Rajasekhar D, Srinivasa Rao P V L N, Latheef S A A, Saibaba K S S, Subramanyam G
Departments of Cardiology, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507, Andhra Pradesh, India.
Indian J Med Sci. 2004 Nov;58(11):465-71.
Higher prevalence of coronary heart disease (CHD) has been reported in south Indian population, which cannot be accounted for by the traditional risk factors like hyperlipidemia. Identification of new risk factors may help in treatment and prevention of CHD in this part of the world. In an attempt to investigate the causes of increased incidence of CHD in this part of the world, we intended to look for oxidative stress in our patients as a possible risk factor. As an initial step in this perspective, a case- control study was conducted to find out the serum antioxidant levels and their association with CHD in south Indian population.
A tertiary care hospital; Case--control study.
One hundred thirty nine angiographically proven CHD patients (aged 29-75 years) were studied against 59 population based healthy controls (aged 29-72 years) free of CHD. Fasting serum cholesterol, triglycerides, HDL cholesterol, erythrocyte and plasma glutathione peroxidase and superoxide dismutase were estimated on automated clinical chemistry analyzer. LDL cholesterol and VLDL cholesterol were calculated. Vitamins A and E were estimated using high performance liquid chromatography (HPLC).
Unpaired t test was used to compare means. Binary logistic regression was done to find out the association between dependent and independent variables.
Significantly higher levels of Total Cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratio and lower HDL cholesterol levels were observed in patients when compared to controls. No significant difference of plasma and erythrocyte glutathione peroxidase and superoxide dismutase activity was observed between patients and controls. Significantly lower levels of vitamin E in patients than in controls was observed (P<0.001). Serum vitamin E was inversely associated with coronary heart disease even after controlling for age and other coronary risk factors (Odds ratio 0.898, 95% CI 0.826-0.976 P=0.01).
The results of present study suggest that deficiency of vitamin E may be an independent risk factor of CHD. This study brings out the need for long- term monitoring of vitamin E supplementation as a preventive measure for CHD in the population studied.
据报道，印度南部人群冠心病（CHD）的患病率较高，而高脂血症等传统危险因素无法解释这一现象。识别新的危险因素可能有助于在世界这一地区治疗和预防冠心病。为了调查世界这一地区冠心病发病率增加的原因，我们打算在患者中寻找氧化应激作为一种可能的危险因素。作为这一观点的初步步骤，我们进行了一项病例对照研究，以了解印度南部人群血清抗氧化剂水平及其与冠心病的关系。
一家三级护理医院；病例对照研究。
对139例经血管造影证实的冠心病患者（年龄29 - 75岁）与59例无冠心病的基于人群的健康对照者（年龄29 - 72岁）进行研究。使用自动临床化学分析仪测定空腹血清胆固醇、甘油三酯、高密度脂蛋白胆固醇、红细胞和血浆谷胱甘肽过氧化物酶以及超氧化物歧化酶。计算低密度脂蛋白胆固醇和极低密度脂蛋白胆固醇。使用高效液相色谱法（HPLC）测定维生素A和维生素E。
采用非配对t检验比较均值。进行二元逻辑回归以找出因变量和自变量之间的关联。
与对照组相比，患者的总胆固醇/高密度脂蛋白胆固醇和低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值显著更高，高密度脂蛋白胆固醇水平更低。患者与对照组之间血浆和红细胞谷胱甘肽过氧化物酶及超氧化物歧化酶活性无显著差异。观察到患者的维生素E水平显著低于对照组（P<0.001）。即使在控制年龄和其他冠心病危险因素后，血清维生素E仍与冠心病呈负相关（比值比0.898，95%可信区间0.826 - 0.976，P = 0.01）。
本研究结果表明维生素E缺乏可能是冠心病的一个独立危险因素。本研究表明有必要对所研究人群进行长期的维生素E补充监测，作为预防冠心病的一项措施。
