Association of lipids with coronary heart disease in a saudi population

Mohmed Elfatih Ashmaig,Khalifa Ashmeik,Atif Ahmed,Muheeb Abdulla,Samia Sobki

doi:10.1590/s1677-54492011000200007

Abstract

BACKGROUND: The Saudi population is known to have an unhealthy diet in addition to physical inactivity. OBJECTIVE: To investigate the lipid-mediated risk factors that might be associated with increased incidence of coronary heart diseasein the Saudi population as this was found in Western populations. MATERIALS AND METHODS: Two hundred and twenty subjects suspected of having coronary heart disease underwent coronary angiography and blood draw following a 12-hour fast. Total and HDL cholesterol, triglycerides, Lp(a) and lipoprotein lipase were measured by standard methods. Small, dense LDL was measured by the iodixanol method with an ultracentrifugation of only 2.5 hours. RESULTS: One hundred and forty subjects were found to be positive for coronary heart disease while 80 subjects were shown to be negative for this disease. Statistically significant risk factors for coronary heart disease in the Saudi population were hypertriglyceridemia (1.93±0.95 versus1.45±0.16 mmol/L;p<0.0001); low HDL cholesterol (1.09±0.55 vs 1.33±0.63 mmol/L, p=0.0001); high Lp(a) (46.8±45.58 versus 29.06±17.03 mg/dL;p=0.019); and the presence of small, dense LDL (1.0314±0.0028 versus 1.0300±0.0003 g/kg;p=0.0099). Total cholesterol (4.99±1.11 versus 4.75±1.11 mmol/L;p=0.099), LPL (35.56±26.6 versus 27.89±11.96 IU/L;p<0.059), and LDL cholesterol (3.06±1.12 versus 2.79±1.08 mmol/L;p=0.08) were not found to be statistically significant coronary heart disease risk factors. CONCLUSIONS: This study indicates that high TG, low HDL, high Lp(a) and the presence of small, dense LDL may contribute to the incidence of coronary heart disease and that TC was not significantly associated with incidence of coronary heart disease in the Saudi population.

Highlights

Coronary heart disease (CHD) is the leading cause of morbidity and mortality inindustrial and developing countries
In a 15-year long populationbased prospective study of 11,068 Japanesesubjects aged between 40-69 years initially free of CHD or stroke, the incidence of CHDwas positively correlated to high triglycerides in both genders8.a 17-year meta-analysis of population-based prospective studies of 46,413men and 10,864 women confirmed that plasma triglyceride level is a significant riskfactor for cardiovascular disease independent of HDL-cholesterol levels for both men andwomen[9]
The hypothesis of this study is that the predominance of small dense LDL and the elevated levelsof traditional coronary risk factors influenced by diet and physical inactivity might play a role asmajor risk factors for CHD in an angiographically defined unique group in the Saudi Arabianpopulation. This under-studied Saudi population has been targeted for multiple lipid-mediatedrisk factors measurement, the small, dense LDL.The objective of this study was to evaluate this hypothesis on the strength of the availableevidence that the Saudi population has a diet and lifestyle that is inappropriate for cardiovascularhealth[24].We hypothesize that the Saudi population will demonstrate increased cardiovascular riskas determined by traditional and emerging biomarkers of CHD risk, small, dense LDL

Summary

Introduction

Coronary heart disease (CHD) is the leading cause of morbidity and mortality inindustrial and developing countries. In a 15-year long populationbased prospective study of 11,068 Japanesesubjects aged between 40-69 years initially free of CHD or stroke, the incidence of CHDwas positively correlated to high triglycerides in both genders[8].a 17-year meta-analysis of population-based prospective studies of 46,413men and 10,864 women confirmed that plasma triglyceride level is a significant riskfactor for cardiovascular disease independent of HDL-cholesterol levels for both men andwomen[9]. Significant risk factors for coronary heart disease in the Saudi population were hypertriglyceridemia (1.93±0.95 versus1.45±0.16 mmol/L;p

Objectives

Methods

Results

Conclusion