ROLE OF HETEROGENEITY OF LIPIDS IN PREDICTING RISK OF ATHEROMA FORMATION IN METABOLIC SYNDROME

Abstract

Objective: Assessing impact of heterogeneous lipids in predisposing cardiovascular (CV) atheroma formation in adolescents with metabolic syndrome (MS).
Study Design: Cross-sectional analytical.
Place and Duration of Study: Educational Institutes of Lahore. Six months
Material and Methods: A total of 193, 17-25 year old subjects, 106 males and 87 females were recruited. A record regarding each subject’s personal, socioeconomic, educational, dietary and family histories was taken. They underwent the following anthropometric measurements: waist circumference/WC (cm), hip circumference/HC (cm), height (inches), weight (kg), waist hip ratio/WHR, body mass index/BMI and blood pressure. Laboratory investigations included fasting blood samples for glucose and lipids; including total cholesterol (TC), high density
lipoprotein-cholesterol (HDL-c), low density lipoprotein-cholesterol (LDL-c) and triglycerides (TG). Calculations for TG/HDL ratio and TC/HDL ratio were made.
Results: Metabolic syndrome (MS) was present in 26 (13.5%) individuals. Male to female ratio was 3:1. Values of waist circumference, blood pressure, fasting plasma glucose, triglyceride and HDL-c, were all high. On comparison of fasting lipid profile, TC/HDL ratio and TG/HDL ratio, it was observed that the average total cholesterol, HDL cholesterol, TCL/HDL ratio were insignificant. The average triglyceride level and TG/HDL ratio were all high. The ROC curve for total cholesterol, HDL-c, TG, TC/HDL and TG/HDL ratio yielded 0.555, 0.526, 0.912, 0.548 and 0.913 areas under the curve. Plasma TG, TG/HDL ratio produced significant p-values < 0.001. Abnormal triglycerides and TG/HDL ratio at a cutoff of 3.98 was diagnosed with high sensitivity and specificity.
Conclusion: Fasting triglyceride and HDL-c play a major role in the pathogenesis of MS at an early age. Triglyceride level and TG/HDL ratio as opposed to HDL-c and TC/HDL-c clearly define the risk for development of atheroma formation in our adolescent population.