INVESTIGATION OF SOME MACRO AND TRACE METALS IN CORONARY HEART DISEASE

Abstract

Atherosclerosis is a specific hardening of the arteries and in most cases is the underlying pathological condition of coronary heart disease (CHD). Besides risk factors like hypercholesterolemia and hypertension, metals may also be invloved as evidenced by previous studies. Serum copper, zinc, magnesium of CHD subjects (judged by coronary angiography) and controls were analysed by flame atomic absorption spectrophotometry (FAAS). Graphite furnace atomic absorption spectroscopy was used for analysis of manganese. Cholesterol from the various lipoprotein fractions in the plasma: High density lipoprotein-cholesterol (HDLC) and total cholesterol (TC) including triglycerides were also analysed. Demographic data like sex, age, race, height, weight and smoking status were also collected. All calculations were done using Statistical Package for Social Sciences (SPSS). Copper was not significantly different in CHD subjects when compared to the controls in Chinese, p=0.3840. This was also the case for Indians, p=0.2860. Healthy Indians (age adjusted mean=0.92±0.20µg/ml) had significantly higher levels of copper than Chinese (age adjusted mean=0.82±0.15µg/ml), p=0.0020. Total cholesterol (TC) was significantly correlated with copper in both healthy Chinese (rs=0.4532) and Indians (rs=0.2979). Copper was also correlated with low density lipoprotein cholesterol (LDLC) in both healthy Chinese (rs =0.4237) and Indians (rs=0.2651). Serum zinc was found to be significantly higher in Indian CHD subjects (median=0.83µg/ml, range=0.57-1.33µg/ml) than controls (median=0.74µg/ml, range=0.47-1.0lµg/ml) with p< 0.0005 but it was not significantly different in Chinese, p=0.3720. Zinc was also significantly higher in Chinese controls (age adjusted mean=0.92±0.19µg/ml) than the Indian controls (age adjusted mean=0.89±0.17µg/ml), p< 0.0005. Zinc was correlated with LDLC (rs=0.2566) in Indians. Serum magnesium was not significantly different in both Chinese CHD (p=0.0780) and Indian CHD subjects (p=0.0760). However, it was found that Chinese controls had higher serum magnesium (mean=23.0±2.2µg/ml) than Indian controls (mean=21.3±1.8µg/ml), p< 0.0005. Serum manganese was not found to be significantly different in Indian CHD subjects and in controls, p=0.6882. Serum manganese was also not significantly different between the Chinese and Indian controls, p=0.0679. Zinc to copper ratio (RZC) was not significantly different between Chinese CHD subjects and controls, p=0.9260. Indian CHD subjects had significantly higher RZC (age adjusted mean=0.92±0.19) than controls (age adjusted mean=0.83±0.23) with p=0.0150. Healthy Chinese had significantly higher RZC (age adjusted mean=1.07±0.31) than Indians (age adjusted mean=0.81±0.23), p< 0.0005. HDLC was significantly lower in Chinese CHD (BMI adjusted mean=25±10mg/dl) and controls (BMI adjusted mean=49±11mg/dl), p< 0.0005. Indian CHO subjects also had lower HDLC (median=27mg/dl; range=6-50mg/dl) than controls (median=39mg/dl; range=21-98mg/dl), p< 0.0005. Healthy Chinese also had significantly higher HDLC (median=47mg/dl; range=30- 92mg/dl) than Indians (median=39mg/dl; range=21-98mg/dl), p< 0.0005. TG was significantly higher in Chinese CHD subjects (BMI adjusted mean=145mg/dl) than controls (BMI adjusted mean=117mg/dl), p< 0.0010. TG was not significantly different between Indian CHD and controls (p=0. 8937). TG was also significantly higher in healthy Indians (age adjusted mean=141mg/dl) than healthy Chinese (age adjusted mean= 117mg/dl), p=0.0140. TC levels were significantly higher in controls than CHD subjects in both Chinese (p=0.0201) and Indians (p=0.0300). Chinese CHD subjects: median=218mg/dl, range= 85-348mg/dl; Chinese controls: median=233mg/dl, range= 128-35Smg/dl; Indian CHO subjects: mean=2165±52mg/dl; Indian controls: mean=235±44mg/dl. TC:HDLC was significantly higher in healthy Indians (mean=5.8) than Chinese (mean=5.0), p< 0.0005 indicating higher risk of CHD for Indians than Chinese. HDLC was found to be lower in CHO subjects who smoked (BMI adjusted mean=23 ±9mg/dl) than in CHD subjects who did not smoke (BMI adjusted mean=28± 12mg/dl) with p=0.0230.