“Serum high-density lipoprotein cholesterol (hdl-cholesterol) in Ghanaians in relation to risk factors for Ischaemic Heart disease”

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In this study the enzymatic and chemical methods of estimating total serum cholesterol were compared. The enzymatic method of estimation was found more suitable as a result of its specificity, with levels about the “true” serum total cholesterol concentration. The serum total cholesterol and High Density Lipoprotein Cholesterol levels were measured in 284 men and women ad (20-69) years, in an attempt to establish the normal levels for Ghanaians. These subjects were sampled from among the University community, Ayia Township and some from the Kumasi city. Premenopausal females had higher HDL-C levels and therefore higher HDL-ratios, than men, probably as a result of induced HDL synthesis by the ovarian hormones. Postmenopausal female’s become more ‘sat-risk” than their male counter-parts upon the withdrawal of the hormones. The overall effect was the narrowing of the HDL difference between the male and female sexes till in the fifth decade when they bath run at almost equal risk to developing CVD. Cigarette stroking, obesity, hypercholesterolaemia and diabetes mellitus were the most potent risk factors studied in the work. The marked inverse relationship between index body weight (IBW) and HDL cholesterol levels was emphasised and trust be seriously considered in the investigation of risk factors for CVD. Smoking and diabetes millitus were shown to be risk factors to CVD and their inverse and direct relationships with HDL-C and TC were respectively established. These relationships were stronger with smoking than with controlled diabetes mellitus. A smoker therefore runs a greater risk than a diabetic. The level of HDL-C in controlled diabetes mallitus is influenced by the type of hypoglycaemic therapy administered. As shown in this work, diabetics on sulphonyl – ureas were found to have lower IDL-C levels, in direct contrast to the increasing levels observed with insulin-dependent diabetics (345). The level of glycosylated haemoglobin (BhA1) correlated with the level of blood sugar and therefore could be used as an index for diabetic control. HbA1 levels were found to be unaffected by the type of treatment, even though the sugar levels were controlled5 in sore diabetics. This confirmed that, HbA1 once formed remained in the red blood cell through out its life span. Uncontrolled diabetes is associated with decreasing HDL-C levels and increasing TC levels as depicted in the adult male alloxandiabetic rats. The glycosylated haemoblobiin levels increased with the severity of diabetes. It was again shown that the formation of HbA1 was slow and non-enzymatic rather dependent on the concentration of blood glucose level. Severe hyperglycaemia was observed to cause death probably as a result of vascular complications. Physiological imbalance may also lead to the development of ketoacidiosis, coma and consequently death.
A thesis submitted to the Department of Molecular Medicine, School of Medical Sciences,of the Kwame Nkrumah University of Science and Technology for the award of Master of Science in Chemical Pathology,1983.