Ethnic immunity to coronary heart disease?
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Published on: August 7, 2017
W J Vermaak1, J B Ubbink, R Delport
1Department of Chemical Pathology, Faculty of Medicine, University of Pretoria, South Africa.
Insights
Black individuals exhibit lower coronary heart disease (CHD) risk factors, including cholesterol and apolipoprotein levels, compared to white individuals. These biochemical differences, observed from birth, suggest a reduced susceptibility to an atherogenic diet in Black populations.
Area of Science:
- Biochemistry
- Cardiovascular Health
- Ethnic Health Disparities
Background:
- Dietary fat intake is a primary factor in coronary heart disease (CHD) rates.
- Significant differences in CHD rates exist among ethnic groups, despite shared risk factors like hypertension and obesity.
- CHD is notably less common in Westernized Black Africans despite high prevalence of risk factors.
Purpose of the Study:
- To investigate biochemical differences in lipid profiles and related factors between Black and White neonates and adults.
- To determine if ethnic differences in CHD risk factors are present at birth and persist into adulthood.
- To assess the responsiveness of Black and White individuals to an atherogenic diet.
Main Methods:
- Measurement of cord blood lipid profiles (Total Cholesterol, LDL Cholesterol, Apolipoprotein B) in Black and White neonates.
- Comparison of serum lipid profiles (TC, LDLC, apo B, HDLC, Apolipoprotein AI), homocysteine, and coagulation factor VII in adult Black African males and age-matched White males.
- Analysis of individuals exposed to the same Western diet and environment for at least two years.
Main Results:
- Black neonates had significantly lower cord blood Total Cholesterol (12.1%), LDL Cholesterol (18.3%), and Apolipoprotein B (22.4%) compared to White neonates.
- Adult Black Africans showed lower serum TC (10.7%), LDLC (18.7%), and apo B (39.7%), but higher HDLC (20.2%) and Apolipoprotein AI (9.5%) than Whites.
- Adult Black Africans also exhibited lower homocysteine (45.6%) and coagulation factor VII (26.6%) levels.
Conclusions:
- Black individuals are biochemically less responsive to an atherogenic diet compared to White individuals.
- These protective biochemical differences are evident at birth and persist into adulthood.
- Findings suggest a genetic or inherent biological basis for lower CHD rates in Black populations, independent of environmental factors.
Abstract:
Dietary fat intake is often regarded as a major determinant of coronary heart disease (CHD) rate and it has been deemed unnecessary to invoke racial or other factors to explain the differences in CHD rates among different ethnic groups. Despite a high prevalence of CHD risk factors such as hypertension, obesity, and smoking, CHD remains a rarity in westernized black Africans. Cord blood total cholesterol (TC), low density lipoprotein cholesterol (LDLC) and apolipoprotein B (apo B) levels were measured and found to be respectively 12.1%, 18.3% and 22.4% lower in black neonates when compared to white neonates. These differences were again studied in a group of young black African males and a comparable group of age-matched whites who had been exposed to the same environment and western diet for at least 2 years. Although the body mass indices and serum albumin concentrations in the adult males were not significantly different, serum levels of TC, LDLC and apo B were 10.7%, 18.7% and 39.7% lower in the blacks, respectively. Furthermore, high density lipoprotein cholesterol (HDLC) and Apolipoprotein AI were 20.2% and 9.5% higher, homocysteine 45.6% lower and coagulation factor VII 26.6% lower in the adult black Africans. It is concluded that blacks are biochemically less responsive to an atherogenic diet than whites and these differences are already present at birth.
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