Role of Apo B and Apo A1 Levels in Relation to Conventional Lipid Profile in Patients of Ischaemic Heart Disease with or without Type II Diabetes Mellitus

Abstract

Introduction: Ischaemic Heart Disease (IHD) or Coronary Artery Disease (CAD) is the most prevalent chronic disease and the main leading cause of death in the world, with more than half a million newly diagnosed IHD patients each year. Central to this are disorders of lipoprotein metabolism. Apolipoprotein B (Apo B) and Apolipoprotein A1 (Apo A1) are structural and functional components of lipoprotein particles that serve as transporters of cholesterol. Apo B and Apo A1 are among the emerging markers for Cardiovascular Diseases (CVD). Routine conventional lipid profile does not incorporate these markers. Aim: To determine the level of Apo A1 and Apo B in patients of IHD with or without Type II Diabetes Mellitus (T2DM) and analyse the significance of these parameters over the conventional lipid profile. Materials and Methods: The case-control study was conducted at Government Medical College, Bhavnagar, Gujarat, India from July 2013 to December 2013. The study consists of 100 participants including 50 having IHD only (Group I), 50 having IHD with T2DM (Group II) as study groups and 50 healthy individuals (Group III) as control. Various biochemical parameters including Apo B and Apo A1 were analysed and statistically evaluated to come to conclusion. Results: The demographic details of the participants which shows no significant different in age and gender among groups I, II and III. Apo B and A1 were elevated in group I and II and were found highly significant (p-value <0.0001) as compared to the group III. There was positive correlation of serum Apo B levels with total cholesterol (r=0.495, p-value <0.0001), Low-Density Lipoproteins (LDL-C) (r=0.526, p-value <0.0001) and Apo A1 (r=0.685, p-value <0.0001) in group I and LDL-C (r=0.468, p-value=0.001) and Apo A1 (r=0.754, p-value <0.0001) in group II. Similarly, Apo A1 levels were positively correlated with Apo B (r=0.685, p<0.0001) in group I and LDL-C (r=0.305, p-value=0.031) and Apo B (r=0.754, p-value <0.0001) in group II. Conclusion: As the Apo B and Apo A1 cover both atherogenic and antiatherogenic lipid parameters respectively, it can be used as a better predictor of development of IHD with and without T2DM in comparison to conventional parameters of lipid profile.