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

Chackathayil, Julia (2013). Antecedents, characterisation and validity of cardiovascular disease biomarkers amongst South Asians in the UK. University of Birmingham. Ph.D.

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Abstract

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.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

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