Correlation between HDL Level with Clinical and Biochemical Markers of Atherogenesis OC04-OC07
Dr. M Sudhakar Rao,
A/512, Sambhavi Sovereign Near Country Inn, Manipal-576104, Karnataka, India.
Introduction: HDL cholesterol (HDL-C) level is an independent predictor of risk for cardiovascular events in both genders, low levels of which have been demonstrated to have an inverse association with cardiovascular disease and mortality. Anthropometric measurements serve as surrogate markers for atherogenic burden. Atherosclerosis represents a chronic inflammatory process and low HDL being an inflammatory state, inflammatory markers such as high-sensitivity C Reactive Protein (hs-CRP) may provide an adjunctive method for global assessment of cardiovascular risk. TG/HDL ratio has been proved to have a high association with prevalence of metabolic syndrome and with insulin resistance.
Aim: To find out the correlation between High Density Lipoprotein (HDL) level with clinical and biochemical markers of atherogenesis.
Materials and Methods: This cross-sectional study was conducted with a study population of 200 individuals, who were either in-patients or outpatients in the Department of Medicine at Kasturba Medical College (KMC), Manipal Karnataka, India. (Study period July 2012-July 2014). Individuals aged 18-70 years being investigated for dyslipidemia for the first time were included. Data was collected by in person interview by specific questionnaire. Height, weight, waist circumference and hip circumference were measured as per standard protocol. Laboratory reports were noted for the estimation of Fasting Blood Sugar (FBS), HDL and Triglycerides (TG), hs-CRP, fasting insulin. Serum LDL was calculated. Statistical data analysis was done using SPSS 16.0 version. Mean and median values were calculated corresponding to the data. Results were analysed using Pearson’s and Spearman’s correlation coefficient. Independent t-test and Mann-Whitney’s tests were used for calculation of significance of correlation.
Results: Among the studied individuals 53% (106) were males and 47% (94) were females. A total of 77%(154) of the individuals with low HDL and 70%(140) individuals with normal HDL had abnormal waist circumference. Mean Waist Hip Ratio (WHR) was same across groups with low and normal HDL. Mean Body Mass Index (BMI) was similar in both the groups among males; however, a statistically significant difference was found among females. Abnormal waist circumference was found similar across both the groups. Median hs-CRP showed a statistically significant higher values among individuals with lower HDL. Fasting insulin and HOMA-IR was higher among individuals with low HDL (vs normal HDL), but it was statistically insignificant. Median TG/HDL ratio among 41 individuals were found to be 3.08, which was higher than the cut-off to signify insulin resistance. HOMA-IR and TG/HDL ratio showed a statistically significant positive correlation suggesting that TG/HDL ratio can be used as a marker of insulin resistance.
Conclusion: This study revealed that anthropometric indices showed an inverse correlation with HDL levels, with BMI being a better predictor of HDL-C changes. HDL was lower in individuals with insulin resistance, with TG/HDL ratio being a significant marker of insulin resistance.