The increased risk of cardiovascular disease (CVD) amongst South Asians (SAs) is unclear. This thesis examined potential biomarkers to address this. Cross-sectional data on SAs from community (n=1304) and hospital (n=148) populations was collected. Biomarkers were analysed by genotyping, mass spectrometry, automated-immuno-colourimetric-assays, ELISAs, and a new in-house assay for a novel marker, ferritin bound to apolipoprotein B. Diagnostic performance was assessed using receiver operating curves, logistic and linear regression models. C-reactive protein (CRP) was a comprehensive marker of CVD risk, where a range of 1.43-2.30 mg/L maximised sensitivity and specificity. CRP SNP (single nucleotide polymorphism) -390C>T/A contributed minimally to variation in CRP levels. Non-fasting triglycerides discriminated SAs at increased CVD risk, where APOA5 SNP -1131T>C was an independent predictor of triglycerides but APOC3 SNP -455T>C and -482C>T were not associated with triglycerides. The performance of IL-6, vWF, D-dimer and P-selectin were poor in comparison to CRP and triglycerides. BNP discriminated SAs with systolic heart failure with a cut off value of 36.4 pmol/l. Of the newly investigated biomarkers, a link between haemoglobin abnormalities and CVD was observed potentially through a mechanism involving iron transportation on lipoproteins. CRP and triglycerides should be considered in the routine CVD risk assessment of SAs.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:577838 |
| Date | January 2013 |
| Creators | Chackathayil, Julia |
| Publisher | University of Birmingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.bham.ac.uk//id/eprint/4418/ |
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