Lipoprotein lipids and the prevalence of hyperlipidaemia in rural India

Obstetric history and its association with cardiometabolic risk factors: a case-control study among Bhil Women of Rajasthan, India

Pregnancy and childbearing are special reproductive events having an impact on women’s health and demographic trends. Reproductive health is not only linked to biological events of gestation and birth, but also are intricately linked to women`s status and their role in society. The current study focuses on the impact of bad obstetric history in the development of cardiometabolic risk factors. The present retrospective case-control study was conducted among Bhil tribal women of Rajasthan, India. A total of 287 women participated in this study which included 125 cases and 162 controls. Data on somatometric measurements, physiological measurements and lipid profile were recorded and analysed using SPSS version 25.0. The mean number of conceptions differed significantly between pregnancy in cases (5.06±1.85) and pregnancy in controls (3.19±1.56). Cases were characterised with significantly increased mean SBP (p=0.010), although the values (116.68±23.04) fell within the normal range. Bad obstetric history was found to be a risk factor for central obesity, hypertension and dyslipidemia among the Bhil women. It was also found to be relatively associated with adverse demographic/lifestyle variables which could enhance the effect of cardiometabolic risk factors. Women with bad obstetric history need special care and lifestyle variables need to be adjusted for better health outputs.

Recent trends in epidemiology of dyslipidemias in India

Dyslipidemia is the most important atherosclerotic risk factor. Review of population based studies in India shows increasing mean total cholesterol levels. Recent studies have reported that high cholesterol is present in 25–30% of urban and 15–20% rural subjects. This prevalence is lower than high-income countries. The most common dyslipidemia in India are borderline high LDL cholesterol, low HDL cholesterol and high triglycerides. Studies have reported that over a 20-year period total cholesterol, LDL cholesterol and triglyceride levels have increased among urban populations. Case-control studies have reported that there is significant association of coronary events with raised apolipoproteinB, total cholesterol, LDL cholesterol and non-HDL cholesterol and inverse association with high apolipoproteinA and HDL cholesterol. Prevalence of suspected familial hypercholesterolemia in urban subjects varies from 1:125 to 1:450. Only limited studies exist regarding lipid abnormalities in children. There is low awareness, treatment and control of hypercholesterolemia in India.

Feasibility of Development of a Cohort in a Rural Area of Sub-Himalayan Region of India to Assess the Emergence of Cardiovascular Diseases Risk Factors

Introduction. Rural area of India is facing epidemiological transitions due to growth and development, warranting a longitudinal study to assess the development of CVDs risk factors. Objective. Feasibility of setting up a rural cohort for the assessment and development of biochemical risk factors for CVDs. Methodology. In Himachal Pradesh, house-to-house surveys were carried out in six villages for anthropometry and assessment of lipid profile. All the information was stored in specifically designed web-based software, which can be retrieved at any time. Results. A total of 2749 individuals of more than 20 years of age were recruited with a 14.3% refusal rate. According to Asian criteria, measured overweight and obesity (BMI > 27.5 kg/m²) were 44.9% and 10.5%, respectively. Obesity was significantly more (P = 0.01) among females (11.7%) as compared to males (8.4%). The prevalence of prehypertension and hypertension was observed to be 16.3% and 37.4%, respectively. Eighty percent of individuals had borderline (46.5%) to high (35.4%) level of triglycerides (TGs). Elevated total cholesterol (TC) and low density lipoprotein (LDL) level were observed among 30.0% and 11.0% individuals only. Conclusion. A high prevalence of biochemical risk factors for CVDs in a rural area urges establishment of an effective surveillance system.

Community based assessment of biochemical risk factors for cardiovascular diseases in rural and tribal area of himalayan region, India

Context. Evident change in nutrition and lifestyle among individuals of urban and rural areas raises suspicion for similar change in tribal area population of India. Aim. To study the biochemical risk factor for CVDs in rural and tribal population of Sub-Himalayan state of India. Settings and Design. Cross-sectional study in rural (low altitude) and tribal (high altitude) area of Himachal Pradesh, India. Methodology. Blood lipid profile using standard laboratory methods. Statistical Analysis. Chi-square test and multiple linear regression analysis. Results. Total of 900 individuals were studied in both areas. As per Asian criteria, obesity (BMI 27.5-30.0 kg/m(2)) was observed to be significantly high (P = 0.00) as 13.7% in tribal area as compared to 5.5% in rural area. Normal level of TC (<200 mg/dL) and LDL (<130 mg/dL) was observed in the majority of the population of both areas, whereas, at risk level of HDL (<40 mg/dL) was present in half of the population of both rural and tribal areas. The prevalence of borderline to high level of TGs was observed to be 60.2% and 55.2% in rural and tribal (P = 0.10) area, respectively. Conclusion. Prevalent abnormal lipid profile in tribal area demands establishment of an effective surveillance system for development of chronic diseases.

Plasma total cholesterol level and some related factors in northern Iranian people

BACKGROUND

In middle age people, hypercholesterolemia (HC) has been included as a risk factor for cardiovascular disease.

OBJECTIVES

The main objective of this study was to evaluate the prevalence of HC and some related factors in the north of Iran.

MATERIALS AND METHODS

This was a population-based cross-sectional study that enrolled 1995 subjects (997 males and 998 females) in 25-65 year age using stratified cluster sampling. Interviewers recorded the data using a multidimensional questionnaire including anthropometric indexes. Plasma cholesterol was measured in the morning after a 12-hour fast and determined by an auto-analyzer. HC was defined by a total plasma total cholesterol level over 200 mg/dl. The SPSS.16 software was used to analyze data.

RESULTS

The mean age of the participant was 44.2 years and mean ± SD plasma total cholesterol level in men and women was 196.7 ± 39.11 and 209.4 ± 42.9, respectively. Generally, the prevalence of HC was 50.4% with a significant differences between men (44.7%) and women (57%) (P < 0.05). The mean plasma total cholesterol levels were significantly differenced among age groups, location area, BMI, and waist circumferences (P < 0.001). Women gender (OR = 1.64), 55-65 years old (OR = 2.79), BMI ≥40 kg/m(2) (OR = 10.0), and abdominal obesity (OR = 2.47) were associated with increased risk of HC (P = 0.001 and 95%CI for all).

CONCLUSION

HC is one of the most health problems in the northern Iran and it is more common in women than in men. General and abdominal obesity are the most common risk factors for HC.

Antihyperglycemic and antihyperlipidemic activities of 2-(4-[(2-hydroxybenzyl) amino]-phenyl amino-methyl)-phenol in STZ induced diabetic rats

Oral administration of 2-(4-[(2-hydroxybenzyl) amino]-phenyl amino-methyl)-phenol (HBPMP) (30 mg/kg) to Streptozotocin (STZ) rats produced significant antidiabetic activity after 6 h of HBPMP administration. Treatment of the STZ rats with HBPMP (30 mg/kg/day) for 30 days resulted in a significant decrease in their Fasting Blood Glucose (FBG), Serum Total Cholesterol (TC), Low Density Lipoprotein-Cholesterol (LDL-C), Very Low Density Lipoprotein-Cholesterol (VLDL-C) and triglycerides (TG) along with an increase in serum High Density Lipoprotein-Cholesterol (HDL-C) levels. Activities of Serum Aspartate transaminase (AST), Alanine transaminase (ALT) and Alkaline phosphatase (ALP) and levels of blood urea and creatinine were improved to near normal levels in the treated STZ rats indicating the protective role of the HBPMP against liver and kidney damage and its non-toxic property. In conclusion, HBPMP possesses antihyperglycemic and antihyperlipidemic activities.

Hypolipidemic activity of crude polyphenols from the leaves of Clerodendron colebrookianum Walp in cholesterol fed rats

This study evaluated the hypolipidemic effect of crude polyphenol fraction from Clerodenrdon colebrookianum (CPCC) leaves in cholesterol fed rats. Crude polyphenol fraction was obtained from the ethyl acetate extract of Clerodenrdon colebrookianum (CC). Investigation was conducted by administering graded oral doses (0.25 g, 0.5 g and 1 g/kg b. w. /day) of the CPCC for a period of 28 days. Significant (p < 0.01) rise in plasma total cholesterol (TC), triglycerides (TG), phospholipids (PL), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C) and decrease in high-density lipoprotein cholesterol (HDL-C) were observed in cholesterol fed rats. Increased lipid profile has been depleted and high-density lipoprotein cholesterol (HDL-C) has been increased after chronic feeding of CPCC. In addition, CPCC extract enhanced the excretion of fecal cholesterol (FC) but could not arrest the 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase activities. Histopathological observations showed loss of normal liver architecture in cholesterol fed rats which were retained in CPCC treated groups. Moreover, the analysis of CC extract demonstrated the presence of substantial amount of total polyphenols, flavonoids and tannins content, further HPLC analysis led to the identification and quantification of two most important biologically active secondary metabolites i.e. (+) Catechin (432 ppm) and Quarcetin (105 ppm). The findings of this study suggested that CPCC had a strong hypolipidemic function and could be used as a supplement in healthcare foods and drugs.

Association of educational, occupational and socioeconomic status with cardiovascular risk factors in Asian Indians: a cross-sectional study

BACKGROUND

To determine correlation of multiple parameters of socioeconomic status with cardiovascular risk factors in India.

METHODS

The study was performed at eleven cities using cluster sampling. Subjects (n = 6198, men 3426, women 2772) were evaluated for socioeconomic, demographic, biophysical and biochemical factors. They were classified into low, medium and high socioeconomic groups based on educational level (<10, 10-15 and >15 yr formal education), occupational class and socioeconomic scale. Risk factor differences were evaluated using multivariate logistic regression.

RESULTS

Age-adjusted prevalence (%) of risk factors in men and women was overweight or obesity in 41.1 and 45.2, obesity 8.3 and 15.8, high waist circumference 35.7 and 57.5, high waist-hip ratio 69.0 and 83.8, hypertension 32.5 and 30.4, hypercholesterolemia 24.8 and 25.3, low HDL cholesterol 34.1 and 35.1, high triglycerides 41.2 and 31.5, diabetes 16.7 and 14.4 and metabolic syndrome in 32.2 and 40.4 percent. Lifestyle factors were smoking 12.0 and 0.5, other tobacco use 12.7 and 6.3, high fat intake 51.2 and 48.2, low fruits/vegetables intake 25.3 and 28.9, and physical inactivity in 38.8 and 46.1%. Prevalence of > = 3 risk factors was significantly greater in low (28.0%) vs. middle (23.9%) or high (22.1%) educational groups (p<0.01). In low vs. high educational groups there was greater prevalence of high waist-hip ratio (odds ratio 2.18, confidence interval 1.65-2.71), low HDL cholesterol (1.51, 1.27-1.80), hypertriglyceridemia (1.16, 0.99-1.37), smoking/tobacco use (3.27, 2.66-4.01), and low physical activity (1.15, 0.97-1.37); and lower prevalence of high fat diet (0.47, 0.38-0.57),overweight/obesity (0.68, 0.58-0.80) and hypercholesterolemia (0.79, 0.66-0.94). Similar associations were observed with occupational and socioeconomic status.

CONCLUSIONS

Low educational, occupational and socioeconomic status Asian Indians have greater prevalence of truncal obesity, low HDL cholesterol, hypertriglyceridemia, smoking or tobacco use and low physical activity and clustering of > = 3 major cardiovascular risk factors.

Antihyperglycemic and antihyperlipidemic activities of ethanolic extract of Zygophyllum album in streptozotocin-induced diabetic mice

Zygophyllum album has been mentioned in Tunisian system of folk medicine to be of value in the treatment of diabetes mellitus. The present study was designed to investigate the possible antihyperglycemic effects of ethanolic extracts of the whole plant of Z. album on blood glucose, plasma insulin, serum lipids and hepatic glycogen and metabolism enzymes of carbohydrate in streptozotocin (STZ)-induced diabetic mice. Administration of the ethanolic extract from plant (100 and 300 mg/kg body weight) for 14 days resulted in significant reduction in plasma glucose, cholesterol, triglycerides, low-density lipoprotein, very-low-density liprotein, hepatic glucokinase and glycogen in STZ diabetic mice. In addition to that, significant increase in plasma high-density lipoprotein, hepatic phosphofructokinase and glucose-6 phosphate dehydrogenase was observed in STZ diabetic mice. After administration of the ethanolic extract, the increased level of plasma insulin is not significant in diabetic mice. In conclusion, the present results showed that the ethanolic extract of Z. album possesses significant antihyperglycemic and antihyperlipidemic effects in experimental model of diabetes mellitus.

Sida rhomboidea.Roxb aqueous extract down-regulates in vivo expression of vascular cell adhesion molecules in atherogenic rats and inhibits in vitro macrophage differentiation and foam cell formation

The present study evaluates efficacy of Sida rhomboidea.Roxb (SR) leaves extract in ameliorating experimental atherosclerosis using in vitro and in vivo experimental models. Atherogenic (ATH) diet fed rats recorded significant increment in the serum total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), very LDL (VLDL), autoantibody against oxidized LDL (Ox-LDL), markers of LDL oxidation and decrement in high-density lipoprotein (HDL) along with increment in aortic TC and TG. The ex vivo LDL oxidation assay revealed an increased susceptibility of LDL isolated from ATH rats to undergo copper mediated oxidation. These set of changes were minimized by simultaneous co-supplementation of SR extract to ATH diet fed rats. Histopathology of aorta and immunolocalization studies recorded pronounced atheromatous plaque formation, vascular calcification, significant elastin derangements and higher expression of macrophage surface marker (F4/80), vascular cell adhesion molecule-1 (VCAM-1) and p-selectin in ATH rats. Whereas, ATH+SR rats depicted minimal evidence of atheromatous plaque formation, calcium deposition, distortion/defragmentation of elastin and accumulation of macrophages along with lowered expression of VCAM-1 and P-selectin compared to ATH rats. Further, monocyte to macrophage differentiation and in vitro foam cell formation were significantly attenuated in presence of SR extract. In conclusion, SR extract has the potency of controlling experimental atherosclerosis and can be used as promising herbal supplement in combating atherosclerosis.

Twenty-year trends in cardiovascular risk factors in India and influence of educational status

BACKGROUND

Urban middle-socioeconomic status (SES) subjects have high burden of cardiovascular risk factors in low-income countries. To determine secular trends in risk factors among this population and to correlate risks with educational status we performed epidemiological studies in India.

METHODS

Five cross-sectional studies were performed in middle-SES urban locations in Jaipur, India from years 1992 to 2010. Cluster sampling was performed. Subjects (men, women) aged 20-59 years evaluated were 712 (459, 253) in 1992-94, 558 (286, 272) in 1999-2001, 374 (179, 195) in 2002-03, 887 (414, 473) in 2004-05, and 530 (324, 206) in 2009-10. Data were obtained by history, anthropometry, and fasting blood glucose and lipids estimation. Response rates varied from 55 to 75%. Mean values and risk factor prevalence were determined. Secular trends were identified using quadratic and log-linear regression and chi-squared for trend.

RESULTS

Across the studies, there was high prevalence of overweight, hypertension, and lipid abnormalities. Age- and sex-adjusted trends showed significant increases in mean body mass index (BMI), fasting glucose, total cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides (quadratic and log-linear regression, p < 0.001). Systolic blood pressure (BP) decreased while insignificant changes were observed for waist-hip ratio and low-density lipoprotein (LDL) cholesterol. Categorical trends showed increase in overweight and decrease in smoking (p < 0.05); insignificant changes were observed in truncal obesity, hypertension, hypercholesterolaemia, and diabetes. Adjustment for educational status attenuated linear trends in BMI and total and LDL cholesterol and accentuated trends in systolic BP, glucose, and HDL cholesterol. There was significant association of an increase in education with decline in smoking and an increase in overweight (two-line regression p < 0.05).

CONCLUSION

In Indian urban middle-SES subjects there is high prevalence of cardiovascular risk factors. Over a 20-year period BMI and overweight increased, smoking and systolic BP decreased, and truncal obesity, hypercholesterolaemia, and diabetes remained stable. Increasing educational status attenuated trends for systolic BP, glucose and HDL cholesterol, and BMI.

Antihyperlipidemic effect of the methanolic extract from Lagenaria siceraria Stand. fruit in hyperlipidemic rats

ETHNOPHARMACOLOGICAL RELEVANCE

Lagenaria siceraria Stand. (Cucurbitaceae) fruits have been used, traditionally, in the treatment of hyperlipidemia and atherosclerotic impasse and considered as cardioprotective and cardiotonic drug.

AIM OF THE STUDY

The present work was undertaken to investigate the effects of methanolic extract from Lagenaria siceraria in experimentally induced hyperlipidemia in rats.

MATERIALS AND METHODS

Methanolic extract of Lagenaria siceraria fruits (LSFE) (100, 200 and 300 mg/kg; p.o.) was administered to the high fat-diet-induced hyperlipidemic rats for 30 days to evaluate its antihyperlipidemic activity. Atorvastatin (10mg/kg; p.o.) was used as a standard drug.

RESULTS

At the 30 th day, most significant reduction in lipid levels in the LSFE treated rats as compared to the rats fed with high-fat diet at the 0th day were: total cholesterol 290.14+/-18.42 mg/dl vs. 228.58+/-16.38 mg/dl, low-density lipoprotein cholesterol 195.14+/-8.86 mg/dl vs. 120.57+/-8.11 mg/dl, triglyceride 232.41+/-15.22 mg/dl vs. 181.79+/-15.68 mg/dl, very low-density lipoprotein cholesterol 46.48+/-3.04 mg/dl vs. 36.35+/-3.13 mg/dl (P<0.0001). Conversely, high-density lipoprotein cholesterol levels were significantly (P<0.0001) increased from 48.52+/-6.52 to 71.66+/-5.14 mg/dl. The increase in weight in rats administered with LSFE was less when compared to rats fed with high-fat diet. Moreover, LSFE also exhibited significant increase in excretion of bile acids.

CONCLUSION

The results demonstrate that the LSFE has a definite antihyperlipidemic potential. There is also a valid scientific basis for consuming it in the treatment of coronary artery diseases in India.

Prevalence and association with diabetes and obesity of lipid phenotypes among the hypertensive Chinese rural adults

BACKGROUND

Both dyslipidemia and hypertension are important risk factors for cardiovascular disease. Studies have found that there is a higher risk of dyslipidemia among hypertensive patients. This study was designed to investigate the epidemiologic features of some forms of dyslipidemia in rural hypertensive adults in China.

METHODS

A cross-sectional survey was conducted during 2004 to 2006 through a cluster multistage sampling of a resident group of 6412 hypertensive individuals (2805 men and 3607 women), aged >/= 35 years, in the countryside of Liaoning, China. The cutpoints of lipid phenotypes were based on the 1992 recommendations of the European Atherosclerosis Society.

RESULTS

The most prevalent abnormality was isolated hypercholesterolemia (34.1% for men and 37.3% for women). Mixed dyslipidemias was the second most prevalent abnormality (14.3%). Isolated hypertriglyceridemia was observed in 5.6% of the sample. The prevalence of normotriglyceridemic hypoalphalipoproteinemia and severe dyslipidemia was 2.0% and 3.3%, respectively. Only a few samples had the abnormality of hypertriglyceridemia/hypoalphalipoproteinemia (.8% for men and .3% for women). The prevalence of isolated hypertriglyceridemia, mixed dyslipidemias, and severe dyslipidemia was higher in diabetic patients compared with nondiabetic patients, in either men or women. Compared with those of normal weight, obese men had a higher prevalence of mixed dyslipidemias and hypertriglyceridemia/hypoalphalipoproteinemia, whereas isolated hypertriglyceridemia was prevalent in both genders.

CONCLUSION

The prevalence of lipid phenotypes among these hypertensive patients was relatively high, even in rural China. Diabetes and obesity, the modifiable risk factors, increased the likelihood of having several forms of an atherogenic lipid profile.

Significant lipid, adiposity and metabolic abnormalities amongst 4535 Indians from a developing region of rural Andhra Pradesh

BACKGROUND AND OBJECTIVE

Both migrant and local urban populations of Asian Indians have high rates of cardiovascular disease. Metabolic risk factors appear key to this phenomenon but data from rural India are few. We sought to determine the prevalence and distribution of lipids, obesity and metabolic syndrome in a rural region of Andhra Pradesh.

METHODS

Sampling was done in 20 villages representative of the project area with an age- and sex-stratified group of 4535 adults > or =30 years selected at random from a local census list. The sample represented 13% of all adults > or =30 years in the 20 villages with a response rate of 81%. All participants had interviewer administered questionnaire, physical examination and fasting finger-prick glucose. Every fourth individual had venous blood testing for lipid profile (n=1085). Analysis was done using weighting to obtain estimates of risk factor levels for the adult population in the 20 villages. In addition to standard WHO and 2005 NCEP-ATPIII classifications, exploratory 'Asian' definitions were used for overweight and abdominal obesity.

RESULTS

The population mean levels of total, LDL, HDL-cholesterol and triglycerides were 4.5 (4.4-4.6) mmol/L, 2.8 (2.7-2.9) mmol/L, 1.1 (1.06-1.13) mmol/L, 1.5 (1.4-1.6) mmol/L for men; and 4.8 (4.7-4.9) mmol/L, 3.0 (3.0-3.1) mmol/L, 1.2 (1.16-1.22) mmol/L, 1.3 (1.2-1.4) mmol/L for women. 18.4% of men and 26.3% of women were overweight rising to 32.4% of men and 41.4% of women if 'Asian' definitions were used. Criteria for NCEP-ATPIII metabolic syndrome were met by 26.9% of men and 18.4% of women with figures of 32.5% and 23.9%, respectively, if 'Asian' waist cut-offs were substituted.

CONCLUSIONS

Dyslipidaemia, adiposity and metabolic syndrome were common in this rural Indian population and prevalence was much greater if proposed Asian definitions for adiposity were used. Metabolic risk factors likely play a major role in cardiovascular disease in this region.

Prevalence of dyslipidemia and associated factors among the hypertensive rural chinese population

BACKGROUND

Dyslipidemia plays a crucial rule in the development of cardiovascular disease, which has become the leading cause of death in most developed countries as well as in developing countries. This study was designed to investigate the epidemiological features of dyslipidemia in rural adults with hypertension in China.

METHODS

A cross-sectional survey was conducted during 2004-2006 through a cluster multistage sampling to a resident group of 6,412 individuals (2,805 men, 3,607 women) with hypertension, aged >/=35 years, in the countryside of Liaoning, China. Serum lipids levels were proposed by National Cholesterol Education Program Adult Treatment Panel III.

RESULTS

Of the study population 34.4% had borderline high total cholesterol (TC), 16.9% had high TC, and 8.8% had low high-density lipoprotein cholesterol (HDL-C). The population with borderline high, high, and very high low-density lipoprotein cholesterol (LDL-C) was 15.7, 3.5, and 0.9%, respectively. In addition, 15.9% had borderline high triglycerides (TG), 17.8% had high TG and 2.0% had very high TG. After adjusting for independent variables, TC and TG had the same risk with fasting plasma glucose (FPG) and body mass index. Risk factors of TC and LDL-C were women, age and FPG. Mongolia nationality as a protective factor positively correlated with TC, LDL-C, and TG. Women, age, drinking, and classification of blood pressure were protective factors but Mongolia nationality was a risk factor for HDL-C.

CONCLUSIONS

This study demonstrated that the prevalence of dyslipidemia was relatively high among rural hypertensive patients in China and there were many modifiable risk factors for dyslipidemia such as hypertension, weight, and impaired glucose metabolism. To prevent dyslipidemia and to reduce the increasing burden of cardiovascular disease in rural areas with the undeveloped economy of China, the first aim for us is to reduce these risk factors.

Hypolipidemic effect of different extracts of Clerodendron colebrookianum Walp in normal and high-fat diet fed rats

Clerodendron colebrookianum Walp (family, Verbenaceae) has been used as a home remedy by the Mizo people of north eastern (NE) region of India in their folklore medicine as a cardioprotective (mainly against high blood pressure) agent. The scientific basis for their use has yet to be established. Therefore, in this investigation an attempt has been made to study the effect of different extracts of the leaves of Clerodendron colebrookianum Walp (CC) on serum lipid profile which is closely associated with many cardiovascular diseases. It was found that after administration of both crude and organic extracts the serum lipid profile, i.e. total cholesterol (TC), triglycerides (TG) and low density lipoprotein (LDL) lowered significantly (P<0.001) from their respective control except TG in methanol extract (ME)-treated rats. The decreased percentage of TC, TG and LDL after administration of crude extract (CE) and ethylacetate extract (EE) with normal diet were found to be 35, 39 and 48%, and 33, 18 and 91%, respectively, after 7 days of treatment. In case of ME the lowering of TC and LDL were noted to be 41 and 85%, respectively. Both TC and TG were lowered significantly (P<0.001) even after the administration of crude extract against high-fat diet. Significant increase of cardioprotective lipid, i.e high density lipoprotein (HDL) after administration of EE (46%) and ME (38%) was another interesting finding of this experiment. Total cholesterol:HDL and LDL:HDL ratios were significantly lower in the experimental group. Therefore, it was concluded that the leaves of CC have definite cardioprotective potentiality, and there is a valid scientific basis for consuming it for better health in NE region of India.

Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population

OBJECTIVE

Epidemiological study among urban subjects in western India to determine prevalence of diabetes, insulin resistance syndrome (IRS) and their risk factors.

METHODS

Randomly selected adults > or =20 years were studied using stratified sampling. Target sample was 1,800 (men 960, women 840). 1123 subjects (response 62.4%) were evaluated and blood samples were available in 532 men and 559 women (n=1091, 60.6%). Measurement of anthropometric variables, blood pressure, fasting blood glucose and lipids was performed. Atherosclerosis risk factors were determined using current guidelines. Diabetes was diagnosed when the subject was a known diabetic or fasting blood glucose was > or =126 mg/dl, impaired fasting glucose (IFG) diagnosed when fasting glucose was 110-125 mg/dl. IRS was diagnosed when any three of-IFG, high triglycerides >150 mg/dl, low HDL cholesterol (men<40 mg/dl, women<50 mg/dl), central obesity (men>102 cm, women>88 cm), or high normal blood pressure (>130/>85 mmHg) or hypertension-were present.

RESULTS

Diabetes was present in 70 men (13.2%) and 64 women (11.5%). Age-adjusted prevalence of diabetes was 9.3% in men (95% confidence intervals (CI) 6.7-11.8), 8.1% in women (CI 5.8-10.4) and 8.6% overall (CI 6.9-10.3). IFG was in 28 men (5.3%) and 29 women (5.2%). IRS was present in 52 men (9.8%) and 114 women (20.4%) with age-adjusted prevalence of 7.9% in men (CI 6.7-9.1) and 17.5% in women (CI 14.4-20.6) with an overall prevalence of 12.8% (CI 10.8-14.8). Other metabolic abnormalities of IRS in men and women were high triglycerides in 32.1 and 28.6%, low HDL cholesterol in 54.9 and 90.2%; central obesity in 21.8 and 44.0%, and high normal blood pressure or hypertension in 35.5 and 32.4%. IFG subjects had similar atherosclerosis risk factor profile as normal subjects while those with IRS and diabetes had significantly greater prevalence of obesity, central obesity, hypertension, high triglycerides and low HDL (P<0.01).

CONCLUSIONS

There is s significant prevalence of diabetes and IRS in this urban Indian population. Subjects with diabetes as well as IRS have greater prevalence of obesity, central obesity, hypertension, hypertriglyceridemia and low HDL as compared with normal subjects.

A water-extract of the Korean traditional formulation Geiji-Bokryung-Hwan reduces atherosclerosis and hypercholesteremia in cholesterol-fed rabbits

Geiji-Bokryung-Hwan (GBH), a drug preparation consisting of five herbs of Cinnamomi Ramulus (Geiji), Poria Cocos (Bokryun), Mountan Cortex Radicis (Mokdanpi), Paeoniae Radix (Jakyak) and Persicae Semen (Doin), is a traditional Korean herbal medicine that is widely used in the treatment of atherosclerosis-related disorders. A water extract of GBH was found to scavenge 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals and inhibit low-density lipoprotein (LDL) oxidation more effectively than probucol, a well-known commercially available antioxidant. In order to evaluate the anti-atherogenic potential of this medication, New Zealand White (NZW) rabbits were fed a normal diet for 12 weeks, a high cholesterol diet, a high cholesterol diet containing 1% probucol or a high cholesterol diet containing 5% water-soluble extract of GBH. Both GBH and probucol reduced plasma cholesterol levels. LDLs from the GBH-treated group were more resistant to Cu(2+)-induced oxidation and contained more vitamin E than LDLs from the high cholesterol diet group. Endothelial damage, determined at week 6, was reduced by 55% in the GBH group (P<0.01). GBH treatment reduced an atherosclerotic area in the abdominal aorta by 58% (P<0.05) and cholesterol deposition in the thoracic aorta by 55% (P<0.05). The severity of atherosclerosis in the GBH group was significantly reduced after an adjustment using cholesterol exposure as an index of the cholesterol-lowering effect. On the other hand, diet-induced hyperlipidemic rabbits were given water extract of GBH in doses of 50 (Group B) and 200 mg/kg (Group C) and compared with controls (Group A). At 40 days after intervention in groups A, B and C, total and LDL cholesterol levels were significantly lowered (P<0.01). LDL/high density lipoprotein (HDL) ratio was also significantly decreased (P<0.01). This study concludes that the reduction in atherosclerosis by GBH relies not only on its cholesterol-lowering effect but also more heavily on its antioxidant potential, which prevents endothelial damage and inhibits LDL oxidative modification in hypercholesterolemic animals.

Influence of fish consumption on the distribution of serum cholesterol in lipoprotein fractions: comparative study among fish-consuming and non-fish-consuming populations

The objective of this study was to investigate serum lipoprotein levels in order to assess cardiovascular disease (CVD) risk factors between fish-consuming populations and non-fish-consuming populations, as it has been speculated that fish intake reduces CVD risk. A representative sample of one thousand subjects (529 men and 471 women) were selected, with ages ranging from 20 to 70 years, from 40 villages belonging to fish-consuming (500) or non-fish-consuming (500) populations. Serum lipoprotein lipids such as total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were analysed biochemically using standard procedures. The ratios of TC: HDL-C and LDL-C: HDL-C were computed. Mean values of serum LDL-C and the ratios of LDL-C: HDL-C and TC: HDL-C were significantly lower and HDL-C levels were higher in fish-consumers than in non-fish-consumers. The concentrations of HDL-C decreased with increasing age, while the reverse was true for LDL-C and for the LDL-C: HDL-C and TC: HDL-C ratios. There were significant sex differences for certain age groups in both of the population groups. The 5th, 50th and 95th percentile cut-off values for these parameters were lower in fish-consumers than in non-fish-consumers. The prevalence of individuals at risk of CVD because of low HDL-C (<35 mg/dL), high LDL-C (>130 mg/dL) and their atherogenic ratios (LDL-C: HDL-C >3.5 and TC: HDL-C>4.5) was significantly greater in non-fish-consumers. This study highlights that the fish-consuming population had a lower atherogenic risk than the non-fish-consuming population. The intake of fish may have substantial implications for public health and health economy by decreasing the risk of CVD. However, more studies are warranted to better define the mechanisms of cardioprotection by dietary fish and fish oils.

Smoking and lipid cardiovascular risk factors in Vietnamese refugees in Australia

BACKGROUND

The effects of smoking and sex on lipid risk factors for cardiovascular disease were examined among Vietnamese people newly arrived in Australia.

METHODS

Immigrants recruited through Refugee Screening had anthropometric data recorded and blood collected to measure total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and triglyceride (TG) by Reflotron; apolipoprotein A-1 (apo A-1) and apolipoprotein B-100 (apo B) by immunoturbidimetric analyses (Turbitimer); and lipoprotein (a) (LP (a)) by ELISA. A questionnaire determined behavioral variables known to influence cardiovascular risk and Statview, Minitab, and SPSS were employed for data analysis.

RESULTS

Lipoprotein profiles of men (n = 242) and women (n = 159) were compared. Crude TC and apo B were similar; HDL, apo A-1, and LP (a) were higher in women, TG was higher in men. After adjustment (age, BMI, WHR, years of smoking, and drinks per week), only apo A-1 and LP (a), were higher in women. "At risk" levels of TC or apo B did not differ by gender; risk of low apo A-1 was higher among men. Smokers had a significant risk (crude and adjusted) of low HDL, low apo A-1, and high LP (a). The sex difference in HDL was removed by a single adjustment for smoking; male smokers had higher LP (a) than male nonsmokers.

CONCLUSION

Male and female Vietnamese immigrants had similar adjusted lipid profiles. Smoking had a marked detrimental effect on lipids.

Prevalence and determinants of coronary heart disease in a rural population of India

BACKGROUND

The prevalence and determinants of coronary heart disease (CHD) have been inadequately studied in rural areas of developing countries.

METHODS

Entire communities were surveyed in randomly selected villages in Rajasthan, India. A physician-administered questionnaire, physical examination, and electrocardiogram (ECG) were performed on 3148 adults > or = 20 years of age (1982 males, 1166 females). Fasting blood samples for determination of lipids were obtained from 202 males and 98 females. Prevalence of coronary risk factors--smoking, hypertension, sedentary life-style, obesity, and hypercholesterolemia--was determined. CHD was diagnosed on basis of past documentation, response to WHO-Rose questionnaire, or changes in ECG. Three methods were used: (a) documentation, history, and ECG criteria, (b) ECG-Q, ST, or T changes, and (c) presence of Q waves.

RESULTS

Coronary risk factors: smoking was present in 51% males and 5% females, hypertension (> or = 140/90 mmHg) in 24% males and 17% females, hypercholesterolemia (> 200 mg/dl) in 22%, diabetes history in 0.2%, and irregular physical activity or sedentary habits in 85%. Other risk factors were lack of formal education in 44%, obesity (body-mass index > or = 27 kg/m2) in 6% and truncal obesity (waist-hip ratio > or = 0.95) in 5%. The prevalence of CHD (clinical + ECG criteria) was 3.4% in males and 3.7% in females. According to ECG criteria only, it was 2.8% in males and 3.3% in females and according to Q-waves only, it was 1.6% in males and 0.9% in females. Multivariate logistic regression analysis showed that age and smoking in males and age and systolic blood pressure in females were associated with higher prevalence of Q-wave CHD. In males, higher educational level and prayer habit were associated with lower prevalence.

CONCLUSIONS

Prevalence of CHD in this rural community is higher than in previously reported Indian studies. Smoking, hypertension, and sedentary lifestyle have high prevalence. Significant determinants of CHD are increasing age and smoking while education and prayer-habit are protective.

Hypocholesterolaemic effects of Terminalia arjuna tree bark

Diet-induced hyperlipidaemic rabbits were given 50% ethanolic extract of Terminalia arjuna tree bark in doses of 100 mg/kg (Group B, n = 6) and 500 mg/kg (Group C, n = 6) and compared with controls (Group A). At 60 days of intervention in Groups A, B and C mean +/- S.E.M. total cholesterol was 574 +/- 61, 320 +/- 29 and 217 +/- 44 mg/dl, respectively (P < 0.01); LDL cholesterol was 493 +/- 57, 271 +/- 30 and 162 +/- 44 mg/dl (P < 0.01); HDL cholesterol was 59 +/- 7, 36 +/- 3 and 35 +/- 4 mg/dl (P = n.s.); triglyceride was 108 +/- 13, 67 +/- 6 and 101 +/- 26 mg/dl (P = n.s.); cholesterol/HDL ratio was 10.1 +/- 1.3, 9.2 +/- 1.1 and 6.1 +/- 1.0 (P = n.s.); and LDL/HDL ratio was 8.7 +/- 1.3, 7.8 +/- 1.1 and 4.5 +/- 1.0 (P < 0.01). The extract did not adversely affect biochemical tests of liver and renal function and haematological parameters.

Hypolipidaemic effect of Myristica fragrans fruit extract in rabbits

The ethanolic extract of nutmeg (Myristica fragrans) was studied in albino rabbits for its effects on experimentally induced hyperlipidaemia. After inducing hyperlipidaemia in 12 rabbits a dose of 500 mg/kg of the extract was administered orally daily for a period of 60 days in 6 rabbits (experimental group); the rest of the rabbits were observed as controls. When compared with the control of rabbits the levels of lipoprotein lipids were significantly lower in the experimental group after 60 days; total cholesterol 573 +/- 61 vs. 209 +/- 27 mg/dl, low density lipoprotein (LDL) cholesterol 493 +/- 57 vs. 131 +/- 25 mg/dl, and triglycerides 108 +/- 14 vs. 67 +/- 9 mg/dl P < 0.001). High density lipoprotein (HDL) cholesterol levels were not significantly different (59 +/- 7 vs. 65 +/- 4 mg/dl, P = n.s.). Total cholesterol:HDL ratio and LDL:HDL ratio were significantly lower in the experimental group. The Myristica fragrans extract showed platelet anti-aggregatory ability. There were significantly lower levels of total cholesterol in heart (3.7 +/- 0.5 vs. 2.2 +/- 0.5 mg/100 g) and liver (11.9 +/- 1 vs. 1.5 +/- 0.4 mg/100 g). The toxicity studies showed absence of any adverse effects on various haematological and biochemical parameters.