Epidemic of Coronary Artery Disease in Young Indians: Comparative Study of Lipid Indices in Children of Patients with and without Premature Coronary Artery Disease

Abstract

Aims and Objectives: The aim is to study the role of routine and advanced lipids in predicting the premature coronary artery disease (PCAD) risk in children of patients who have presented with PCAD. Subjects and Methods: Our study enrolled 193 children (of PCAD patients-as cases) and 193 children of healthy adults as controls after satisfying the inclusion and exclusion criteria. Both groups had children aged between 4 and 21 years and were age-matched. Fasting samples were drawn for conventional lipid profile, lip (a), small dense low-density lipoprotein (SD LDL), Apolipoprotein-A1 (Apo A1), and Apolipoprotein-B (Apo B). Furthermore, lipid indices such as lipid pentad index (LPI), lipid tetrad index, atherogenic index, and lipid ratios such as Apo B/Apo A1, total cholesterol/high-density lipoprotein (TC/HDL), and HDL/LDL ratio were calculated. Results: The group had 51.8% males and 48.2% females. Body mass index was normal in the study group, but reached statistical significance in cases (19.2 ± 3.27 vs. 17.6 ± 2.98; P = 0.01). History of smoking, either active or passive, and gender had a neutral effect on the lipid parameters. The levels of TC, LDL-C, non-HDL, triglycerides, non-HDL, very LDL, Lip (a), and Apo-B were higher and reached statistical significance in cases and the levels of HDL-C and Apo A-I were low in cases. The LDL-C/HDL-C ratio (2.99 ± 1.31 vs. 2.3 ± 0.74; P < 0.001) and TC/HDL-C ratio (5.35 ± 3.2 vs. 4.0 ± 1.01; P < 0.001) was higher in cases. In addition, the LDL-C/HDL-C ratio and LPI were found to be a better predictors of PCAD. Conclusions: Children of PCAD patients were noted to have a higher association of dyslipidemia when compared to controls. Conventional lipids and Lip (a) were high whereas Apo A-I levels were found to be low when compared to controls. SD LDL, LDL/HDL ratio, and LPI can be used as screening tests to predict the occurrence of premature CAD. Therefore, these children should undergo screening for the presence of dyslipidemia. Thereby measures for a healthy life can be initiated early.