Carotid intima-media thickness correlation with lipid profile in patients with familial hypercholesterolemia versus
Samia Perwaiz Khan1, Khwaja Zafar Ahmed, Zia Yaqub
1Department of Pharmacology, Ziauddin University, Karachi. samiaperwaiz@hotmail.com
Insights
Carotid intima-media thickness (CIMT) is elevated in familial hypercholesterolemia (FH) patients and strongly correlates with LDL cholesterol. Increased CIMT predicts premature cardiovascular disease risk in FH individuals.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Genetics
Background:
- Familial hypercholesterolemia (FH) is an inherited disorder leading to high LDL cholesterol levels.
- This elevated cholesterol significantly increases the risk of premature cardiovascular diseases.
- Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis.
Purpose of the Study:
- To assess CIMT variations in FH patients.
- To evaluate CIMT as a predictive marker for early cardiovascular disease in FH.
- To correlate CIMT with lipid profiles, specifically LDL cholesterol.
Main Methods:
- A comparative study involving FH patients and age-matched controls.
- Clinical diagnosis of FH based on established criteria including premature coronary disease and xanthomas.
- Measurement of CIMT using B-mode ultrasonography and correlation with LDL levels via Pearson's test.
Main Results:
- FH patients exhibited significantly higher mean CIMT (0.77 ± 0.18 mm) compared to controls (0.59 ± 0.08 mm).
- A substantial correlation was found between mean CIMT and LDL-cholesterol levels (r = 0.725, p < 0.001).
- Arterial plaques were present in 25% of FH cases.
Conclusions:
- CIMT is significantly increased in individuals with familial hypercholesterolemia.
- Elevated CIMT in FH patients correlates with high LDL-cholesterol levels.
- Both increased CIMT and elevated LDL-cholesterol are predictive markers for premature cardiovascular diseases in FH.
Objective:
To determine the variations in carotid intima-media thickness (CIMT) in familial hypercholesterolemia (FH) patients and its use as predictive marker for premature cardiovascular diseases.
Study Design:
Comparative study.
Place And Duration Of Study:
National Institute of Cardiovascular Diseases and Dr. Ziauddin Hospital, Karachi, from June 2008 to October 2009.
Methodology:
Familial hypercholesterolemia was clinically diagnosed by premature coronary diseases, xanthomas, arcus cornealis and family history of premature coronary heart diseases. Controls were age matched normal individuals without hypercholesterolemia. Their lipid profile was tested after overnight fasting. CIMT was measured in mm using B-mode ultrasonography using linear probe. Student t-test was applied to compare mean CIMT of cases and the control. The mean CIMT values of the FH cases were correlated with LDL using Pearson's correlation test.
Results:
Forty cases with hypercholesterolemia gave consent to participate in the study. These patients had total cholesterol ≥200 mg/dL and LDL ≥160 mg/dL as compared to twenty controls of similar age with total cholesterol ≤200 mg/dL and LDL ≤130 mg/dL. Mean CIMT for the cases was 0.77 ± 0.18 mm while mean CIMT for control was 0.59 ± 0.08 mm. The mean CIMT for the cases ranged from 0.7-1.83 mm and 0.48-0.73 mm for controls. Among the FH cases, 25% (n=11) had arterial plaques. Mean CIMT was significantly correlated to LDL-cholesterol (r = 0.725**, p < 0.001).
Conclusion:
In this study, CIMT was found to be significantly increased in familial hypercholesterolemia and it correlated with raised LDL-cholesterol. Both are predictive of premature cardiovascular diseases.
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