I= STUDIES ON SERUM CONCENTRATION OF APOLIPOPROTEIN-A, APOLIPOPROTEIN-B AND Lp(a) IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS CRAFT
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Title of Thesis
STUDIES ON SERUM CONCENTRATION OF APOLIPOPROTEIN-A, APOLIPOPROTEIN-B AND Lp(a) IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS CRAFT

Author(s)
Asal Khan Tareen
Institute/University/Department Details
University of Karachi/Department of Biochemistry
Session
2002
Subject
Biochemistry
Number of Pages
210
Keywords (Extracted from title, table of contents and abstract of thesis)
serum concentration, apolipoprotein-a, apolipoprotein-b, lp(a), coronary artery bypass, coronary artery disease (cad), glucose, cholesterol, tag

Abstract
Coronary artery disease (CAD) has been the leading cause of death in industrialized countries for male over 40 years of age and female over 50 years of age. There has been alarming rise in the incidence of CAD in Pakistan. In comparison to caucacian the incidence of CAD is very high in younger population, for which the actual reason is yet not known. Considering the influence of environmental, nutrition and genetic factors it is very pertinent to identify the risk factors that must be responsible for this early onset.

The main objective of this study was to determine the serum lipids, lipoprotein and apolipoprotein A1, apolipoprotein B and Lp (a) as risk factor associated with CAD, and determine the correlation between older and younger patients with regards to the presence of conventional risk factors. For this purpose a one to one case control study was conducted during a two years period 1996-1998 on angio-graphically diagnosed patients of coronary artery bypass graft (CABG) at National Institute of Cardiovascular disease (NICVD) Karachi.

The risk factors which were assessed in this study were: diabetes mellitus, smoking, hypertension, family history of CAD, obesity, sedentary life style. Biochemical parameters measured were: lipid profile, Apo-A1, Apo-B and Lp(a). Descriptive univariate stratified and multivariate analysis was done using, statistical package for the social sciences (SPSS). A Chi Square test independent samples t tests, one way Nova and logistic regression, correlation was applied to se the association between outcome and independent variable as well as between independent variable where appropriate. A total of the cases 80% were age 40 and above while this is 78% among control.

Univariate analysis showed significant association among sedentary life (SL). They were more among cases as compared to control (OR = 12.57, 95% CI:3.68, 42.98) Serum TAG levels (OR=2.45,95% CI:1.27, 4.72), HDL-C (OR = 4.95,95% CI:2.35, 10.42, apolipoprotein-A1 (OR = 1.86, 95% CI:1.032, 3.360), apolipoprotein-B (OR = 10.49, 95% CI:4.40, 24.76) and lipoprotein (a) (OR = 2.15, 95% CI:1.20, 3.84) when stratified on age (≤ 40, ≥ 40 years).

Triacylglycerol levels, HDL-C, apolipoprotein A, LDL-C and HDL-C ratio, total cholesterol and HDL-C ratio were found to be significant among age ≥ 40 years while LDL-C, apolipoprotein B and LP(a)_was highly significant among age ≤ 40 years.

In multivariate analysis significant association were found among age, SL, TAG, HDL-C apo-B and Lp(a) and they were more among cases than control, age (AOR = 3.57, 95% CI 1.30, 9.83), sedentary life (AOR = 15.63, 95% CI 3.86, 63.58), serum TAG levels (AOR = 2.27, 95% CI 0.94, 5.48), HDL-C (AOR = 3.57, 95% CI 1.30, 9.83), apolipoprotein B (AOR = 13.21, 95% CI 4.8,36.810) and Lp(a) (AOR = 2.30, 95% CI 1.04, 5.0) were identified as risk factors in multivariate analysis.

Download Full Thesis
1431.99 KB
S. No. Chapter Title of the Chapters Page Size (KB)
1 0 Contents
143.71 KB
2 1 Introduction
397.69 KB
  1.1 Apolipoprotein and Coronary Artery Disease 12
  1.2 Cigarette Smoking and CAD 18
  1.3 Lipoprotien (a) Abnormalies in Men with Premature Coronary Artery Disease 20
  1.4 Triacylglycerol and CHD 31
  1.5 Classical Risk Factors and Emerging Elements in The Risk Profile for Coronary Artery Disease 36
3 2 Materials and Methods
174.13 KB
  2.1 Inclusion/Exclusion Criteria 55
  2.2 Patients Histories 55
  2.3 Sample Collection 59
  2.4 Estimation of Serum Glucose 61
  2.5 Estimation of Serum Cholesterol 64
  2.6 Estimation of Serum TAG 67
  2.7 Estimation of HDL-Cholesterol 70
  2.8 Estimation of LDL-Cholesterol 73
  2.9 Estimation of Lipoprotein (a) 74
  2.10 Estimation of Apo -A, and Apo -B 77
  2.11 Statistical analysis. 80
  2.12 Sample Size 82
4 3 Results
589.11 KB
  3.1 Stratified Analysis 93
  3.2 Correlation Coefficient 137
  3.3 University Analysis 141
  3.4 Multivariate Analysis 144
5 4 Discussion
131.58 KB
  4.1 Significance of sex and age 150
  4.2 Prevalence of Risk factors 151
6 5 References 164
237.94 KB
7 6 Appendices 194
237.94 KB