosis and in the pathogenesis of coronary artery disease in the Indian context.
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Affiliation(s)
- Binita Goswami
- Department of Biochemistry, G. B. Pant Hospital, New Delhi-110002, India.
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Rajappa M, Sen SK, Sharma A. Role of pro-/anti-inflammatory cytokines and their correlation with established risk factors in South Indians with coronary artery disease. Angiology 2008; 60:419-26. [PMID: 18796448 DOI: 10.1177/0003319708321101] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cytokines are responsible for the modulation of immunological and inflammatory processes and play a significant role in the pathogenesis of coronary artery disease. We estimated the levels of pro-/anti-inflammatory cytokines in South Indian patients with coronary artery disease. The study population comprised of groups 1-3: 100 patients each with acute myocardial infarction, unstable angina, and stable angina, respectively, and group 4 (100 healthy controls). Cytokine levels (interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-alpha) were estimated by enzyme-linked immunosorbent assay (ELISA). Interleukin-6, interleukin-8, and tumor necrosis factor-alpha levels were significantly higher in patients from groups 1 and 2, than in group 3 and controls. Acute myocardial infarction patients exhibited higher serum levels of interleukin-10 compared with other groups and control subjects. Patients with unstable angina had significantly lower interleukin-10 concentrations than those with stable angina. The ratios of pro-/anti-inflammatory cytokines in all the study groups increased significantly when patients with unstable angina were compared to other groups. In patients with acute myocardial infarction, interleukin-10 and tumor necrosis factor-alpha levels showed significant correlation with established risk factors such as body mass index, blood pressure, and lipid levels. Acute myocardial infarction patients show elevation in proinflammatory and anti-inflammatory cytokines, while unstable angina is associated with low levels of serum interleukin-10. Higher levels of anti-inflammatory cytokine interleukin-10 may be needed to provide protection in unstable angina. These cytokines are markers of coronary artery disease and may be used for the identification of high-risk patients with unstable angina/acute myocardial infarction.
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Affiliation(s)
- Medha Rajappa
- Department of Ocular Biochemistry, Dr. R.P. Centre for Ophthalmic Sciences, India Institute of Medical Sciences, New Delhi 110029, India
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Abstract
Biochemical Markers of AtherosclerosisThis paper is a brief review of some lipid parameters and serum markers of inflammation in a view of their predictive relevance for the atherosclerotic disease. A discourse on the importance of measuring different lipids and lipoproteins, concentration of LDL particles and apolipoprotein levels is still underway. Also, the recommendations for apolipoprotein (a), phenotypization and other lipid markers have not yet been established. In recent years the recommendations imply simultaneous measuring of multiple markers and calculating the lipid index values such as lipid tetrad index (LTI), lipid pentad index (LPI) and atherogenic index of plasma (AIP). Several circulating markers of inflammation such as C-reactive protein, serum fibrinogen and elevated leukocyte number, are consistently associated with atherosclerosis. In spite of a lack of evidence on measuring the C-reactive protein in a wide population, the guidelines for its application in diagnostics and therapy of coronary heart disease were developed. Some proinflammatory cytokines, adhesion molecules and markers of leukocyte activation are promising markers, requiring, however, more detailed prospective evaluation. The question to be elucidated is if these inflammatory markers are directly involved in the pathogenic process.
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