Apolipoprotein B as the best predictor of coronary artery disease in Iranian normolipidemic patients

Association Between Apolipoprotein B and Coronary Artery Disease Among Hypertensive Patients: A Systematic Review of the Prospective and Retrospective Studies

The predictive value of apolipoprotein B (apo B) has been proven in the development of coronary artery disease (CAD) among normotensives only, but it has not been directly studied in hypertensive patients. The objective of this study is to explore the association between apo B and CAD among patients with hypertension. Search strategies were conducted on September 24, 2022, and involved the databases PubMed, Web of Science, and Scopus. The current systematic review included observational case-control and cohort study design involving adult humans, both hypertensives and normotensives. The selected studies were restricted to those written in the English language and published after 2000. Reviews, interventional, animal, and overlapping studies, grey literature, and articles without full text were excluded from the current study. The modified Newcastle-Ottawa Scale was used to assess the risk of bias for the screened studies after data extraction. Out of 3644 publications, only five studies were included in the review, including 5222 participants. Of those, 2335 were hypertensive, 733 of them developed CAD, and 296 normotensive subjects developed CAD. The average apo B was 1.09 g/l and 1.07 g/l for hypertensives and normotensives, respectively. The risk of developing CAD is higher in patients with hypertension, or those with higher apo B. Moreover, the risk of CAD was exacerbated in hypertensive participants with elevated apo B. This systematic review highlights the independent power of apo B on the development of CAD among both hypertensive and normotensive subjects.

The association between apolipoprotein A-1 plasma level and premature coronary artery disease: A systematic review and meta-analysis

BACKGROUND

Apolipoprotein A-1 (Apo A-1) is a constituent of high-density lipoprotein (HDL) and emerging evidences put forward a potential association between Apo A-1 plasma levels and premature coronary artery disease (pCAD). The aim of the present study is to gather relative literature and perform a systematic review and meta-analysis regarding the association between serum ApoA-1 levels and pCAD.

METHODS

Medline (via PubMed), Scopus, Embase and Web of Science databases were searched from the inception of databases until December 7, 2020. All articles reporting the plasma levels of ApoA-1 in patients with pCAD and the control group were included. A meta-analysis with pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) was reported. Subgroup analyses were done based on the observed heterogeneity in results.

RESULTS

Seventeen case-control studies were included. ApoA-1 plasma level was calculated to be lower in pCAD patients compared with the control group (SMD: -0.67; 95% CI: -0.48 to -0.86; P < .001). The subgroup analysis and meta-regression showed that the variation in gender distribution, the development level of the target population's country and quality score of included studies were the main sources of heterogeneity. It was observed that the relationship was only significant in the developed countries (P < .001). Also, the heterogeneity was reduced when the analysis was limited to males (I² = 57.2%) and females only (I² = 26.0%).

CONCLUSION

In conclusion, there seems to be a significant association between the serum levels of ApoA-1 and pCAD. However, all of the included studies had a case-control design and since there is no good quality and prospective cohort studies included, reliability of the current evidence is debatable. Therefore, further well-designed cohort studies are required to assess the impact of serum ApoA-1 reduction on pCAD onset.

The risk of cardiovascular events based on the Framingham criteria in Adults Living in Mashhad (Iran)

BACKGROUND AND AIM

Cardiovascular diseases are a problem in low- and middle-income countries, such as Iran. The present research was performed to identify risk factors contributing to cardiovascular diseases and their distributions among the adult population of Mashhad (Iran) using the Framingham criteria.

METHODS

This cross-sectional population-based study performed in 2015 on 2,976 adults living in Mashhad (Iran) using Stratified cluster-random sampling method. Demographic information was acquired by surveyors in the research team using a checklist and referring to a medical laboratory for laboratory assessments. The 10-year risk of cardiovascular diseases for the participants was calculated using the Framingham criteria and was classified into three classes: low risk (<10%), intermediate risk (10-20%), and high risk (>20%). The analysis was done by SPSS Version 11.5 by using the Independent-samples t-test, Kruskal-Wallis, and analysis of variance (ANOVA).

RESULTS

A total of 2,978 participants aged 16-90 participated in our cross-sectional study with an average age of 43.5±14.7 years. Total risk scores among men and women were 7.29±6.3 and 5.8±6.03, respectively. Compared to women, men exhibited a significantly higher risk of cardiovascular diseases (p<0.001). Average heart age among men and women was estimated at 50.37±18.7 and 48.8±17.0 respectively, i.e. significantly older heart age was obtained for men compared to women (p<0.001).

CONCLUSION

According to this study, men are at a great risk of cardiovascular events, so we should develop our screening and educational program especially for this population.

Evaluation of Lipid Profile and Apolipoproteins in Essential Hypertensive Patients

INTRODUCTION

Essential hypertension is one of the most common diseases of the Indian population contributing greatly to the morbidity, mortality and economic burden. It has a strong association with cardiovascular disease and abnormal lipid metabolism. Not only the traditional lipid parameters, but also the novel lipid components like Apo A1 and Apo B100 also have been identified to play a role.

AIM

The present study was done to evaluate serum lipid profile and Apo A1, Apo B 100 in essential hypertensive patients and correlate their values with the degree of hypertension.

MATERIALS AND METHODS

Fasting samples from 55 age and sex matched controls and 55 essential hypertensives were tested for plasma glucose, serum urea, creatinine, lipid profile, apo A1 and apo B100. The cases were subclassified based on the severity of hypertension according to JNC criteria.

RESULTS

The study showed a significantly raised value for serum cholesterol, triacylglycerol, Low Density Lipoprotein (LDL), Very Low-Density Lipoprotein (VLDL) in the hypertensive patients than the control group whereas serum High-Density Lipoprotein (HDL) registered a fall in the cases. Apo A1 revealed a non-significant fall in the hypertensive patients. In contrast, there was a rise in the serum apo B100 in the cases. Apo B100/apo A1 ratio was significantly raised in both stage I and stage II hypertensive patients in comparision to the controls. When correlated, serum apo A1 revealed a negative association where as serum apo B 100 showed a positive association with systolic and diastolic bloood pressure. Both LDL/HDL and apoB100/apo A1 and apo B100 revealed a significant positive association with both SBP and DBP. However, apoB100/apo A1 revealed a more positive association in comparision to LDL/HDL ratio (r=0.749, p<0.001, r=0.756, p<0.001 vs r=0.336, p<0.000, r=0.312, p<0.001).

CONCLUSION

Apo B100/apoA1 has emerged as an important complementary parameter in addition to traditional lipid ratio for evaluation of risk for future cardiovascular disease.

Advanced Atherogenic Index for the Assessment of Consolidated Lipid Risk in Premature Coronary Artery Disease Patients in India

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.

The apolipoprotein B/apolipoprotein A-I ratio as a potential marker of plasma atherogenicity

Background. The apolipoprotein (apo) B/apoA-I ratio represents the balance between apoB-rich atherogenic particles and apoA-I-rich antiatherogenic particles, and this ratio is considered to be a marker of cardiovascular risk. Although many studies have demonstrated the importance of the apoB/apoA-I ratio in predicting the presence or absence of cardiovascular disease, less is known about apoB/apoA-I ratio as a marker of plasma atherogenicity. Methods. A total of 157 normolipidemic men aged 20–59 years were included in the study. The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apoA-I, apoB, and apoE were determined after a 12 h fasting period. Results. The median of the apoB/apoA-I ratio in the studied normolipidemic subjects was 0.52, with values ranging from 0.19 to 2.60. The percentage of subjects with the apoB/apoA-I ratio exceeding 0.9 (the accepted risk value of cardiovascular disease) was 19.1%. The subjects with apoB/apoA-I>0.9 were characterized by higher TG levels and atherogenic index of plasma (AIP) and lower values of ratio of low-density lipoprotein cholesterol (LDL-C) to apoB (LDL-C/apoB) and apoE levels compared with men with apoB/apoA-I<0.9. Conclusion. Despite normolipidemia, the subjects with the unfavorable apoB/apoA-I ratio had more atherogenic lipid profile.

Association Between Apo Lipoprotein B Levels at Admission of Patients and Short-term Morbidity and Mortality After Myocardial Infarction

INTRODUCTION

Dyslipidemia is an important risk factor in cardiovascular diseases. Different studies have shown that Apolipoprotein B (Apo B) is one of the best predictors in determining cardiovascular diseases and patients follow up after cardiovascular events. We hypothesized that there is a relation between Apo B levels and cardiovascular events in patients who have myocardial infarction (MI). In addition, Apo B may be an appropriate marker for following these patients after MI.

METHODS

In this study, 220 patients with acute myocardial infarction were allocated at their admission to the hospital. They were followed for three months after MI and their morbidity and mortality rates were evaluated. Apo B levels were measured immunoturbidimetrically.

RESULTS

Apo B levels were significantly higher in patients with the events including coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI) and malignant arrhythmias (P = 0.001).

CONCLUSION

Apo B levels can be an appropriate indicator of cardiovascular events in patients after MI.

The angiotensin converting enzyme D allele is an independent risk factor for early onset coronary artery disease

OBJECTIVE

The role of angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in early onset coronary artery disease age < 55years (ECAD) is controversial. The aim of this study was to further evaluate the role of this ACE(I/D) gene polymorphism on the risk of premature CAD in patients from western Iran.

METHODS

The ACE(I/D) genotypes were detected by PCR-RFLP in 323 individuals undergoing their first coronary angiography. Patients were placed into two groups: ECAD and late onset CAD age ≥ 55years (LCAD).

RESULTS

We found a statistically significant association of the ACE D allele, as homozygous or ACE ID plus DD genotypes (ID+DD), only in the ECAD subjects OR=1.35, p=0.015, OR=3.27, p=0.014, and OR=2.8, p=0.013, respectively. In addition, there was a significant association after adjustment for the absence of history of diabetes, presence of normolipidemia and absence of history of blood pressure [OR 1.38, p=0.017 and 2.35, p=0.02]. Our results indicated that the ACE D allele is a risk factor for early onset of CAD even after correcting for conventional risk factors. The incidence of triple vessel disease was significantly higher in individuals carrying ACE(D/D) genotype in ECAD patients compared to those who carried ACE(I/I) genotype (OR 3.38; p=0.019; 57.5% vs. 42.5%; p=0.013).

CONCLUSION

The presence of D allele of ACE can be important independent risk factor in the onset of CAD patients less than 55 years old in a west population of Iran. Larger collaborative studies are needed to confirm these results.

The effects of a PRECEDE-based educational program on depression, general health, and quality of life of coronary artery bypass grafting patients

BACKGROUND

Depression is commonly reported as a consequence of coronary artery bypass grafting surgery. It is the most important barrier to proper treatment of cardiac patients, causing failure in accepting the condition, decreasing the motivation in following the therapeutic recommendations, and negatively affecting the patients' function and quality of life.

OBJECTIVE(S)

The objective of this study was to investigate the effects of a PRECEDE-based educational program on depression, general health, and quality of life in coronary artery bypass grafting surgery patients.

METHODS

The experimental study included 54 post-bypass surgery patients in Isfahan Cardiovascular Research Center. The patients were randomly assigned to intervention and comparison groups (27 patients in each). The data were collected using four questionnaires (Cardiac Depression Scale, General Health Questionnaire-12, SF-36, and a PRCEDE-based questionnaire to measure predisposing, reinforcing, enabling factors, and self-help behaviors). All subjects were pre-tested. The intervention, consisting of nine educational sessions per week (60-90min each) was implemented. The patients were followed for 2 months post-intervention and post-tested at the end of the second month.

RESULTS

Following the educational intervention, the mean scores of predisposing factors, enabling factors, reinforcing factors and self-helping behaviors were significantly increased in the intervention group, compared to the comparison group (p<0.001). The mean score for depression in the comparison group (104.5±30.4) and intervention group (112.8±21.9) decreased significantly following educational intervention, but the change was more pronounced in the intervention group compared with the control group (66.2±22 vs. 89.2±27.8). The difference between the two groups on the basis of general health was statistically significant (p<0.0001). Improvements in quality of life on the basis of physical function (p<0.04), role limitations resulting from emotional status (p<0.01), and mental health (p<0.04) were statistically significant.

CONCLUSION

The findings of the study confirmed the effectiveness of an educational program based on the PRECEDE Model on decreasing depression level, improving general health, and increasing quality of life in coronary artery bypass grafting surgery patients.

Circulating ICAM‐1, VCAM‐1, E‐Selectin, P‐Selectin, and TNFRII in Patients with Coronary Artery Disease

OBJECTIVE

To evaluate the relationship between the serum concentration of tumor necrosis factor receptor 2 (TNFRII) and some adhesion molecules [including intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), P-Selectin, and E-Selectin] and coronary artery stenosis.

DESIGN AND SETTING

Observational (cross-sectional) study in a University Heart Hospital in Tehran, Iran.

PATIENTS

75 patients with angiographically proven coronary artery disease were compared with 81 individuals who had undergone coronary angiography with no significant evidence of stenosis (control subjects).

METHODS

Soluble adhesion molecules and TNFRII were determined by enzyme-linked immunosorbent assay technique. sICAM-1 and sP-selectin values were significantly higher in patients with coronary artery disease than in control subjects [146(38) vs. 132(48) p < 0.04 and 275(107) vs. 241(104) ng/ml p < 0.04 respectively]. Multiple logistic regression analysis showed sICAM-1 an independent discriminating risk factor for coronary artery disease (p < 0.03). Prediction models that incorporated sICAM-1 in addition to other established coronary risk factors were significantly better at predicting risk than the models based on the other risk factors alone. Multiple regression analysis indicated that sP-selectin levels were greater in patients with single-vessel disease than in the respective normal (p < 0.01).

CONCLUSIONS

Our findings suggest that sICAM-1 has an association with s1 coronary artery disease as such; the evaluation of this marker may improve the coronary risk assessment in Iranian patients.

Plasminogen activator inhibitor-1 polymorphism (4G/5G) predicts recurrence in nonhyperlipidemic postinfarction patients

OBJECTIVE

Nonhyperlipidemic postinfarction patients are at high risk for recurrent coronary events by virtue of incident myocardial infarction (MI); however, few studies assess risk beyond incident MI. The aim of this study was to assess such risk as a function of 37 atherosclerosis-associated genetic polymorphisms and 17 blood marker variables.

METHODS AND RESULTS

Screening of polymorphisms in nonhyperlipidemic postinfarction patients revealed significant risk only for the 4G/5G insertion/deletion polymorphism in the promoter of the plasminogen-activator inhibitor-1 (PAI-1) gene. Outcome event mapping, an exploratory data analysis tool, was then applied to define a subgroup (182 patients from total study population of 846 nondiabetic patients) exhibiting maximal functional dependence of risk on the PAI-1 polymorphism. Cox multivariable regression analyses within the subgroup adjusted for significant clinical covariates and medication use as a function of the PAI-1 polymorphism and 17 atherosclerosis-associated blood markers revealed significant risk for patients homozygous for the 4G allele (hazard ratio 4.30, 95% CI 1.98 to 9.33, P=0.00023), and lack of significant risk-association with any blood marker.

CONCLUSIONS

In a subgroup of normolipidemic postinfarction patients, only the PAI-1 4G/5G polymorphism was associated with recurrent risk from a set of atherosclerosis-associated genetic polymorphisms and blood markers.

Plasma apolipoproteins and risk for age related maculopathy

AIM

To determine if elevated plasma levels of atherogenic and/or anti-atherogenic lipoproteins are risk factors for developing age related maculopathy (ARM).

METHODS

In a cross sectional study in a university clinic setting, 129 patients (72 women and 57 men) underwent colour fundus photography, acuity and contrast sensitivity assessment, and electroimmunoassays of plasma apolipoproteins B (apoB) and A-I (apoA-I), the principal proteins of low density and high density lipoproteins, respectively. Maculopathy stage was assigned using the AREDS grading system.

RESULTS

Levels of apoB in no ARM, mild, intermediate, and advanced ARM groups were 93.3, 91.8, 95.2, and 98.2 mg/dl, respectively. Levels of apoA-I were 147.4, 148.6, 141.0, and 144.9 mg/dl in the same groups. There was no significant association between these measures, typical for age, and maculopathy stage.

CONCLUSION

Although drusen associated with ARM and ageing contain cholesterol and apoB, like the lipid rich core of an atherosclerotic plaque, the results of this study and our previous work in toto make the prospects of a plasma origin for these lesion constituents increasingly untenable. This conclusion is consistent with an emerging hypothesis that a large lipoprotein of intraocular origin is an important pathway for constituent retinal lipid processing and the biogenesis of drusen.

The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy--a review of the evidence

During the last several years interest has focused on the importance of the lipid-transporting apolipoproteins--apoB transports all potentially atherogenic very low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL) and LDL particles, and apoA-I transports and acts as the major antiatherogenic protein in the HDL particles. The evidence for the apoB/apoA-I ratio being a strong, new risk factor for cardiovascular (CV) disease and a target for lipid-lowering therapy is reviewed. Results from clinical prospective studies and lipid-lowering trials in healthy subjects and in patients with different clinical manifestations of atherosclerosis are reported. Risk of nonfatal and fatal myocardial infarction and stroke, and manifestations of atherosclerosis documented by angiographic, ultrasound and other techniques has been related to conventional lipids and apolipoproteins (apo). The cholesterol balance determined as the apoB/apoA-I ratio has repeatedly been shown to be a better marker than lipids, lipoproteins and lipid ratios. The results indicate that the apoB/apoA-I ratio is a simple, accurate and new risk factor for CV disease--the lower the apoB/apoA-I ratio, the lower is the risk. Guidelines should be developed in order to recognize the important clinical risk information embedded in the apoB/apoA-I ratio.

Cardiovascular risk factors in males with hypertriglycemic waist (Tehran Lipid and Glucose Study)

BACKGROUND

Many studies performed on nontraditional risk factors have proposed a metabolic triad including increased serum level of apolipoprotein B, hyperinsulinemia and high small, dense LDL-C as a risk factor of cardiovascular diseases. Hypertriglycemic waist (increased waist circumference as well as high fasting triglyceride level) can be used as a simple criterion to predict the metabolic triad. The aim of this study was to investigate the prevalence of hypertriglycemic waist and the frequency of cardiovascular risk factors in the affected population.

MATERIALS AND METHODS

The study was performed on 4169, 18-70 y-old male subjects of the population of Tehran Lipid and Glucose Study (TLGS). The subjects fell into four groups with respect to serum level of fasting triglycerides (Tg) and waist circumference (WC). Subjects of group 1 had serum Tg > or =1.8 mmol/l as well as WC > or =95 cm, while those of group 2 had Tg > or =1.8 mmol/l and WC <95 cm. The triglycerides level was less than 1.8 mmol/l in groups 3 and 4, whereas WC was > or =95 cm and lower than 95 cm, respectively. Cardiovascular risk factors, anthropometric and laboratory variables were compared between the groups.

RESULTS

In total, 784 subjects had high serum levels of Tg as well as increased WC. The mean age of subjects was significantly higher in groups 1 and 3 compared to others (37+/-15, 48+/-14, 41+13 and 46+/-13 y of age in groups 4, 3, 2 and 1, respectively, P<0.001). The prevalence of cardiovascular risk factors was significantly higher in group 1 as compared with others. Systolic and diastolic blood pressure, body mass index and WC were significantly higher in group 1 than in the others. Serum total cholesterol, Tg and LDL-C were significantly higher in group 1 compared to others, whereas HDL-C was significantly lower in this group. The prevalence of subjects who had at least four risk factors was 75 and 8% in groups 1 and 4, respectively.

CONCLUSION

Hypertriglycemic waist can be used as a simple criterion to predict cardiovascular risk factors.

Circulating ICAM‐1, VCAM‐1, E‐Selectin, P‐Selectin, and TNFαRII in Patients with Coronary Artery Disease

OBJECTIVE

To evaluate the relationship between the serum concentration of TNFalphaRII and some adhesion molecules (including ICAM-1, VCAM-1, P-selectin and E-selectin) and coronary artery stenosis.

DESIGN AND SETTING

Observational (cross-sectional) study in a university heart hospital in Tehran, Iran.

PATIENTS

81 patients with angiographically proven coronary artery disease were compared with 75 individuals who had undergone coronary angiography with no significant evidence of stenosis (control subjects).

METHODS

Soluble adhesion molecules and TNFalphaRII were determined by enzyme-linked immunosorbent assay technique. sICAM-1 and sP-selectin values were significantly higher in patients with coronary artery disease than in control subjects (146 +/- 38 vs. 132 +/- 48 p < 0.04 and 275 +/- 107 vs. 241 +/- 104 ng/ml p < 0.04 respectively). Multiple logistic regression analysis showed sICAM-1 as an independent discriminating risk factor for coronary artery disease (p < 0.03). Prediction models that incorporated sICAM-1 in addition to other established coronary risk factors were significantly better at predicting risk than the models based on the other risk factors alone. Multiple regression analysis indicated that sP-selectin levels were greater in patients with single-vessel disease than in the respective normal (p < 0.01).

CONCLUSIONS

Our findings suggest that sICAM-1 has an association with stable coronary artery disease and the evaluation of this marker may improve the coronary risk assessment in Iranian patients.

Association of lipids, lipoproteins, apolipoproteins and paraoxonase enzyme activity with premature coronary artery disease

BACKGROUND AND DESIGN

The association of serum apolipoprotein (apo) A-I and apo B concentrations and paraoxonase (PON) enzyme activity with angiographically determined coronary artery disease (CAD) was investigated in Iranian non-diabetic patients with premature CAD and control participants in a sex- and age-matched case-control study.

METHODS

The study population consisted of 59 non-diabetic patients with premature CAD and 55 CAD control participants. Premature CAD was defined as the presence of angiographically proven coronary stenosis (> or =50% involvement) in men and women younger than 55 and 65 years, respectively. Apolipoprotein concentrations were measured by immunoturbidometric assay and paraoxonase/arylesterase activities by spectrophotometric assay of p-nitrophenol/phenol production following addition of paraoxon/phenylacetate to serum.

RESULTS

In CAD patients, increased concentrations of total cholesterol (215 +/- 43 compared with 193 +/- 43, P < 0.001), low-density lipoprotein cholesterol (137 +/- 46 compared with 116 +/- 39, P < 0.05) and apo B (102 +/- 24 compared with 84 +/- 17, P < 0.001) and a decreased ratio of apo A-I/apo B (1.7 +/- 0.4 compared with 2.0 +/- 0.6, P < 0.001) were observed compared to the control group. Other study variables were not significantly different between the two groups. On multiple logistic regression analysis, the only marker for discrimination between the CAD+ group and the CAD- control group was apo B level.

CONCLUSIONS

In Iranian non-diabetic patients with premature CAD, the concentration of apo B is a better marker than traditional lipids in discriminating between CAD+ and CAD- patients. The lack of significant difference in PON activity between CAD patients and control participants supports the concept of interethnic variability in PON activity and gene polymorphism observed in other studies.

Reference intervals of Apo A-1 , Apo B and Apo B/Apo A-1 ratio in sample of macedonian population

The disorders of serum concentration of Apolipoproteins A-1 and B (Apo A-1 and Apo B), as well as of Apolipoprotein B/Apoliporotein A-1 ratio (Apo B/ Apo A-1) are considered to be independent risk factors for coronary heart disease. It is recommended that each laboratory should asign its own reference intervals for Apo A-1 and Apo B, as well as for Apo B/Apo A-1 ratio, as these depend on the geographical location. For this purpose we determined the serum concentration of Apo A-1 and Apo B and we calculated the Apo B/Apo A-1 ratio in 122 healthy individuals from Macedonian population (70 women and 52 men), aged 18-60 years. We used commercial, standardized manual immunoturbidimetric assay (Randox). The obtained concentrations (x ± SD) were: Apo A-1 = 1.39 ± 0.28 g/l in the female population and 1.42 ± 0.27 g/l in the male population, Apo B = 0.95 ± 0.24 g/l in the female and 1.00 ± 0.23 g/l in the male population. The calculated Apo B/Apo A-1 ratio was 0.70 ± 0.17 in the female subgroup and 0.72 ± 0.18 in the male subgroup. Student's t-test detected no significant difference (p>0.05) in mean values for Apolipoproteins A-1 and B and for Apo B/Apo A-1 ratio between female and male subgroups, which lead to the conclusion that division according to sex is not necessary from diagnostic point of view. The Apo A-1 and Apo B concentrations estimated for the mixed group (N=122) were 1.40 ± 0.28 g/l and 0.97 ± 0.23 g/l. The Apo B/Apo A-1 ratio estimated for whole group was 0.71 ± 0.17. The type of distribution of values for Apo A-1, Apo B and Apo B/A-1 ratio was tested by calculating the values of coefficient of asymetry (Skewness), coefficient of flatness (Kurtosis) and standard deviations of these coefficients. The distribution of values was according to Gaussian curve for all three parameters. Therefore, according to the normal distribution reference intervals for Apo A-1, Apo B and Apo B/Apo A-1 ratio was estimated parametrically (mean ± 2 standard deviations). Reference intervals for Apo A-1 were 0.84 - 1.96 g/l, 0.51 - 1.43 g/l for Apo B and 0.37- 1.05 for Apo B/Apo A-1 ratio.