Khafaji Hadi Abdul Ridha Hadi, Bener Abdulbari, Osman Mohammed, Al Merri Ajayeb, Al Suwaidi Jassim
Department of Cardiology and Cardiovascular Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
Vasc Health Risk Manag. 2012;8:7-14. doi: 10.2147/VHRM.S22894. Epub 2011 Dec 30.
To study the effect of strict prolonged fasting on lipid profile, serum leptin, and high- sensitivity C-reactive protein (hs-CRP) in patients with different stable cardiac illnesses and look for associated new cardiac events and any correlation between entire variables.
A total of 56 patients of different stable cardiac illnesses were followed in our cardiology outpatient for 3 months. Data concerning their ability to fast were collected: New York Heart Association class of congestive cardiac failure, angina class, previous myocardial infarction, previous coronary artery bypass graft, percutaneous coronary intervention, severity of valvular lesion, metallic prosthetic valve, and traditional risk factors (diabetes mellitus, insulin requirement, hypertension, hypercholesterolemia, smoking habit, and obesity). Detailed clinical examination and electrocardiography were performed in all patients in three consecutive visits before, during, and after Ramadan. Echocardiographic and angiographic findings and medication plans were collected from patient records. Lipid profile, serum leptin, and hs-CRP were assessed before, during, and after Ramadan.
All patients fasted during Ramadan: 80.4% were male, 67.9% were aged >50 years, 71.4% had no change in their symptoms during fasting while 28.6% felt better. No patient has deteriorated. 91.1% of the patients were compliant with medicine during Ramadan, 73.2% after. 89.3% were compliant with diet during Ramadan with no significant change in body weight in the follow-up period. No cardiac or noncardiac morbidity or mortality was reported. High- density lipoprotein-cholesterol (HDL-C) decreased significantly during compared to before fasting (P = 0.012). Low-density lipoprotein-cholesterol (LDL-C) significantly increased during compared to before fasting (P = 0.022). No statistically significant changes were observed in total cholesterol (TC), triglycerides (TG), serum leptin, or hs-CRP. Significant correlation was observed between TC and hs-CRP during fasting (P = 0.036), but not with TG, LDL-C, or HDL-C (P > 0.05). Neither of these correlated with serum leptin (P > 0.05), but significant correlation was observed between hs-CRP and serum leptin (P < 0.05).
Ramadan fasting in stable cardiac patients has no effect on their clinical status, serum leptin, or hs-CRP, but results in decrease in HDL-C, increase in LDL-C, with significant correlation between TC and hs-CRP during Ramadan, but not with TG, LDL-C, or HDL-C, and with significant correlation between hs-CRP and serum leptin before, during, and after fasting.
研究严格延长禁食对不同稳定型心脏病患者血脂谱、血清瘦素和高敏C反应蛋白（hs-CRP）的影响，并寻找相关的新心脏事件以及所有变量之间的相关性。
在我们的心脏病门诊对56例不同稳定型心脏病患者进行了3个月的随访。收集了有关他们禁食能力的数据：纽约心脏协会充血性心力衰竭分级、心绞痛分级、既往心肌梗死、既往冠状动脉搭桥术、经皮冠状动脉介入治疗、瓣膜病变严重程度、金属人工瓣膜以及传统危险因素（糖尿病、胰岛素需求、高血压、高胆固醇血症、吸烟习惯和肥胖）。在斋月前、斋月期间和斋月后连续三次就诊时，对所有患者进行了详细的临床检查和心电图检查。从患者记录中收集了超声心动图和血管造影结果以及用药计划。在斋月前、斋月期间和斋月后评估血脂谱、血清瘦素和hs-CRP。
所有患者在斋月期间均禁食：80.4%为男性，67.9%年龄>50岁，71.4%在禁食期间症状无变化，28.6%感觉好转。没有患者病情恶化。91.1%的患者在斋月期间遵医嘱服药，斋月后为73.2%。89.3%的患者在斋月期间遵守饮食规定，随访期间体重无显著变化。未报告心脏或非心脏发病率或死亡率。与禁食前相比，斋月期间高密度脂蛋白胆固醇（HDL-C）显著降低（P = 0.012）。与禁食前相比，斋月期间低密度脂蛋白胆固醇（LDL-C）显著升高（P = 0.022）。总胆固醇（TC）、甘油三酯（TG）、血清瘦素或hs-CRP未观察到统计学上的显著变化。禁食期间观察到TC与hs-CRP之间存在显著相关性（P = 0.036），但与TG、LDL-C或HDL-C无关（P>0.05）。这些均与血清瘦素无相关性（P>0.05），但hs-CRP与血清瘦素之间存在显著相关性（P<0.05）。
稳定型心脏病患者斋月禁食对其临床状态、血清瘦素或hs-CRP无影响，但会导致HDL-C降低、LDL-C升高，斋月期间TC与hs-CRP之间存在显著相关性，但与TG、LDL-C或HDL-C无关，且禁食前、禁食期间和禁食后hs-CRP与血清瘦素之间存在显著相关性。
