31.12.17 Evaluation of Lipid Profile in Patients with Anemia in Mirpur AJK

Original Article

 

Lipid Profile in Patients with Anemia

Evaluation of Lipid Profile in Patients with Anemia in Mirpur AJK

Rashad Mahmood1, Khuram Shahzad Khan1, Zara Shaukat4, Faisal Bashir2 and Asnad3

ABSTRACT

Objective: The objective of this study to evaluate   saliva  biochemical composition of pregnant women   and non- pregnant women in Mirpur  AJK.

Study Design: Cross-sectional study

Place and Duration of Study: This study was conducted at the department Physiology and Biochemistry Department of Mohtarma Benazir Bhutto Shaheed Medical College Mirpur AJK from March 2018 to   August 2019.

Materials and Methods: Total 200 anemic patients were selected male and female and 100 control healthy people were selected for the study. Lipid profile (Total cholesterol, HDL, VLDL and triglycerides) was estimated in both groups in anemic patient and control healthy people. Blood samples were collected from both groups anemic and healthy people. Samples were analyzed by Micro lab 300 for lipid profile for both groups anemic and control .Merck kits were used for analysis of lipid profile in both groups.  Hematology study was conduct by used hematology analyzer. Kits of Merk Company were used for analysis.

Results: The total mean cholesterol (mg\dl)   in anemic patients was 182.6 ± 29.5 while in healthy control was  193.6 ± 30.5.The mean LDL (mg\dl) in anemic patients was  105.8 ± 15.5 while in healthy control was  118.7± 19.3. The mean HDL (mg\dl)   in anemic patients was 42.77± 8.4while in healthy control was 59.3 ± 8.1. The mean Triglycerides (mg\dl) in anemic patients was120.2 ± 29.while in healthy control was 133.3 ± 31.2. Result showed that lipid profile is lower in anemic patient as compare to healthy control subjects .The mean Hb (g/dl) in anemic patients was8.88 ± 1.32   while in healthy control subjects   was12.79 ± 1.43. The mean Serum iron (μg/dl) in anemic patients was38.32 ± 6.35while in healthy control subjects was96.15 ± 18.68.  The mean TIBC (μg/dl) in anemic patients was 399.03 ± 41.48 while in healthy control subjects   was282.72 ± 27.04. The mean Serum ferritin (μg/dl) in anemic patients was9.93 ± 3.8 while in healthy control subjects was49.4 ± 31.00.

Conclusion: The result showed that in anemia and lipoprotein relationship exist but the type of anemia is not affect the relationship. The lipoprotein level is decreased in anemic patient as compare to control.

Key Words: Lipid profile, Anemic patients

Citation of article: Mahmood R, Khan KS, Shaukat Z, Bashir F, Asnad. Evaluation of Lipid Profile in Patients with Anemia in Mirpur AJK. Med Forum 2020;31(12):77-80.

 

 

INTRODUCTION

Iron Deficiency (ID) is widespread nutritional disorder developing countries regardless of age, gender and socioeconomic status. Due to its complications, iron deficiency anemia becomes a big public health problem.

One of the risk factor of coronary artery disease (CAD) is Dyslipidemia and another public health issue is anemia.

 

 

1. Deartment of Physiology /ENT2 / Biochemistry3, Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur, AJK.

4. Department of Physiology, Foundation University Islamabad Campus.

 

 

Correspondence: Dr.  Asnad, Associate Professor of Biochemistry, Mohtarma Benazir Bhutto Shaheed Medical College, Mirpur, AJK

Contact No: 0332-3698204

Email: drasnadkhan@gmail.com

 

 

Received:    June, 2020

Accepted:    September, 2020

Printed:        December, 2020

 

 

Anemia is more common in low socioeconomic status.1 Anemia have role as protective on lipid profile and reduced the risk of CAD. In upper socioeconomic class more prevalence of CAD as compare to lower socioeconomic class. Nutritional Anemia is high prevalence in lower socioeconomic class.2 some studies showed contradictory result regarding lipid profile and anemia relationship. 3In some studies observed that VLDL levels and triglycerides are high in anemia due to iron deficiency as compare to non-anemic patients.4 lipoprotein (LDL) cholesterol were found lower in anemic patients. Where in other study found that high-density lipoprotein (HDL), LDL, VLDL, and triglyceride levels are decreased in anemic patients as compare to control and health people. 5 Different study studies showed that   deficiency of iron in animal caused alteration in the lipid profile.6,7 That when the concentration of the iron is low in animal IDA iron deficiency anemia  it  changed the  high-density lipoprotein (HDL), LDL, VLDL, and triglyceride levels in animal. In other study of human, Iron deficiency anemia  lipid profile  is lower  with respect iron  deficiency .8,9   In severe IDA, Low levels of triglycerides and total cholesterol (TC), in young Korean girls are decreased and returned  normal after therapy of iron.11These results and observations showed that there is variation in both findings.  So we conducted this study to evaluate   the lipid profile (high-density lipoprotein (HDL), LDL, VLDL, and triglyceride) in anemic patients and non anemic control healthy people.

MATERIALS AND METHODS

This study was conducted in the department Physiology and Biochemistry Department of Mohtarma Benazir Bhutto Shaheed Medical College Mirpur AJK from March 2018 to    August 2019. It was cross section –control study. Total 200 anemic patients were selected male and female and 100 control health people are selected for the study. Lipid profile (Total cholesterol, HDL, VLDL and triglycerides) was estimated in both groups in anemic patient and control healthy people. Blood samples were collected from both groups anemic and health people. Samples were analyzed by Micro lab 300 for lipid profile for both groups anemic and control .Merck kits were used for analysis of lipid profile in both groups.  Hematology study was conduct by used hematology analyzer. Kits of Merk Company are used for analysis.

Statistical Analysis: SPSS for Windows version 20 (SPSS, Inc., Chicago, IL, USA) was employed for all statistical analyses.

RESULTS

The total mean cholesterol (mg\dl) in anemic patients was182.6 ± 29.5 while in healthy control was 193.6 ± 30.5.The mean LDL (mg\dl) in anemic patients was 105.8 ± 15.5 while in healthy control was 118.7± 19.3. The mean HDL (mg\dl) in anemic patients was 42.77± 8.4while in healthy control was 59.3 ± 8.1. The mean Triglycerides (mg\dl) in anemic patients was120.2 ± 29.while in healthy control was 133.3 ± 31.2. Result showed that lipid profile is lower in anemic patient as compare to healthy control subjects .The mean Hb (g/dl) in anemic patients was8.88 ± 1.32   while in healthy control subjects   was12.79 ± 1.43.

Table No.1:  Participant Characteristics

 

(n=200)

 Anemic Patients

 Control (n=100) 

Age (years)

51.4 + 10.2

49.7 + 10.3

Male /Female (%)

100/100

50/50

Body weight (Kg)

68.9 + 10.8

69.3 + 11.2

BMI (kg/m2)

24.7 + 2.6

24.5 + 2.5

The mean Serum iron (μg/dl) in anemic patients was38.32 ± 6.35while in healthy control subjects was 96.15 ± 18.68. The mean TIBC (μg/dl) in anemic patients was 399.03 ± 41.48 while in healthy control subjects   was 282.72 ± 27.04.The mean Serum ferritin (μg/dl) in anemic patients was9.93 ± 3.8 while in healthy control subjects was 49.4 ± 31.00.

Table No.2: Lipid Profile of Anemic Patients and Control Health People

Anemic patients   (n=200)

Control (n=100) 

Fasting Blood Glucose(mg/dl)

97.8 ± 4.3

99.4 ± 4.6

Total Cholesterol (mg/dl)

182.6 ± 29.5

193.6 ± 30.5

LDL  (mg\dl)

105.8 ±  15.5

118.7± 19.3

HDL  (mg\dl)

42.77± 8.4

59.3 ± 8.1

Triglycerides (mg\dl)

120.2 ± 29.5

133.3 ± 31.2

Table No.3:Hematological profile of anemic Patients and Control Health People

Anemic patients   (n=200)

Control (n=100)

Hb  (g/dl)

8.88 ± 1.32

12.79 ± 1.43

Serum iron (μg/dl)

38.32 ± 6.35

96.15 ± 18.68

TIBC (μg/dl)

399.03 ± 41.48

282.72 ± 27.04

Serum ferritin (μg/dl)

9.93 ± 3.8

49.4 ± 31.00

DISCUSSION

Iron Deficiency (ID) is widespread nutritional disorder developing countries regardless of age, gender and socioeconomic status. Due to its complications, big public health problem is IDA iron deficiency anemia. 12

The major risk factor in the development of CAD is Dyslipidemia.13.14This study was conducted in the department Physiology and Biochemistry Department of Mohtarma Benazir Bhutto Shaheed Medical College Mirpur AJK from March 2018 to    August 2019. It was cross section –control study. Total 200 anemic patients were selected male and female and 100 control health people are selected for the study. Lipid profile (Total cholesterol, HDL, VLDL and triglycerides) was estimated in both groups in anemic patient and control healthy people. Blood samples were collected from both groups anemic and health people. Samples were analyzed by Micro lab 300 for lipid profile for both groups anemic and control .Merck kits were used for analysis of lipid profile in both groups.  Hematology study was conduct by used hematology analyzer. Kits of Merk Company are used for analysis. Iron and cholesterol are important for human body any deficiency of both caused serious effect on humen body. The level of iron and cholesterol are important. One of the risk factor of coronary artery disease (CAD) is Dyslipidemia and another public health issue is anemia. Anemia is more common in low socioeconomic status. Anemia have role as protective on lipid profile and reduced the risk of CAD. In upper socioeconomic class more prevalence of CAD as compare to lower socioeconomic class.   Nutritional Anemia is high prevalence in lower socioeconomic class.  Some studies showed contradictory result regarding lipid profile and anemia relationship. In some studies observed that VLDL levels and triglycerides are high in anemia due to iron deficiency as compare to non-anemic patients. lipoprotein (LDL) cholesterol were found lower in anemic patients. Where in other study found that high-density lipoprotein (HDL), LDL, VL DL, and triglyceride levels are decreased in anemic patients as compare to control and health people. Different study studies showed that   deficiency of iron in animal caused alteration in the lipid profile. That when the concentration of the iron is low in animal IDA iron deficiency anemia  it  changed the  high-density lipoprotein (HDL), LDL, VLDL, and triglyceride levels in animal. In other study of human, Iron deficiency anemia lipid profile is lower with respect iron deficiency in severe IDA, Low levels of triglycerides and total cholesterol (TC), in young Korean girls are decreased and returned normal after therapy of iron. These results and observations showed that there is variation in both findings Our result showed that amemic and non-anemic both groups plasma cholesterol and lipoprotein are significant lower that in anemic patient the lipoprotein is lower as compare to non-anemic control. The total mean cholesterol (mg\dl)   in anemic patients was 182.6 ± 29.5 while in healthy control was 193.6 ± 30.5.The mean LDL (mg\dl) in anemic patients was 105.8 ± 15.5 while in healthy control was 118.7± 19.3. The mean HDL (mg\dl)   in anemic patients was 42.77± 8.4while in healthy control was 59.3 ± 8.1. The mean Triglycerides (mg\dl) in anemic patients was120.2 ± 29.while in healthy control was 133.3 ± 31.2. Result showed that lipid profile is lower in anemic patient as compare to healthy control subjects .The mean Hb (g/dl) in anemic patients was8.88 ± 1.32 while in healthy control subjects   was12.79 ± 1.43. The mean Serum iron (μg/dl) in anemic patients was38.32 ± 6.35while in healthy control subjects was 96.15 ± 18.68.  The mean TIBC (μg/dl) in anemic patients was 399.03 ± 41.48 while in healthy control subjects   was282.72 ± 27.04. The mean Serum ferritin (μg/dl) in anemic patients was9.93 ± 3.8  while in healthy control  subjects  was49.4 ± 31.00.In the study of Choi et al. that there is no significant difference both groups anemic patient and control health people at moderate iron deficiency while in severe iron deficiency anemia patient serum total cholesterol and triglyceride level are significantly reduced .15Ece et al. result showed  that  tat serum hemoglobin  have linked with cholesterol and triglyceride concentrations.16 Higher levels of triglyceride and lower HDL-cholesterol levels were  found in anemic patient as compare to control and healthy people.17 Increased erythropoiesis lead increased demand and ultimately  lead   hypercholesterolemia  in anemic patients.18  Iron used  as cofactor in many biochemical reaction  which caused lipid metabolism abnormality  in patients.19 In the study of Graham et al. showed that iron increased in hepatic storage , which caused  up regulation of  HMG-CoA reeducates of cholesterol biosynthesis, rate-limiting enzyme.20 The  result showed that in anemia and lipoprotein  relationship  exist but the type of anemia is not affect the relationship.

CONCLUSION

The result showed that in anemia and lipoprotein relationship exist but the type of anemia is not affect the relationship. The lipoprotein level is decreased in anemic patient as compare to control.

Author’s Contribution:

Concept & Design of Study:

Rashad Mahmood

Drafting:

Khuram Shahzad Khan, Zara Shaukat

Data Analysis:

Faisal Bashir, Asnad

Revisiting Critically:

Rashad Mahmood, Khuram Shahzad Khan

Final Approval of version:

Rashad Mahmood

Conflict of Interest: The study has no conflict of interest to declare by any author.

REFERENCES

1.      Reddy KK, Rao AP, Reddy TP. Socioeconomic status and the prevalence of coronary heart disease risk factors. Asia Pac J Clin Nutr 2002;11:98-103.

2.      Shah T, Purohit G, Harsoda JM. Prevalence of coronary heart disease in different socioeconomic status: Is dyslipidemia a future threat? Int J Biomed Adv Res 2015;6:120-3.

3.      Verma U, Shankar N, Madhu SV, Tandon OP, Madan N, Verma N. Relationship between iron deficiency anaemia and serum lipid levels in Indian adults. J Indian Med Assoc 2010;108:555-8, 562.

4.      Antappanavar VB, Biradar SG, Patil V, Biradar PM, Mithare S, Sharma AK. A study of correlation between iron deficiency anaemia and serum lipid profile in Indian adults in BRIMS, Bidar. Int J Adv Med 2014;1:96-100.

5.      Sandeep N, Rao VD, Hanumaiah A, Rampure D. Lipid profile changes in anemia. Transworld Med J 2014;2:29-32.

6.      Au YP, Schilling RF. Relationship between anemia and cholesterol metabolism in ‘sex-linked anemia’ (gene symbol, sla) mouse. BiochimBiophysActa. 1986;883:242-6.

7.      Sherman AR. Serum lipids in suckling and post weaning iron-deficient rats. Lipids 1979;14:
888-92.

8.      Tanzer F, Hizel S, Cetinkaya O, Sekreter E. Serum free carnitine and total triglyceride levels in children with iron deficiency anemia. Int J VitamNutr Res 2001;71:66-9.

9.      Ece A, Yigitoglu MR, Vurgun N, Guve H, Iscan A. Serum lipid and lipoprotein profile in children with iron deficiency anemia. Pediatr Int 1999;41:
168-73.

10.  Lewis M, Iammarino RM. Lipemia in rodent iron deficiency anemia. J Lab Clin Med 1971;78:
546-54.

11.  Choi JW, kim SK, Pai SH. Changes in serum lipid concentrations during iron depletion and after iron supplementation. Ann Clin Lab Sci 2001;31:151-6.

12.  Department of Nutrition of Health and Development, World Health Organisation. Nutrition for health and development a global agenda for combating malnutrition (progress report), 2007. Available at: http//whqlibdoc. who.int /hq/2000/WHO_NHD_00.6.pdf. Accessed 29 May 2007.

13.  Kwiterovich PO Jr. Clinical relevance of the biochemical, metabolic, and genetic factors that influence low-density lipoprotein heterogeneity. Am J Cardiol 2002;90:30i-47i.

14.  Korphonen T, Savolainen MJ, Koistinen MJ. Association of lipoprotein cholesterol and triglycerides with the severity of coronary artery disease in men and women. Atherosclerosis 1996;127:213-20.

15.  Choi JW, Kim SK, Pai SH. Changes in serum lipid concentrations during iron depletion and after iron supplementation. Ann Clin Lab Sci 2001;31:151-6.

16.  Ece A, Yigitoglu MR, Vurgun N, Güven H, Iscan A. Serum lipid and lipoprotein profile in children with iron deficiency anemia. Pediatr Int 1999; 41:168-73.

17.  Yang S, Chen XY, Xu XP. The Relationship Between Lipoprotein-Associated Phospholipase A(2), Cholesteryl Ester Transfer Protein and Lipid Profile and Risk of Atherosclerosis in Women with Iron Deficiency Anaemia. Clin Lab 2015;61:
1463-9.

18.  Frazer DM, Anderson GJ. The orchestration of body iron intake: How and where do enterocytes receive their cues? Blood Cells Mol Dis 2003; 30:288-97.

19.  Ahmed U, Latham PS, Oates PS. Interactions between hepatic iron and lipid metabolism with possible relevance to steatohepatitis. World J Gastroenterol 2012;18:4651-8.

20.  Graham RM, Chua AC, Carter KW, Delima RD, Johnstone D, Herbison CE, et al. Hepatic iron loading in mice increases cholesterol biosynthesis. Hepatol 2010;52:462-71.