Islam M Z, Islam M N, Bhowmik T K, Roy A K, Saha B, Hossain M S, Paul P K, Ahmed H, Islam S A, Shakil S S
Dr Md Zahidul Islam, Assistant Professor, Department of Cardiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh.
Mymensingh Med J. 2018 Jul;27(3):508-512.
Incidence of coronary artery disease (CAD) is increasing in developing countries in Bangladesh with improvement of socioeconomic status, urbanization, changes of dietary habits and lifestyle. Dyslipidaemia is one of the major contributors increase CAD risk. This study was aimed to find out the association of low level HDL-C with acute coronary syndrome. This cross sectional study was conducted in the department of cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from August 2009 to May 2010. Sociodemographic characteristics, smoking, hypertension, FBS, serum total cholesterol level, HDL-C, LDL-C, Triglyceride level were important variable considered. A total number of 100 respondents consisted of 50 cases (patient) Group I and 50 healthy people (control) Group II. Investigations included ECG, Troponin-I, FBS and Fasting Lipid Profile. The data was analyzed by computer with the help of SPSS. Chi-square test, T-test, ANOVA test used as test of significance. The mean level in cases of HDL-C 39.3±5.1 and in control level HDL-C 34.2±3.4 statistically significant (p<0.0001). In both group low concentration HDL-C (<40mg/dl) risk for CAD. Un-adjusted odds ratio 95% CI determinants of ACS, HDL-C of OR was 0.2. So, HDL-C is not protective factor. In multivariate logistic regression analysis that adjusted for confounders of HDL-C level (age, sex, smoking, hypertension, TC, LDL-C, TG) associated with ACS. HDL-C was strong predictor of ACS (RR in the highest) compared with lowest quarantile = 0.02; (95% CI=0.003-0.173; P for trend <0.0001). The study reflected that low HDL-C level associated with ACS. Categorization of patients with ACS on the basis HDL-C level may be helpful for risk stratification and management.
随着社会经济地位的提高、城市化进程、饮食习惯和生活方式的改变，孟加拉国等发展中国家的冠状动脉疾病（CAD）发病率正在上升。血脂异常是增加CAD风险的主要因素之一。本研究旨在探讨低水平高密度脂蛋白胆固醇（HDL-C）与急性冠状动脉综合征之间的关联。这项横断面研究于2009年8月至2010年5月在孟加拉国迈门辛市迈门辛医学院医院心脏病科进行。社会人口学特征、吸烟、高血压、空腹血糖（FBS）、血清总胆固醇水平、HDL-C、低密度脂蛋白胆固醇（LDL-C）、甘油三酯水平是纳入考虑的重要变量。共有100名受访者，其中50例为病例组（患者），50例为健康对照组。调查项目包括心电图、肌钙蛋白I、FBS和空腹血脂谱。数据借助SPSS软件在计算机上进行分析。采用卡方检验、T检验、方差分析作为显著性检验。病例组HDL-C的平均水平为39.3±5.1，对照组HDL-C的平均水平为34.2±3.4，差异具有统计学意义（p<0.0001）。两组中HDL-C浓度低（<40mg/dl）均为CAD的危险因素。未调整的优势比95%可信区间中，HDL-C是急性冠状动脉综合征（ACS）的决定因素，OR为0.2。因此，HDL-C不是保护因素。在对HDL-C水平的混杂因素（年龄、性别、吸烟、高血压、总胆固醇、LDL-C、甘油三酯）进行调整的多因素逻辑回归分析中，HDL-C与ACS相关。与最低四分位数相比，HDL-C是ACS的强预测因子（RR最高）=0.02；（95%CI=0.003-0.173；趋势P<0.0001）。该研究表明，低HDL-C水平与ACS相关。根据HDL-C水平对ACS患者进行分类可能有助于风险分层和管理。
