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A clinical study of lipid profile in hospital population.

Introduction

In an average Indian population diseases due to altered levels of lipid profile are more. A number of diseases including coronary artery disease (CAD) are manifested due to the accumulation of fat in the sub endothelial space of arteries. There is a great variations in serum lipid values in rural population and usually are affected by food habits, life style, races and socio-economic status etc (1). A reference value may be defined as a value obtained by observation or measurements of a particular type of quantity on the reference individual (2). An increased value of lipid profiles can be seen in some other clinical condition such as hypothyroidism and obesity (3). Decreased values are always associated with hyperthyroidism and the condition generally called hypo lipidemia. Hence estimation of lipid profiles will help in the diagnosis of these diseases.

Materials and Methods

The present study was conducted for a period of one year from June 2008 to May 2009. During this period the patients came to Dr.Pinnamaneni Siddhartha Institute of Medical Science and Research Foundation and Rx Labs and Research Centre, Gannavaram were screened for lipid profile. The present study comprises 243 patients, out of which 146 were males (age ranges from 20-80 yrs) and 97 were females (age ranges from 20-80 yrs). The patients show one or other clinical symptoms of heart disorder. For the sake of present study the patients were again categorized according to their age & sex, in order to know that which group is more prone to the lipid related diseases. 12 hours overnight fasting blood sample was collected about 3 ml; serum was separated and analyzed for lipid profile with in 5 hrs after collection. The test kit used for Total Cholesterol (4), HDL-Cholesterol (5), Triglycerol (Tg) (6), was procured from Nicholas Piramal India Ltd, Navi Mumbai. LDL- Cholesterol and VLDL-Cholesterol were estimated by FRIEDWALD'S formula (7). The remaining chemicals and reagents used in this study are of analytical reagent grade (AR) procured from SD Fine-Chem Ltd, Mumbai. The results were statistically evaluated with Mean [+ or -] SE with probability (P<0.05).

Results

The mean values of lipid profile Total Cholesterol, HDL-Cholesterol, Triglycerol (Tg), LDL-Cholesterol and VLDL-Cholesterol of male are presented in the Table-I & the mean values of lipid profile Total Cholesterol, HDL-Cholesterol, Triglycerol (Tg), LDL- Cholesterol and VLDL-Cholesterol of female are presented in the table-II. The overall lipid profiles (MEAN [+ or -] SE) of both male and female with age groups are presented in table -III. The graphs I & II represents the mean values of lipid profile in male and female. The graph III, IV & V represents the mean values of lipid profile with differentiation of age groups like <40 yrs, 41-60 and >61 yrs in both males and females.

* The data shown were means of male patients

* The data shown were menas of female patients

[GRAPHIC 1 OMITTED]

* The graph represents the mean values of lipid profile male with age group differentiation i.e. <40 yrs, 41-60 yrs and >61 yrs

[GRAPHIC 2 OMITTED]

* The graph represents the mean values of lipid profile female with age group differentiation i.e. <40 yrs, 41-60 yrs and >61 yrs

[GRAPHIC 3 OMITTED]

* The graph represents the mean values of lipid profile of male and female with age group differentiation i.e. <40 yrs.

[GRAPHIC 4 OMITTED]

* The graph represents the mean values of lipid profile of male and female with age group differentiation i.e. 41-60 yrs. Graph-V

[GRAPHIC 5 OMITTED]

* The graph represents the mean values of lipid profile of male and female with age group differentiation i.e. >61 yrs.

Discussion

The results of the present study clearly show that the number of males more than the females, who has under gone the biochemical analysis of lipid profiles. Among those the age group 41-60 yrs is more both in males and females, which indicate the lipid associated disorders are more prone in this age group, when compared with the remaining age groups. The abnormalities of blood lipids are related mainly to different dietary habits of people, life style, and heredity along with other factors. Triglycerides serve as depots of metabolic fuels and as energy source (8). When we compared this data with the normal data, there is no significance variation was seen. But the people are suffering with one or other clinical symptoms of heart related problems. As it is evident that the lipid molecules play a major role in various diseases, the prevalence is more for coronary artery diseases which are always associated with lipidemies. Epidemiological studies suggested that triglycerides play an important role in determining the most of the lipid related disorders. The primary course of high triglycerides includes familial hyper cholesterolemia and secondary effecter can arise due to carbohydrate, alcohol and diabetes induced high triglycerides, obesity, chronic renal failure nephritic syndrome, excessive stress etc (9). The life style of a person can highly influence the lipid parameters. The habit of smoking, alcohol consumption can modify the lipid levels (10). The nicotine stimulates the release of adrenalin leading to increased serum concentration of fatty acids, this fatty acids is stimulates of hepatic synthesis and can release cholesterol (11). Atherosclerosis is caused by many other factors like consumption of fat, excessive drinking of alcohol, hypertension etc (12). So the incidence of lipid disorders is found to be more in male patients. In female patients, another reason for the increase of lipid profile in the serum is lack of exercises and sedentary life style. A moderate level of exercises can help to utilize the fats stored in the adipose tissue.

The present study concludes that complete history of the patients to categorize according to their life style, food habits, level of exercise are necessary to know the incidence of lipid related disorders. The patients are, more in the age group 41-60 yrs that clearly indicates the lipid related disorders are more in this group But the female patients shows more values when compared with the male in the same age group. So the risk group is 41-60 yrs.

References

[1] Robert K.Murray Daryl K. Granner, Peter A. Mayes, Victor W. Rod Well: Harper's Biochemistry, 25th Edition. 2004

[2] Burtis CA, Ashwood ER. Establishment and use of Reference Values, Tietz Text book of Clinical chemistry, chapter 14, 3rd Edition 1991.

[3] David W.Martin, Harper's review of Biochemistry, 20th Edition. 1985.

[4] Trider P, Estimation of Serum Cholesterol Ann. Clin. Biochemistry, 6:24, 1969

[5] Harris N Galpchian V, and Rifai N, Three routine methods for measuring High Density Lipo protein cholesterol compared with the reference method. Clin.Chem 42:738-743, 1996

[6] Bethesda MD, NIH/NHLBINIH Publication No.95-3044, National Institute of Health, National Cholesterol Education Programme: Recommendation on lipoprotein measurement, 1995

[7] Friedwald W.T, Leery R.I and Fredrickson D.S, Estimation of the concentration of Low Density Lipoprotein Cholesterol in plasma without use of the preparative ultracentrifuge. Clin. Chem. 18:499-502, 1972

[8] DM Vasudevan, Sree Kumari s, Text book of Biochemistry, 3rd Edition 2001.

[9] Mysore P.Ram Prasad An update of cellular basis of Atherosclerosis in Hypertriglyceredimia. Ind. J. Clin. Biochem 10:2-8, 1995.

[10] Manson J.E. Tosteson H & Ridker PH The primary prevention of Myocardial infarction. N. Eng. J. Med 326:1406-1416, 1992.

[11] Banonome A. Pagnon. Biffabti S Opportune A, Sorgato F, Dorella M. Maiorono M and Ursine F, Effect of dietary monounsaturated and polyunsaturated fatty acids on the susceptibility of plasma low density lipoproteins to oxidative modifications: arterioscler. Thromb 12:529-533, 1992.

[12] U.Satyanarayana, Biochemistry. 1999.

(1) Raja Kumar Parabathina, (2) Lakhmana Swamy Parasa, (3) Aswani Kumar Kamisetty and 4Somasekhara Rao Kaza

(1) Email: kumar rajaparabathina@yahoo.co.in

(1) Ph.D Scholar, Department of Biochemistry, Acharya Nagarjuna University, Nagarjuna Nagar, Guntur

(2) Rx labs & Research Centre, Gannavaram.

(3) Deparmment of Vety, Biochemistry, NTR CVSc, Gannavaram

(4) (Rtd) Professor, Department of Chemistry, ANU PG Centre, Nuzvid
Table I: The Mean values of lipid profile of Male.

Age group in years
Parameter in mg/dl   <40   41-60   >61

Total Cholesterol    198    200    192
HDL-Cholesterol       37     40     38
Triglycerol (Tg)     197    194    191
LDL- Cholesterol     144    141    134
VLDL-Cholesterol      28     28     28

* The data shown were means of male patients

Table II: The Mean values of lipid profile of Female.

Age group in years
Parameter in mg/dl   <40   41-60   >61

Total Cholesterol    213    228    224
HDL-Cholesterol       38     39     40
Triglycerol (Tg)     204    211    204
LDL- Cholesterol     119    129    125
VLDL-Cholesterol      32     31     30

* The data shown were means of female patients

Table III: The Mean  [+ or -]  SE values of lipid profile
of Male & Female.

Age group in
years                            <40

Parameter in
mg/dl               Male(35)            Female(31)

Total          198 [+ or -] 3.9     213 [+ or -] 2.5 *
Cholesterol
HDL-            37 [+ or -] 0.64     38 [+ or -] 1.2
Cholesterol
Triglycerol    197 [+ or -] 2.3 *   204 [+ or -] 2.2 *
(Tg)
LDL-           144 [+ or -] 2.5 *   119 [+ or -] 3.2
Cholesterol
VLDL-           28 [+ or -] 1.65     32 [+ or -] 1.3
Cholesterol

Age group in
years                            41-60

Parameter in
mg/dl               Male(82)            Female(55)

Total          200 [+ or -] 2.8     228 [+ or -] 3.9
Cholesterol
HDL-            40 [+ or -] 0.8      39 [+ or -] 1.1
Cholesterol
Triglycerol    194 [+ or -] 2.3 *   211 [+ or -] 2.3 *
(Tg)
LDL-           141 [+ or -] 3.8     129 [+ or -] 2.7
Cholesterol
VLDL-           28 [+ or -] 1.7      31 [+ or -] 0.86
Cholesterol

Age group in
years                            >61

Parameter in
mg/dl               Male(29)            Female(11)

Total          192 [+ or -] 2.5 *   224 [+ or -] 2.4 *
Cholesterol
HDL-            38 [+ or -] 1.02     40 [+ or -] 2.7
Cholesterol
Triglycerol    191 [+ or -] 2.1 *   204 [+ or -] 2.2 *
(Tg)
LDL-           134 [+ or -] 2.3 *   125 [+ or -] 3.4
Cholesterol
VLDL-           28 [+ or -] 2.4      30 [+ or -] 1.44
Cholesterol

** The data shown were means of all male and female patients.

** Means with * superscripts, within a row differ significantly.
* P <0.05.


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Article Details
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Author:Parabathina, Raja Kumar; Parasa, Lakhmana Swamy; Kamisetty, Aswani Kumar; Kaza, Somasekhara Rao
Publication:International Journal of Biotechnology & Biochemistry
Article Type:Clinical report
Geographic Code:9INDI
Date:Sep 1, 2009
Words:1645
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