Comparative Study of the Level of Atherogenic Markers; Remnant Cholesterol, Non-HDLc, Total Cholesterol-HDLc Ratio and LDLc-HDLc Ratio, in Overweight and Obese Subjects in Nnewi South East Nigeria

Abstract

Background: Obesity elevates the risk of developing diabetes, coronary artery disease, fatty liver, gall stones, sleep apnea, arthritis and various types of cancer. Atherogenic indices have been suggested to be a link from obesity to coronary heart diseases, hence a predisposing factor in the development of cardiovascular disease by obese individuals. We looked at the level of these selected indices and their association with obesity. Aim: The aim of this study is to evaluate and compare the Level of atherogenic markers concentration, in relation to body mass index of overweight and obese participants in Nnewi, South East Nigeria. Methods: A total of 90 apparently healthy obese, overweight and normal weight participants who met the inclusion criteria were randomly enrolled into the study. They were grouped using their body mass index of 18.5 to 24.9 kg/m2 (normal weight), 25 to 29.9 kg/m2 (overweight) and ≥30 kg/m2 (obese). The parameters were measured using standard laboratory methods and statistical analysis was performed using SPSS 20.0. Results: There was progressive increase of remnant cholesterol among the groups. There was no statistical difference (p>0.05) in the mean calculated remnant cholesterol (mmol/l) among the obese (0.72±0.4), overweight (0.68±0.46), and normal weight (0.50±0.28) participants. Mean fasting very low density lipoprotein (VLDL) and triglyceride (TG) (mmol/l) were significantly higher (p<0.05) in overweight and obese participants when compared to normal weight participants respectively, while plasma FBS levels (mmol/l) were significantly lower in normal weight participants when compared to overweight participants and obese participants. RC correlated negatively with non-HDLc and was not significant, but positively with TC/HDLc ratio and not significant also negatively significant with LDLc/HDLc ratio. In the overweight category, RC correlated negatively with non-HDLc, LDLc/HDLc but not significant and positively with TC/HDLc ratio but not significant. Finally in the obese group it was observed that RC correlated negatively with non-HDLc, positively with LDLc/HDLc and TC/HDLc ratio but was not significant. Conclusion: The association of calculated remnant cholesterol with BMI is weak. Non-HDLc is strongly associated with obesity as well as TC/HDLc and LDLc/HDLc ratios. There was a negative correlation between calculated RC and non-HDLc. This suggests that remnant cholesterol can be elevated in any individual without apparent increase in BMI.