Role of lipids and free radicals in diabetic with hypertension and smokers for causation of coronary heart disease
Abstract
Introduction: The major independent risk factors for the development of atherosclerosis are the plasma cholesterol concentration, triglyceride, cigarette smoking, hypertension and diabetes, which are by them self’s risk factor for coronary heart disease. Cardiovascular disease (CVD) threatens to cripple India’s workforce and stunt India’s growth if timely and appropriate public health measures are not instituted. Hyperglycemia, hypertension and cigarette smoking depletes natural antioxidants and facilitates the production of reactive oxygen species (ROS) which has the ability to react with all biological molecules and exert cytotoxic effects on cellular components that promotes and accelerate atherosclerosis. Hence the present study was aimed to find out collective effect of NIDDM, hypertension and cigarette smoking on lipid profile and oxidative stress in progression of CHD events.
Materials and methods: We studied 50 healthy and 50 diabetes with hypertension and or smokers patients (i. e. had two or more CHD risk factors) patients with matched for age and body mass index. Blood samples were drawn after an overnight fast. W e estimated serum triglycerides,total cholesterol, HDL-c and LDL-c and VLDL- c values were calculated by Friedwald’s equation. We also estimated the total serum lipid peroxides by reaction with thiobarbituric acid.
Results: In the control group I mean values of total cholesterol were 180.21 ± 18.13 mg %, LDL-c 106.60 ±18.2 mg%, serum triglycerides were 99.90 ± 16.14 mg %, HDL-c were 53.83 ± 16.42mg% and in the group II serum triglycerides 217.9 ± 19.1 mg% and were significantly increased as compared to group I. The serum HDL-c group II 29.6 ± 8.07mg % were significantly decreased as compared to group I (P is<0.05). The serum lipid peroxides in the group 2nd (296.9.±60.10) were significantly increased as compared to group 1st (180.96±35.16).
Conclusion: It can be concluded that patients of NIDDM with hypertension, smoking have higher total serum cholesterol, serum triglycerides, serum lipid peroxides (MDA), LDL- c and VLDL-c with lower HDL- c. These can be corrected, treated by dietary and life style modification before the development of end organ damage. For realization of exact role of lipid profile and oxidative stress further higher level studies should be done.
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References
Ross R. The pathogenesis of atherosclerosis--an update. N Engl J Med. 1986 Feb 20;314(8):488-500.
Dewan BD, Malhotra KC, Gupta SP. Epidemiological study of coronary heart disease in rural community in Haryana. Indian Heart J. 1974 Apr;26(2):68-78.
Enas EA, Garg A and Davidson MA. Coronary artery disease and it’s risk factors in 1st generation immigrant Asian Indian to the United State of America. Indian Heart Journal 1996,48 (4)343-53.
Castelli WP and Andreson KA .Population at risk prevalence high cholesterol level in hypertensive patients Framingham study.American Journal of Medicine 1986, 80(2A) 23-28.
Bhoraskar AS and Raheja DS. Diabetes and cardiovascular disease Do Asian Indians have a high ethenic susceptibility. Journal of the Association of Physicians of India 1997,34 72-8.
Meigs JB, Singer DE and Sullivan LM. Metabolic control &Prevalent cardiovascular disease in non- insulin dependent diabetes mellitus (NIDDM); The NIDDM patient outcomes research group. American Journal of Medicine 1997,102(1) 38-47.
McLaughlin T, Abbasi F, Cheal K, Chu J, Lamendola C, Reaven G. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003 Nov 18;139(10):802-9.
Kannel WB. Update on the role of cigarette smoking in coronary artery disease. Am Heart J. 1981 Mar;101(3):319-28.
Venkatesan A, Hemalatha A, Bobby Z, Selvaraj N, Sathiyapriya V. Effect of smoking on lipid profile and lipid peroxidation innormal subjects. Indian J Physiol Pharmacol 2006; 50(3): 273-278.
Dincer Y, Akcay T, Aldemir Z and Likoova H . Effect of oxidative stress on Glutathione pathway in red blood cells from patients with insulin-dependent diabetes mellitus. Metabolism 2002, 51(10) 1360-1362.
Maritim AC, Sanders RA, Watkins JB 3rd. Diabetes, oxidative stress, and antioxidants: a review. J Biochem Mol Toxicol. 2003;17(1):24-38.
The American Diabetes association. Diagnosis and classification of diabetes mellitus.Diabetes Care. 2004;27 (supp 1) S5-S10.
Nandiger MA and Chandrakala MV . Estimation of serum total lipid peroxide (MDA). Malanodoaldehyde levels in different organs of rats, subjected to alcohol toxicity. Indian Journal of Clinical Biochemistry. 1986 1 133.
Taskinen MR. Taskinen MR. Diabetes Metab Rev. 1987 Apr;3(2):551-70.
Taskinen MR, Lahdenperä S, Syvänne M. New insights into lipid metabolism in non-insulin-dependent diabetes mellitus. Ann Med. 1996 Aug;28(4):335-40.
Giugliano D, Ceriello A and Paolisso G . Diabetes mellitus, hypertension and cardiovascular disease and oxidative stress. Metabolism,1995, 44(3) 363-368.
Mukaopadhya .Free radicals and diabetes, Role in aetiology and pathogenesis Journal of Diabetic Association of India.1994, 34 5-7.
Feener EP, King GL. Vascular dysfunction in diabetes mellitus. Lancet. 1997 Jul;350 Suppl 1:SI9-13.
Velloso LA, Folli F, Sun XJ and White MF. Cross talk between the Insulin and angiotensin signaling systems. Proceedings of the National Academy of Sciences U.S.A,1996. 93,(22), 12490-5.
Yanbaeva DG, Dentener MA, Creutzberg EC, Wesseling G,Wouters EFM. Systemic effects of smoking. Chest 2007; 131(5),1557-1566.
Pasupathi P, Rao YY, Farook J, Saravanan G, BakthavathsalamG. Effect of smoking on lipids and oxidative stress biomarkers in patients with acute myocardial infarction. Res J Med Med Sci,2009,4(2)151-159.
Benowitz NL. Drug therapy. Pharmacologic aspects of cigarette smoking and nicotine addiction. N Engl J Med. 1988 Nov 17;319(20):1318-30.
Waqar A. Effect of tobacco smoking on the lipid profile of teenagemale population in Lahore City. Int J Med Med Sci 2010; 2(6):172-177.
Halperin RO, Sesso HD, Ma J, Buring JE, Stampfer MJ, Gaziano JM. Dyslipidemia and the risk of incident hypertension in men. Hypertension. 2006 Jan;47(1):45-50. Epub 2005 Dec 12.
Barbosa KB, Volp ACP, Hermsdorff HHM, Navarro-Blasco I, Zulet MA, Martínez JA, et al. Relationship of oxidized low density lipoprotein with lipid profile and oxidative stress markers in healthy young adults: a translational study. Lipids Health Dis.2011; Apr.19,10: 61.
Rashida Meharan, M. Mohsin, Zahida Nasreen, M. Siraj, and M. Ishaq. Significantly increased levels of serum malanodi aldehyde in type 2 diabetics with myocardial infraction. Int. J. Diabetes Dev. Ctries. 2010 Jan-Mar; 30(1):49-51
Mathiyalagan Deepa , Palanisamy Pasupathi , K.B. Vidhya Sankar, P. Rani and S.P. Satish Kumar. Free radicals andantioxidant status in acute myocardial infarction patients with and without diabetes mellitus. Bangladesh Med Res Counc Bull 2009; 35(3), 95-100.
Jeeyar, Hemalatha Wilma Delphine Silvia C.R.. Evaluation of effect of smoking and hypertension on serum lipid profile and oxidative stress. Asian Pacfic J. of Tropical disease. 2011,289-291.
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