Antecedents, characterisation and validity of cardiovascular disease biomarkers amongst South Asians in the UK

[摘要] 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.

[发布机构] University:University of Birmingham;Department:School of Health and Population Sciences

[关键词] H Social Sciences;HT Communities. Classes. Races