Comparison of anthropometric characteristics, nutritional status and lipid profiles between adult male arthrosclerosis patients and controls: A study from Hoogly district in West Bengal, India.
Abstract
Prevalence of atherosclerotic heart disease increases rapidly in both developed and developing countries. However, study on atherosclerotic risk factor in rural West Bengal is lacking. Therefore, present study has been undertaken is compared anthropometric characteristics, nutritional status and lipid profiles between atherosclerosis subjects and controls. A hospital based case-control study was conducted in a state general hospital in Hoogly district of West Bengal, India. A total of twenty male (age: 45 -55 years) atherosclerotic patients (AP) were identified from hospital records. Similarly, controls were identified from the same region who reported no previous history of atherosclerosis. All subjects for this study were selected randomly. Information on anthropometric characteristics, nutritional status and lipid profile was made and recorded following standard methods. There was no significant difference in mean ages between AP and control (CT) (50.8 ± 3.0 vs. 50.9 ± 2.9 years). The AP had significantly (p < 0.001) higher mean values for all variables except body height, dietary Iron and VLDL than those in CT. Whereas, HDL is significantly higher in CT compared with AP (t=3.821, p<0.001). The highest percent differences between the two groups were observed for intake of dietary fat (88.80 %). Moreover, results of linear regression analyses revealed that atherosclerotic status had significant impact (p < 0.0001) on all anthropometric characteristics, dietary nutrient status and lipid profiles except HDL. More importantly, atherosclerotic status explained the highest percent variation in intake of dietary fat (86.2%). The present study indicates that consumption of more dietary fat may be one of the risk factor associated with atherosclerosis. To better understand the actual process dealing with changes in these variables, similar studies in larger samples are needed.
Key Word: Atherosclerosis patient, Anthropometric status, Nutritional status, Lipid profile
Introduction:
Atherosclerosis is a disease in which plaque builds up on the insides of our arteries. So the flow of oxygen-rich blood to our organs and other parts of our body is reduced. This can lead to serious problems including stroke or even death [1]. With the obstruction of blood flow, downstream tissues are starved of oxygen and nutrients leads to develop myocardium, angina or myocardial infarction [2-4]. A recent study [5] reported that cardiovascular diseases are a major cause of death in both developed and developing countries. These risk factors may be influenced by lifestyle modifications such as changes in eating habits and engagement in physical activities. An earlier study [6] suggested that blood lipids and lipoproteins are strongly related to coronary atherosclerosis but their association with cerebrovascular atherosclerosis is less clear. A study by Ford et al [7] experimented that the severity of coronary artery atherosclerosis correlates with plasma concentrations of total cholesterol, LDL-cholesterol, triglycerides and HDL-cholesterol.
The relation between dietary fat and atherosclerosis is a contentious field. The role of dietary oxidized fats / lipid peroxidation (rancid fats) in human is not clear. Laboratory animals fed rancid fats develop atherosclerosis. Rats fed DHA-containing oils experienced marked disruptions to their antioxidant systems as well as accumulated significant amounts of peroxide in their blood, liver and kidney [8]. In another study, rabbits fed atherogenic diets containing various oils were found to undergo the greatest amount of oxidative susceptibility of LDL via polyunsaturated oils. In a study involving rabbits fed heated soybean oil, "grossly induced atherosclerosis and marked liver damage were histologically and clinically demonstrated" [9]. Various anatomic, physiological and behavioral risk factors for atherosclerosis are known. These can be divided into various categories like congenital vs. acquired, modifiable or not, classical or non-classical. So, the age, sex, obesity, blood pressure etc. are the core components of metabolic syndrome.
The information on anthropometric status, nutritional status and lipid profile among atherosclerosis patients (AP) in West Bengal is lacking. In view of these, the present study was conducted to compare anthropometric status, nutritional status and concentrations of lipid profile in atherosclerosis patients and control (CT) living in a rural community.
Materials and Methods:
Selection of Subject:
The subjects for this study were randomly selected from a population of male in a rural community in the District of Hoogly, West Bengal, India. Twenty male atherosclerosis patient (age range 45-55 years) who had suffered continually at least 6-12 months were identified from state general hospital, Hoogly, West Bengal and twenty male subjects (age range 45-55 years) were identified from the same region who reported no previous history of atherosclerosis. The study protocol was approved by institutional ethical committee before initiation of study.
Collection of blood samples and separation of serum:
The subjects were asked to attend the laboratory between 8.00-9.00 a.m. after overnight fasting. Fasting blood samples were drawn from non-smoker and smoker individuals. Serum was obtained by centrifugation at 1500 x g for 15 min of blood samples taken without anticoagulant.
Biochemical estimation:
The extent of serum triglyceride was determined by using the method of Averna et al [10]. Total cholesterol level was measered according to the method of Zlatkis et al [11]. High density liproprotein (HDL) cholesterol were performed by the method of Averna et al [10]. The levels of low density liproprotein (LDL) cholesterol and very high density liproprotein (VLDL) are estimated by the method as described by Sacks et al [12].
Assessment of Anthropometric status:
Selected subjects asked to stand on the platform of the human weighing machine exerting equal pressure on both feet to note the reading of weight and placed on the ground to measured the height by the method as described by Joshi [13]. Body mass index (BMI) is measured by using standard formula: BMI = Weight (kg) / Height (m2). Nutritional status was evaluated based on BMI guidelines for Asia-Pacific populaion [14].
Methods for the assessment of nutritional status:
In different angle like questionnaire, interview and recall methods are used to assess the dietary intake of the selected subjects to know nutritional status according to the method of Joshi [13].
Statistical analysis
The data were expressed as mean ± standard deviation. Comparisons of the means of two groups were made by student t-test. Percent difference was computed with the following formula: Percent Difference (%) = (Mean CT -Mean AP) / Mean CT. Linear regression analyses (atherosclerotic status coded as: 1 = yes; 0 = no) were undertaken to test for the impact of AP status on anthropometric and body composition variables. Odds ratio (OR) and confidence interval (CI) were calculated using standard statistical method. A P-value less than 0.05 are considered as significance.
Results:
There were no significant differences in mean ages between AP (mean = 50.8 years, sd = 3.0) and CT (mean = 50.9 years, sd = 2.9). The mean (sd) and differences in anthropometric characteristics, nutritional status and lipid profile between AP and CT are presented in Table 1. The mean values in AP were significantly (p < 0.001) higher than those in CT for all variables except body height, Iron and VLDL. Whereas, HDL is significantly higher in CT compared with AP (t=3.821, p<0.001). The highest percent differences between the two groups were observed for intake of dietary fat (88.80 %) and LDL (52.85 %), respectively.
Moreover, results of linear regression analyses of atherosclerotic status (independent variable coded as: AP = 1, CT = 0) and anthropometric characteristics, nutritional status and lipid profiles (dependent variable) are presented in Table 2. Results revealed that atherosclerotic status had significant impact (p < 0.0001) on all anthropometric characteristics, nutritional status and lipid profiles. However, atherosclerotic status had significant negative impact on HDL cholesterol. Atherosclerotic status explained the highest percent variation in dietary fat (86.2%) followed by LDL (78.5%), BP-diastolic (72.5%), BP- systolic (66.6%) and cholesterol (58.5%), respectively.
More importantly, results in the present study shows that the prevalence of overweight & obesity (BMI ≥23.0 kg/m2) among AP (70%) had significantly higher compared with CT (20%). They were 9.33 (OR=9.33, 95% CI: 1.78-54.78) fold more chances to be an overweight & obese than their CT. Moreover, overweight & obese subject in both groups (AP & CT) on average had higher mean BP, serum total cholesterol, serum triglycerides, blood glucose and lower HDL cholesterol level, respectively.
Discussion:
Several studies have investigated anthropometric characteristics, dietary nutrients status as well as lipid profiles as risk factor for cardiovascular disease, diabetes mellitus and atherosclerosis in India [15-19] and several countries worldwide [12, 20-24]. Most of the studies are conducted on cardio vascular disease (CVD) and atherosclerosis risk factors in different parts of India. However, information on atherosclerotic risk factor in rural network among adult male subjects in West Bengal is lacking. This preliminary report fulfills the lack of information. This is uniqueness of the present study.
This study provided evidence that AP had significantly higher mean values of lipid profiles, intake of dietary nutrients and anthropometric characteristics except HDL and height. Similar results have been reported in earlier studies worldwide. More importantly, our study found that there was differential amount of gain in dietary fat and lipid profiles in AP. Moreover, differences in mean values of dietary fat and LDL were much more compared to differences in non-fat and dietary nutrients including BMI, total cholesterol, Ca, vitamin-A, vitamin-C, dietary protein and energy, in AP than in CT. Thus, results depicts that the impact of AC is much more pronounced on dietary fat as compared to non-fat dietary nutrients. Subjects of present study consumed high amount of dietary fat than controls. It is well documented that high saturated fat consumption is associated with high blood cholesterol and LDL levels [25].
The present study found that the prevalence of overweight and obesity was higher in AP compared to CT. Since, obesity is associated with on average higher BP, serum total cholesterol, serum triglycerides, blood glucose and lower HDL cholesterol level than lean individuals [26]. Similar results were also found in the present investigation.
In conclusion, the present study indicates that consumption of more dietary fat may be one of the risk factor associated with atherosclerosis. However, it must be pointed out here the present study was case control in nature which can only highlight the differences in anthropometric, dietary nutrient status and lipid profile between AP and CT. To better understand the actual process dealing with changes in these variables, prospective and similar studies in larger samples are needed.
Acknowledgement: The authors would like to thank all subjects for their help and cooperation during study period. The authors would also like thank to Anita Nayek for collection of data and blood sample.
