High Density Lipoprotein Cholesterol as a Risk Factor of Coronary Artery Diseases in Young Western Indians: A Comparison with Other Lipid Markers

Abstract

Introduction: Dyslipidemia – a modifiable risk factor of Coronary Artery Diseases (CAD) is often subjected to ethnic variations. Different communities are known to possess different pattern of lipid abnormalities and study of it is highly required in order to form various preventive strategies. Aim: To compare the prevalence of dyslipidemias in healthy control versus young CAD patients from Western India. We also seek to assess the strength of each associated dyslipidemia and propose a most suited risk factor for this community. Materials and Methods: In this single centric, prospective and case control study 200 subjects (100 patients with CAD & 100 healthy volunteer) were enrolled. Fasting blood sample were collected from the antecubital vein of the subjects under sterile conditions. Lipid profile parameters such as Total Cholesterol (TC), Triglyceride (TG), Total Lipid (TL), Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL), and Very Low Density Lipoprotein Cholesterol (VLDL), Lipoprotein (a) were measured. Statistical Analysis: Comparison between normally distributed data was performed using student’s t-test, whereas, normally not distributed data was assessed using Mann-Whitney U test. Logistic regression analysis was performed to assess the strength of association of an individual risk factor. Significance was taken as two tailed p<0.05. Results: There was equal number of patients divided in case and control group. In all 65 males and 35 females and, 59 males and 41 females in case and control group respectively (p=0.47). The distribution of cardiovascular risk factors was significantly (p<0.05; BMI: 23.96±4.37 vs 22.65±4.55; diabetes: 10% vs 2%; hypertension: 41% vs 11%; Smoking: 11% vs 1%) higher in CAD patients as compared to control population. The level of HDL was significantly lower in cases, whereas all other lipid parameters except LDL were higher in cases as compared to control (p<0.05). Odds ratio analysis showed that low HDL levels 11.76 (95% CI 4.69 to 29.49) is the strongest associate of CAD amongst all other lipids in Western Indian population. Conclusion: The study results conclude that in young CAD patients from western India the role of low HDL is significant as compared to other dyslipidemias.

Keywords

• case-control study
• cardiovascular diseases
• dyslipidemias