| Serum Minerals
and its Relation with Lipid Profiles of Coronary
Heart Disease Subjects |
| Mukul Sinha, Kanta
K Sharma |
 |
Department of
Food and Nutrition, College of Home Science,
Rajendra Agricultural University, Pusa, Samstipur,
Bihar 848 125 |
|
| |
 ABSTRACT |
| |
| Studied suggest relationship of high
intake of sodium and low intake of potassium and
calcium with increased incidence of coronary heart
disease. Data related to serum levels of these nutrients
in the development of coronary heart disease is
scanty. This study depicts not only positive association
of serum sodium level with lipoprotein levels but
also a strong positive association of serum magnesium
with lipoprotein fraction except HDL-C level which
is negatively associated. However serum calcium
showed only negative association with triglyceride
& VLDL_C levels and potassium did not show any
relation with any lipid fraction. Therefore an overall
metabolic study is required in this aspect. |
| |
| INTRODUCTION |
| |
| Coronary Heart Disease (CHD) is continuously
on increase in India. In 1991 India had a total
of 4.04 crore coronary heart disease patients. This
figure was projected to cross 5.25 by 2001 &
by 2013, cardio vascular disease could become the
most important cause of mortality in India, while
CHD will count for 34% of all male deaths and 32%
of all female deaths in the country, warns the WHO
(The Statesman, 27.09.04). On the basis of various
long term prospective studies, a number of risk
factors of CHD have been established. One of the
best documented is the association between elevated
blood lipids and coronary heart disease. Since the
major lipids of the blood circulate as lipoproteins,
there has been a considerable interest on the relationship
between serum lipoproteins and CHD. Several dietary
factors like high carbohydrate, protein, fat and
cholesterol intake have been identified responsible
for elevated blood lipid levels. However data related
to serum level of mineral and serum lipid profiles
of CHD subjects are scanty. Therefore present investigation
was planned to see association of serum mineral
levels with that of serum lipid profiles. |
| |
| Table 1: Age and anthropometry
of CHD and Normal subjects |
| |
| |
CHD (N = 40) |
Normal (N = 20) |
Age, Yrs
Mean ± SD, range |
52 ± 5.17
43-60 |
52 ± 5.55
43-60 |
Height, Meters
Mean ± SD, range |
1.66 ± 0.07
1.50-1.83 |
1.66 ± 0.08
1.55-1.80 |
Weight, Kg
Mean ± SD, range |
67.56 ± 12.5
46-111 |
64.5 ± 10.13
50-85 |
BMI, Kg/m2
Mean ± SD, range |
24.62 ± 3.74
18-34 |
23.30 ± 2.83
18-28 |
|
|
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| MATERIALS
AND METHODS |
| |
| Forty subjects who were diagnosed
clinically and chemically as CHD patients were selected
out of the patients admitted in the Intensive coronary
care unit of Dayanand Medical College and Hospital,
Ludhiana. The subjects belonged to different regions
of the state with age ranging between 35-60 years.
Patients who had suffered from first only were selected
for the study. Twenty normal subjects of the matching
age and sex were selected from families who volunteered
for the study. Information pertaining to age, sex
and anthropology was obtained. The concentration
of total serum cholesterol, triglyceride and serum
minerals was estimated by using standard methods. |
| |
| RESULTS
AND DISCUSSION |
| |
| The mean ± SD age of the patients
and normal subjects were 52 ± 5.2 vs 52 ±
5.6 with a range of 43-60 years. Sex wise 85% were
males and 15% females. Anthropometric indices of
the subjects are given in Table-1. Based on Body
Mass Index criteria of NIN, Hyderabad, obesity was
present in 37.5% of CHD & 25% of normal subjects. |
| |
| Table 2: Serum lipid profile
of CHD and Normal subjects |
| |
| Lipid profile |
CHD (N = 40) |
Normal (N = 20) |
t-value |
Risk value and References |
| Total cholesterol |
209 ± 40 (19.03) |
168 ± 30 (17.95) |
4.04 |
> 2601 |
| LDL-C |
135.5 ± 38 (27.85) |
100 ± 24 (24.33) |
3.79 |
> 1802 |
| HDL-C |
40 ± 5.24 (13.18) |
45.7 ± 9 (18.97) |
3.28 |
< 402 |
| VLDL-C |
32.32 ± 8.61 26.65) |
21.75 ± 12(57.21) |
3.85 |
> 402 |
| Total Cholesterol: HDL-C |
5.21 ± 0.96(18.42) |
3.78 ± 1.95 |
5.44 |
> 52 |
| LDL: HDL-C |
3.45 ± 1.09 (31.73) |
2.27 ± 0.73 (32.16) |
4.35 |
> 32 |
| Triglycerides |
159 ± 43 (27.23) |
109.5 ± 62 (56.54) |
3.62 |
> 165 |
|
| 1.Brechtold et al, 1977; 2.Murray
et al, 1988; 3. Castelli et al, 1977; values are
mean ± SD, * Significant at P < 0.01;
Figures in parenthesis represents CV% |
| |
Serum triglycerides, cholesterol and
lipoprotein levels have been presented in Table-2.
A perusal of this table indicates that significance
was observed between all the values of CHD and normal
subjects. However hypercholesterolemia was observed
only in 10% of CHD and none of normal subjects.
This result is contradictory to the result of the
same state presented by Oshan (1992), who found
53% of the CHD subjects to be hypercholesterolemic.
Increased LDL-C level was also found to be present
in only 12.5% of CHD subjects and none of normals.
A significant positive correlation of LDL-C level
was found with serum triglycerides and rest of the
cholesterol fraction except that of HDL-C level.
However HDL-C level was found to be below risk value
(<40 mg/dl) in 47.5% of CHD and 30% of normal
subjects. A significant difference was also observed
in serum HDL-C levels of CHD and normal subjects.
HDL-C level was also strongly associated with coronary
heart disease as a whole. Which was judged by using
chi-square test (X2=4.04,
P=0.05). Elevated serum triglyceride (>165 mg/dl)
was observed in 40% of CHD and 15% of normal subjects.
Since the distribution of cholesterol in the VLDL
fraction is increased in proportion to ratio of
triglyceride i.e. 5:1, it is not affected otherwise.
Serum minerals (calcium, magnesium, sodium and potassium)
levels have been presented in Table-3. This is quite
clear from the table that serum levels of calcium,
sodium, and magnesium are significantly different
in both the groups. When compared with the normal
range suggested by Murray et al (1990), all the
values fall within normal range. Serum calcium level
negatively correlated to serum triglyceride and
VLDL-C levels. Serum magnesium level was positively
related to LDL-C, T Chol: HDL-C; HDL-C levels of
serum and negatively to HDL-C level (Table-4). Serum
sodium level was also found to be positively related
to serum cholesterol level, serum triglycerides,
LDL-C, VLDL-C, T Chol: HDL-C and LDL: HDL-C and
negatively to serum HDL-C levels. No, report could
be located by the author in these aspects. |
| |
| Table 3: Serum mineral levels
of CHD and Normal subjects |
| |
| Lipid profile |
CHD (N = 40) |
Normal (N = 20) |
t-value |
Normal Range1 |
| Calcium, mg/dl |
8.35 ± 0.9 (10.83) |
9.01 ± 1.0 (11.20) |
2.55** |
8.5-10.3 |
| Magnesium, mg/dl |
1.18 ± 0.33 (28.35) |
0.91 ± 0.41 (50.84) |
2.66* |
1.8-3.0 |
| Sodium, mEq/L |
140.97 ± 5.11(3.62) |
136 ± 10.6 (7.78) |
2.36* |
136-145 |
| Potassium, mEq/L |
4.90 ± 0.72 (14.66) |
4.67 ± 0.78 16.78) |
1.4 |
3.5-5.0 |
|
| Values are mean + SD; *Significant
at P<0.01; **Significant at P<0.05; 1.Murrey
et al (1990); Figures in parenthesis represents
CV% |
| |
| Table 4: Correlation coefficient
between serum mineral and serum lipid profiles of
CHD and Normal subjects |
| |
| Serum mineral |
Serum lipid profiles |
| |
Total cholesterol |
Triglyceride |
HDL-C |
LDL-C |
VLDL-C |
Total chol: HDL-C |
LDL-C: HDL-C |
| Calcium |
- |
-0.298* |
- |
- |
-0.306* |
- |
- |
| Magnesium |
- |
- |
-0.361* |
0.271* |
- |
0.339* |
0.341* |
| Sodium |
0.318* |
0.359* |
- |
0.281* |
0.365* |
0.321* |
0.298* |
| Potassium |
- |
- |
- |
- |
- |
- |
- |
|
| 1.Brechtold et al, 1977; 2.Murray
et al, 1988; 3. Castelli et al, 1977; values are
mean ± SD, * Significant at P < 0.01;
Figures in parenthesis represents CV% |
| |
| CONCLUSION |
| |
| Therefore, present study suggests
an estimation of serum levels of all these minerals
in case of coronary heart disease subjects before
prescribing any dietary treatment. |
| |
| REFERENCES |
| |
| 1. |
Speich M, Chappuls
P, Robinet N, Gelot S, Arnand P (1987). Selenium,
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during 12 days after on acute myocardial infarction.
Clin Chem, 33:21-23. |
| 2. |
MC Carron,DA,
Mirris CD, Hennery HJ and Stantan JL (1984).
Blood pressure and nutrient intake in the
United States, Science, 224:1393-98. |
| 3. |
Morton BC, Nair
RC, Smith FM, Mc Kibbon TG and Pogeneski WJ
(1984). Magnesium 3: 346-52. In Nutrition
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| 4. |
Murray RK, Cranner
DK, Mayes PA and Rodwall VW (1988). Harper’s
Biochemistry. 21st Ed. Appteton and Large,
Prentico-Hall International Inc. |
| 5. |
Oshan S (1992).
Role of dietary and other risk factors in
the pathogenesis of Coronary Heart Disease.
M.Sc. thesis, PAU, Ludhiana. |
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