title: Is the higher risk of cardiovascular disease amongst South Asian populations linked to abnormalities of haemoglobin? A preliminary case control study.
abstract: The elevated burden of cardiovascular disease (CVD) amongst South Asian populations is a complex and multi-factorial phenomenon. South Asians evolved from environments where malaria was endemic, and while haemoglobin disorders frequent this group, a link to CVD has not been described. Using a case-control feasibility study, haemoglobin abnormalities identified by mass spectrometry were compared between South Asian patients with CVD (n = 72) and non-CVD controls (n = 84). Carotid-artery intima media thickness (CIMT) was used as a marker of vascular damage. Ultracentrifugation was used to separate lipoprotein subfractions, which were analysed for iron. Haemoglobin anomalies were more frequent for CVD patients than controls (34.7% vs. 14.3%, P < 0.001), as were subfractionated lipoprotein concentrations of iron (P < 0.001). Patients with haemoglobin disorders had greater CIMT (0.75 vs. 0.65 mm, P = 0.008), and lower HDL cholesterol (0.78 vs. 1.03 mmol/l, P = 0.003). These preliminary data suggest that haemoglobin disorders contribute to atherosclerotic disease in South Asians and further research is warranted.
authors.affiliation: Sandwell Medical Research Unit & University of Birmingham Centre for Cardiovascular Sciences Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK. Jeetesh.Patel@nhs.net
authors.forename: Jeetesh V
authors.initials: JV
authors.lastname: Patel
authors.forename: Julia
authors.initials: J
authors.lastname: Chackathayil
authors.forename: Brian
authors.initials: B
authors.lastname: Gammon
authors.forename: Inessa
authors.initials: I
authors.lastname: Tracey
authors.forename: Adam
authors.initials: A
authors.lastname: Lovick
authors.forename: Paramjit S
authors.initials: PS
authors.lastname: Gill
authors.forename: Amitava
authors.initials: A
authors.lastname: Banerjee
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Scarff
authors.forename: James H
authors.initials: JH
authors.lastname: Scrivens
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hughes
mesh_terms: D001208:Asia; D044466:Asian People; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006455:Hemoglobins, Abnormal; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D006455:Hemoglobins, Abnormal