Evaluation of Apolipoprotein A1, Apolipoprotein B and Lipoprotein(a) as a risk factor for coronary heart disease among Sudanese diabetic patients

Abstract

Atherosclerotic cardiovascular diseases (CVD) are the major causes of mortality in patients with diabetes mellitus. Both quantitative and qualitative abnormalities of lipoproteins were associated with the development of atherogenesis. In this study we concluded to essentially investigated apolipoprotein as a good diagnostic marker for atherosclerosis. A randomly selected 60 Sudanese diabetic patients (30 type1, 30 type2) visited Jabir Abu Alizz Diabetes Centre (Khartoum, Central Sudan) were enrolled in the study during July-September 2005. A total number of 30 healthy volunteered individuals as a control group. Blood specimens were collected from all groups (n = 90) and serum lipid, lipid profiles and Apolipoprotein were determined. Statistical analysis was done, using SPSS package descriptive and comparing different parameters between groups of patients and control. According to assessment blood glucose was increased in patients compared to control (p<0.05), the leve of total cholesterol in patients were: 8% (n = 5) a high level, 8% (n= 5) high normal and 84% (n =50) had a normal level. However no significance in the assessment of triglyceride and VLDL in patients and controls, although there were 5% (n=3) of patients had a high level of both. The study indicated a significance increased (p<0.05) the level of Apolipoprotein B, lipoprotein(a) and LDL cholesterol in patients group compared to controls, [about 15% (n= 9) of patients had a high normal level Apo B, 12% (n= 7) of patients had a high normal level LDL, and 73% (n= 44) [38% (n= 23) type1, & 35% (n= 21) type2], of patients had a high level of Lp(a) than controls]; where in the other hand the level of Apolipoprotein A1 and HDL cholesterol, were significantly increased in controls compared to patients group, [10% (n= 6) of patients were low normal HDL level and also 21% (n= 13) of Apo A1]. The study indicated that there were a significance correlation between apolipoprotein B, LDL cholesterol and Lp(a), and apolipoprotein A1 and HDL cholesterol (p<0.01). The study indicated that lipo(a) and Apo B were increased when compared within group of patients, and it increased in type1 DM compare to type2 DM. The study also concluded to that Lp(a), was increased proprtionally with the age of patients. In conclusion the study confirmed that Apolipoprotein is an important diagnostic marker that can be used for early detection of atherosclerotic cardiovascular disease (CVD) in diabetic patients and follow up of patients, particularly when such information cannot be obtained by use of routine lipid profiles examination.