1.The apolipoprotein B/A-1 ratio in practically healthy participants with normolipidemia
Sodgerel B ; Pilmaa Yo ; Galsumiya L ; Purevsuren D ; Badamsed Ts
Mongolian Medical Sciences 2019;189(3):3-9
Introduction:
Studies demonstrated that the apolipoprotein B/apolipoprotein A-I (Apo B/apo A-I) ratio predicts
cardiovascular risk better than any of the cholesterol indexes. Apo B and Apo A-1 are assumed to be
superiormarkers for lipoprotein abnormalities [1,2]. The concentrations of Apo B and Apo A-1 are associated with cardiovascular disease more strongly than the corresponding lipoprotein cholesterol fractions, the discriminant value of these apoproteins in absolute terms appears to be less important than of their ratio (the Apo B/Apo A-1 ratio) [3, 5-7]. The Apo B/Apo A-1 ratio reflects the balance of atherogenic and antiatherogenic lipoproteins in plasma [4]. Multiple clinical and epidemiological studies have confirmed that the Apo B/Apo A-1 ratio is a superior marker for cardiovascular disease compared with lipids and lipoproteins or their ratios [8, 9].
Goal:
We determined the variation limits of the Apo B/Apo A-1 ratio in healthy participants with normolipidemia
and the relationship of this ratio with other lipid parameters.
Material and Methods:
A total of 146 normolipidemic healthy participants aged 25–60 years were included in the study.
Anthropometric measurements (height and weight) and other personal information were obtained during the clinical examination and the interview. Participants were included in the study using the following criteria:
1. body mass index < 30 kg/m2;
2. TC < 5.2mmol/L;
3. triglycerides (TG) ≤1.7 mmol/L;
4. HDL-C ≥1.03 mmol/L ( woman), ≥ 1.29 mmol/L (male) .
The plasma levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), apo A-I, Apo B and Apo B/Apo A-1 were determined after a 12 h fasting period. The non-HDL-C was calculated as the difference between the TC and HDL-C. Most research data emphasized that the values for the Apo B/Apo A-1 ratio that define a high cardiovascular risk were proposed to be 0.9 for men and 0.8 for women. Statistical Analysis. The statistical analysis was performed using SPSS 21.0 (USA). Differences between the groups were analyzed using the Mann-Whitney test and the chi-squared test. Correlations between the indices were assessed using
the Spearman’s rank correlation. A value of < 0.05 was accepted as statistically significant.
Results:
The relationship of ratio of apolipoprotein (Apo) B/Apo A-1 with other indicators of lipid metabolism in
healthy people with normal lipidemia was analyzed. The Apo B/Apo A-1 ratio in the studied normolipidemic
subjects was 0.69 ± 0.17. The percentage of subjects with the Apo B/Apo A-1 ratio exceeding 0.9 (the
accepted risk value of cardiovascular disease) was 36.3 %.The subjects with Apo B/Apo A-1>0.9 were
characterized by higher HDL-C levels and atherogenic Aпo B, Apo B/Apo A-1 but lower values Apo A-1.
Conclusion
The subjects with normolipidemia the unfavorable Apo B/Apo A-I ratio> 0.9 had more atherogenic lipid
profile.
2.Study on lipid profile values in Mongolian adults
Pilmaa Yo ; Sodgerel B ; Galsumiya L ; Purevsuren D ; Badamsed Ts
Mongolian Medical Sciences 2019;189(3):10-15
Introduction:
Cardiovascular Disease (CVD) is a major cause of morbidity and a leading contributor to mortality in both
developed and developing countries. With rapid socioeconomic development, CVD has reached epidemic
proportions in developing countries in recent decades. Dyslipidemia, elevated level of plasma cholesterol,
together with arterial hipertension, is the main modifiable risk factor atherosclerosis and cardiovascular
diseases (CVD) development. Surveys to monitor and measure dyslipidemia burden in a Mongolian
population has not been conducted in recent years and the available data on the prevalence, types,
and associated factors of dyslipidemia in the general population is relatively insufficient and outdated.
Monitoring of lipid profile at populational level is an important instrument of prevention medicine, applied
for CVD populational risk assessment.
Goal:
Evaluate comparisons of adult blood lipid levels in age, gender and location.
Material and Methods:
In this study, 500 people aged 25-65 were classified into age groups (47.1% for males and 52.9% for
females). Blood plasma in total cholesterol (TC), triglyceride (TG), high density (HDL-C) and low density
(LDL-C) lipoprotein-cholesterol, apolipoprotein - ApoA1, Apo B and ratio of ApoB / ApoA1 were estimated.
Statistical analysis was performed using SPSS 22.0
Results:
Mean age of the participants was 48.8±14.2 years old. Mean values for male TC-4.85±0.92 mmol/l, TG-1.58±1.19 mmol/l, LDL-C-3.24±0.98 mmol/l, HLD-C-1.62±0.21, for women- 4.47±0.96 mmol/l, 1.22±0.47
mmol/l, 2.95±1.01 mmol/l, 1.77±0.23 mmol/l respectively. The mean blood TC,TG levels tended to
increase with age group in male compared to women. The prevalence of an increased blood LDL-C levels
or risks for an increased blood LDL-C was statistically significantly high in male.
Conclusion
The prevalence of lipid was shown as high, that demands respective prevention and management.
3.Result of studying lower extremity arterial occlusive disease by CTA-TASC classification of aorta-iliac and femoral popliteal lesions
Badamsed Ts ; Jargalsaikhan S ; Delgertsretseg D ; Tsetsegmaa B ; Sodgerel B ; Bayaraa T ; Galsumiya L ; Natsagdorj U ; Pilmaa Yo
Mongolian Medical Sciences 2021;197(3):52-58
Background:
Lower extremity arterial diseases are chronic stenosis of the artery and occlusive arterial diseases,
which are commonly caused by atherosclerosis. Prevalence of lower extremity arterial diseases has
positive proportional relationship with age of the patients. Furthermore, prevalence of lower extremity
arterial disease is 16% among the males over the age of 60, whereas prevalence among same aged
woman is 13%. Among the age group of 38 to 59 age, 60 to 69 age and 70-82 age group, prevalence
of lower extremity arterial disease was 5.6%, 15.9%, and 33.8%, respectively.
Goal:
Identifying lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC
classification of aorta-iliac and femoral popliteal lesions.
Obiective:
1. To identify age and sex of the patients with lower extremity arterial occlusive disease and chronic
stenosis of arteries.
2. To identify lower extremity arterial occlusive disease and chronic stenosis of arteries by CTA-TASC classification of aorta-iliac and femoral popliteal lesions.
Material and methods:
Study sample consisted of 237 patients, who were diagnosed with lower extremity arterial occlusive
disease and chronic stenosis of arteries from 2019 to 2020 at reference centre on Diagnostic Imaging
na after R.Purev State Laureate, People’s physician and Honorary professor of the State Third Central
Hospital. Computed angiogram images of lower extremity arteries were examined. Contrast agent
“Ultravist” was pumped by automatic syringe. Lower extremity arterial occlusive disease and chronic
stenosis of arteries are categorized by CTA-TASC classification of аorta-iliac and femoral popliteal
lesions. The youngest participant was 20 years old and the oldest participant was 76 years old.
Common statistical measurements such as means and standard errors were calculated. Probability
of results were checked using Student’s test.
Results:
We have found following results: 185(78.1%±3.0) cases out of 237 diagnosed patients with lower
extremity arterial occlusive disease and chronic stenosis of arteries are males and 52(21.9%±3.0)
cases are female. Distribution of lower extremity arterial occlusive disease and chronic stenosis of
arteries by the age group of patients are: up to 20 years of age is 3 (1.3%±0.7), 21 to 40 years of age
is 14(5.9%±1.5), 41 to 60 years of age is 86(36.3%±3.1) and over the age of 61 is 134(56.5%±3.2).
It is statistically highly significant that experiencing lower extremity arterial occlusive disease and
chronic stenosis of arteries among the age group of over 61(P<0.001).
The result of lower extremity arterial occlusive disease and chronic stenosis of arteries by the CTA-TASC classification of aorta-iliac and femoral popliteal lesions are: CTA-TASS аorta-iliac lesions
A-16(6.8%±1.8), B-8(3.4%±1.2), C-12(5.1%±1.4), D-41(17.3%±2.5), CTA-TASS femoral popliteal
A-41(17.29%±2.5), B-53(22.36%±3.6), C-47(19.83%±2.6), D-96(40.5%±3.2), respectively.
Conclusions
1. Lower extremity arterial occlusive disease and chronic stenosis of arteries occurs 46.5% over the
age of 60 and 78.1% of the patients are males.
2. Following two categories have identified more than the rest, 17.3% CTA-TASC classification of
аorta-iliac lesions, type D and 23.3% CTA-TASC classification of femoral popliteal lesions, type D.
4.The association of testosterone deficiency and risk factors of coronary heart disease in men
Saruuljavkhlan B ; Sodgerel B ; Pilmaa Yo ; Galsumiya L ; Purevsuren D ; Nandin-Erdene B ; Bayaraa T ; Badamsed Ts ; Damdinsuren Ts
Mongolian Medical Sciences 2018;186(4):31-35
Introduction:
Coronary atherosclerosis is the leading cause of morbidity and mortality in the world. Hypogonadism is not considered a traditional risk factor for coronary artery disease (CAD). Higher CVD mortality may be partially attributed to behavioral and physical characteristics of males, including increased smoking, drinking, endocrine and metabolic factor like fat distribution, and low male engagement in preventive care. In the last decades, many studies have suggested that low testosterone levels are associated with increased prevalence of risk factors for CVD, including dyslipidemia and diabetes. For the reason, this research focused on identifying any association between testosterone deficiency and risk factors of coronary heart disease.
Goal:
This study aimed to identify any association between testosterone deficiency and risk factors of coronary heart disease in Mongolian men.
Material and methods:
In this case control study, we determined plasma total testosterone, total cholesterol, triglyceride, high density lipoprotein-cholesterol, apolipoprotein – ApoA1, Apo B and glucose in 287 subjects, among them 125 patients with ACS and 162 healthy subjects. Statistical analysis was performed using SPSS 22.0 of IBM.
Results:
Mean age of the participants was 55.19±6.99 years old. It was found that, mean plasma TT levels in patients with ACS (4.17 ng/ml) was significantly lower than in the healthy subjects (4.70 ng/ml). There was a negative association between plasma TT level and glucose level (r=-0.185; p=0.002) and ApoB/ApoA1 (r=-0.132, p=0.026).
Conclusion
The results in the present study suggest that low plasma TT level may be a risk factor for CHD in men, which may relate to the influence of plasma lipoprotein and glucose metabolism by endogenous testosterone.
5.Coronary computed tomography angiography (CCTA) signs of unstable plaques of coronary artery disease
Badamsed Ts ; Delgertsretseg D ; Jargalsaikhan S ; Erdenechimeg E ; Sodgerel B ; Bayaraa T ; Galsumiya L ; Natsagdorj U ; Pilmaa Yo
Mongolian Medical Sciences 2021;197(3):48-51
Background:
The American Heart Association estimates that more than 1 million people die each
year from acute coronary heart disease and half a million from acute coronary syndrome, and
that $ 115 billion a year is spent on diagnosing and treating coronary heart disease [Word Health
Organization, 2013].
Goal:
In this study we aimed to using coronary computed tomography angiography (CCTA) to
diagnose unstable plaques in coronary artery disease.
Material and methods:
From 2018 to 2021, we performed a coronary computed tomography
angiography (CCTA) scan with a Philips Ingenuity 64-slice computed tomography (64 MD-CT)
device and examined 47 patients diagnosed with unstable coronary artery disease at the Reference
centre on Diagnostic Imaging named after R.Purev State Laureate, People’s physician and Honorary
professor of the State Third Central Hospital.
Common statistical measurements such as means and standard errors were calculated. Probability
of results were checked using Student’s test.
Result:
In studying signs of coronary computed tomography angiography (CCTA) to diagnose unstable
plaques in coronary artery disease that coronary artery diameters more widening to compared healthy
artery 16(34.0%±6.9), low density sites clarify in plaque (lower than +30HU)- 14(29.8%±6.7), small
calcification detect in plaque 36 (74.5%±6.4), ring liked additional density (lower than +130 HU)
sees in edge of plaque (Halo sign)-9(19.2%±5.8), plaque edge roughness, erosion liked changes- 18
(38.3%±7.1), rupture of intima (dissection)- 8(17.0%±5.5).
Conclusion
We detect that computed tomography angiography (CCTA)’s specific signs of unstable
plaque of coronary artery disease are coronary artery diameters widening, low density sites clarify in
plaque (lower than +30HU), small calcification detect in plaque, ring liked additional density (lower
than +130 HU) sees in edge of plaque (Halo sign), plaque edge roughness, erosion liked changes
and rupture of intima.