Ramya Venkatesan, (2023) Serum Lipid Profile and Its Correlation with Iron Deficiency Anemia. Masters thesis, Kilpauk Medical College, Chennai.
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Abstract
INTRODUCTION: In an era where there is an increasing prevalence of atherosclerotic vascular disease, the factors that contribute to atherosclerosis need to be evaluated. Hyperlipidemia is one of the chief contributors to the atherosclerotic process. Yet another significant issue in the spotlight in India is the prevalence of anemia. Anemia, as per the World Health Organisation (WHO), is defined as Hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men. Maram et al. in their study showed that iron deficiency anemia was a significant risk factor for dyslipidemia in the Egyptian population and its treatment led to significant reduction in lipids levels. Studies also have demonstrated that iron deficiency affected lipid metabolism by down regulating apolipoprotein H expression and thus is likely to cause increased cholesterol, triglycerides and LDL in plasma. Thus, with an increase in the prevalence of both Atherosclerotic Cardiovascular disease (ASCVD) and iron deficiency anemia, in India, a correlation, if established, can help in treatment of anemia which will have a beneficial effect on the lipid levels, which in turn can serve as a protective mechanism against ASCVD. AIM OF THE STUDY: 1. To look for a correlation between the lipid profile and iron deficiency anemia. 2. To look for the alterations in lipid profile of the patients after correction of iron deficiency. MATERIAL AND METHODS: STUDY DESIGN: Prospective observational study STUDY PERIOD: 6 months STUDY CENTRE: Dept of General Medicine, Government Kilpauk Medical College, Chennai. TOTAL SAMPLE SIZE: On basis of my reference article, with a confidence interval of 95%, using the method of sample size for difference between the means, my sample size is 66 for each group. Adding 10% for loss to follow up, my final sample size is 73+73 – 146 subjects. INCLUSION CRITERIA: Informed consent. Age >18 years CASES: Patients with iron deficiency anemia without the co-morbidities mentioned in the exclusion criteria. CONTROLS: Non-anemic patients matched for age, sex and BMI., without the conditions mentioned in the exclusion criteria. EXCLUSION CRITERIA: 1. Individuals with chronic diseases like systemic hypertension, diabetes mellitus, prior myocardial infarction, prior cerebrovascular accidents, hypothyroidism, nephrotic syndrome. 2. Patients with liver diseases. 3. Patients on lipid lowering medications, glucocorticoids, diuretics, beta blockers were excluded from the study. 4. Patients with retroviral diseases. 5. Patients with a BMI 25. 6. Age <18 years and pregnancy. SUMMARY: A female predominance was reported in the current study with 82 females (56.2%) and males were 64 (43.8%). In the case group, 42 females were seen and 40 males were included, followed by 31 females and 33 males in the control group. Out of 73 patients in the case group, 41 patients presented with moderate anemia (56.2%), followed by severe anemia in 29 patients (39.7%). All participants in the current study were observed with normal levels of HDL in both groups. The study reports a significant difference in the LDL levels in patients in the case and control groups (p-value = 0.001). Elevated levels of LDL were reported in 7 patients in the case group and 23patientss in the control group. The current study reports that severe anemia patients were seen with increased triglyceride levels (24.1%), followed by increased VLDL levels in 24.1% of the patients. Patients with moderate anemic conditions were seen with elevated levels of triglycerides (14.6%). An increased level of LDL was seen in patients with moderate anemia (14.6%). The study finds that the control group significantly had elevated levels of cholesterol levels when compared with the case group and reports a statistical difference in HDL and LDL levels for the case and control group respectively (p-value <0.0001). The study reports a significant difference concerning the total cholesterol levels among patients with mild, moderate, and severe anemia (p-value <0.0001). In addition, the study also reports a significant difference in the HDL and LDL levels in the case group with a p-value of 0.001. A 3-month follow-up revealed mild anemia in 32.9% of the patients, and 50.7% of patients were not anemia anymore. However, a loss to follow-up was reported in 12 patients (16.4%). 50.7% of patients after a 3-month follow-up were reported with no amenia, however, the prevalence of mild anemia was seen with a mean of 120.54 (SD = 14.44) in 32.9% of patients. The study reports a significant difference in total cholesterol levels with the severity of anemia after 3 months. CONCLUSION: Anemia and lipid profile pose a direct relationship that adversely affects the clinical condition of patients. The current study was conducted among case and control groups with a mean age of 39.52 (SD = 17.08) and 37.26 (SD = 15.75) respectively with a female predominance of 56.2%. The severity of anemic condition differed in the participants out of which 56.2% were moderately anemic and 39.7% were severely anemic. The comparison of LDL levels in the case and control group revealed a significant difference which revealed that patients with anemia are more prone to a decreased level of lipid profile. A significant difference was reported in the comparison of case and control groups concerning the differences in HDL and LDL levels among patients (p-value <0.0001). In addition, the severity of anemia and the decreased levels of total cholesterol in the case group with a significant difference (p-value <0.0001) which demonstrates the correlation of anemic condition with lipid profile. To assess further, the study also conducted a 3-month follow-up for which reported 50.7% of normalized patients and 32.9% with the mild anemic condition. The study finds a significant correlation between total cholesterol levels and a 3-month severity assessment of anemia (p-value <0.0001). To conclude, the current study reports a direct relationship between anemia and the prevalence of altered lipid profiles among patients affected majorly with decreased levels of total cholesterol, HDL, and LDL levels. Hence, patients with anemic conditions can be tested for a lipid profile to prevent further at-risk complications. Similarly, low lipid levels in patients with unknown etiology can be correlated with the incidence of anemia.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg.No.200120102019 |
| Uncontrolled Keywords: | Serum Lipid Profile, Correlation, Iron Deficiency Anemia. |
| Subjects: | MEDICAL > General Medicine > MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 04 May 2021 09:09 |
| Last Modified: | 22 Mar 2024 16:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/15793 |
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