ISSN: 2320-5407 Int. J. Adv. Res.

10(02), 572-575

Journal Homepage: -www.journalijar.com

Article DOI:10.21474/IJAR01/14240
DOI URL: http://dx.doi.org/10.21474/IJAR01/14240

RESEARCH ARTICLE
A STUDY OF LIPID PROFILE IN ANAEMIA

Anita Kumari1, Sanjeet Kumar Singh 2, Ravi Shekhar3 and Swati Mittal4
1. Assistant Professor Physiology, All India Institute of Medical Sciences, Deoghar.
2. Additional Professor Pathology, Indira Gandhi Institute of Medial Sciences, Patna.
3. Additional Professor Biochemistry, Indira Gandhi Institute of Medial Sciences, Patna.
4. Assistant Professor Physiology, All India Institute of Medical Sciences, Deoghar.
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Manuscript Info Abstract
……………………. ………………………………………………………………
Manuscript History Objectives: Both anemia and dyslipidemia are widely prevalent public
Received: 15 December 2021 health problems, especially in the Indian population. Association of
Final Accepted: 17 January 2022 anemia and dyslipidemias were reported in some individual
Published: February 2022 experimental animals. The study was planned to find the changes in
serum lipid profile in adult Indian patients with anemia.
Key words:-
Anemia, Cholesterol, Lipid Profile, Material and methods:100 cases of anemia (hemoglobin <13 gm% in
Triglycerides men and <12 gm% in women), and 100 age and sex matched healthy
controls, in the age group 18-40 years were investigated for any
possible changes in serum lipid profile i.e., triglycerides, total
cholesterol, high density lipoprotein cholesterol, very low density
lipoprotein cholesterol.
Results: The mean cholesterol in patients with anemia was 122.47 ±
29.32 mg/dl, whereas in controls group was 160.43 ± 38.91 mg/dl. The
mean serum triglyceride level in patients with anemia was 89.41 ±
33.1532 mg/dl and in control group was 111.45 ± 40.6632 mg/dl. Mean
high-density lipoprotein levels were 36.13 ± 12.8132 mg/dl in anemic
group and 45 ± 13.032 mg/dl in control group, whereas low-density
lipoprotein (LDL) cholesterol level was 70.12 ± 21.64 mg/dl in the
anemic group and 100.45 ± 30.8032 mg/dl in control group. VLDL
levels were higher in control group (21.96 ± 8.132 mg/dl) compared to
the anemic group (18.34 ± 7.6432 mg/dl).
Conclusion: Lipoproteins levels were significantly abnormal in anemic
as compared to non-anemic subjects.

Copy Right, IJAR, 2022,. All rights reserved.

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Introduction:-
Both anemia1,2,3 and dyslipidemia4 are widely prevalent problems across India, irrespective of the socio-economic
status of the people3,5. Dyslipidemia is one of the important risk factors for development of CAD. Another equally
important public health concern is the prevalence of anemia.

Nutritional deficiency, especially the iron deficiency, is the most common cause of anemia irrespective of age,
gender, and socio-economic status in India. Iron is an essential metal required for many physiological functions of
the body, such as oxygen transport and enzymatic reactions. However, excess iron is harmful because of generation
of free radical leading to tissue damage6,7,8,9.

Corresponding Author:- Sanjeet Kumar Singh 572

Address:- Additional Professor Department of Pathology, Indira Gandhi Institute of Medical
Sciences, Sheikhpura, Patna.
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Several studies have been done to show the relationship between anemia and lipid profile. Verma et al.10 and
Antappanavar et al.11 showed that triglycerides and VLDL levels are increased in iron deficiency anemia as
compared to non-anemic patients, whereas low-density lipoprotein (LDL), cholesterol level were found lower in
anemic patients. Sandeep et al.12 found lower levels of total cholesterol, high-density lipoprotein (HDL), LDL,
VLDL, and triglyceride levels in anemic patients as compared to healthy controls.

Choi J.W. et al.13 found that girls with severe iron deficiency anemia have lower serum total cholesterol and
triglyceride concentrations and returned to normal levels after iron replacement therapy.

The present study is an attempt to investigate the relationship between anemia and blood lipid levels in Indian
adults.

Materials and Methods:-

The study was conducted in the Indira Gandhi Institute of Medical Sciences, Patna, Bihar with prior approval from
Institutional Ethical committee.

The participants were enrolled into the study after obtaining their written informed consent. 100 proven cases of
anemia, both male and female, of age 18-40 years were included in the study after obtaining their written informed
consent.

100 healthy sex matched adults within the same age group were taken as the control group. Anemia was defined as
hemoglobin <13 gm% in men and <12 gm% in women. Patients with diabetes mellitus, CAD, cerebrovascular
disease, nephrotic syndrome, retroviral disease, obesity (BMI> 25 kg/m 2), and those who were receiving
glucocorticoids, diuretics, beta blockers, and statins were excluded from the study. Hb level was estimated by
automated hematology analyser, Sysmex XT 1800i. Analysis of serum lipid levels, which included Total cholesterol
(TC), Triglycerides (TG), High Density Lipoprotein (HDL) cholesterol, Low Density Lipoprotein (LDL) cholesterol
and Very Low Density Lipoprotein (VLDL) cholesterol were done in all subject, using the enzymatic method by
fully auto biochemical analyzer, Beckmen Synchron Clinical System CX4, (Beckman Coulter, Inc, California,
USA).

Statistical analysis:
All results were expressed in Mean±S.D. Data were analyzed using SPSS, version 24. An Independent student’s t-
test was used to compare the means of variables. Pearson’s correlation was used to find out the correlation between
the variables. p value < 0.05 was considered significant.

Result:-
A total of 200 participants were included in the study, which includes 100 cases and 100 controls. Among the cases,
63 were females and 37 were males. In the control group, 58 were females and 42 were males. There was no
difference in the age-wise distribution of patients between two groups. Of 100 cases, 36 had hemoglobin less than 7
gm%, 46 had hemoglobin between 7 and 10 gm%, and 18 had hemoglobin more than 10 gm%.

Table No. 1:- Base line characteristics of Group I and Group II.

Variable Group I (Control) Group II (Anemic)

(n=100) (n=100)
Age (Years) mean±SD 28.07 ±6.03 28.64 ± 6.37
Gender
Males, n 42 37
Females, n 58 63

Table 2 shows the comparison of lipid profile among the anemic group and controls. The levels of serum TG and
serum VLDL were significantly higher in the anemic group, whereas the levels of LDL were significantly lower.

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Table No. 2:- Comparison of lipid profile among Group I and Group II.
Lipid Profile Group I (Control) Group II (Anemic) P value
(n=100) (n=100)
Total cholesterol (mg/dl) 160.45 ± 37.53 152.66 ± 42.63 P>0.05
LDL cholesterol (mg/dl) 97.32 ± 62.37 84.31 ± 36.56 P<0.001
VLDLcholesterol (mg/dl) 21.87 ± 6.75 28.39 ± 8.62 P<0.001
TG cholesterol (mg/dl) 107.39 ± 23.84147 147.76 ± 43.62 P<0.001
HDL cholesterol (mg/dl) 40.08 ± 6.56 37.21 ± 8.63 P>0.05
P<0.001 - Highly significant.P>0.05 - Not significant.

Disscusion:-
Both iron and cholesterol are important metabolites in the human body, and excess or deficiency of either of them
could affect seriously. Iron deficiency is the world’s most widespread nutritional disorder and also the commonest
cause of anemia occurring regardless of age, gender and socio-economic status of the people, affecting both
industrialized and developing countries. It is an important public health problem because of its complications14.

According to WHO, prevalence of iron deficiency is 42.3% in women (15-59 years) and 30% in men (15-59 years)
in the developing world. The report also estimated that 88% of pregnant females and 74% of non-pregnant females
are anemic15.

Dyslipidemia refers to elevated or reduced levels and/or functional impairment of lipoproteins. Primary
dyslipidemias occur due to hereditary defects in lipoprotein metabolism. Secondary dyslipidemia is due to obesity,
hypothyroidism, sedentary lifestyle, type 2 diabetes mellitus, chronic kidney disease, excessive alcohol
consumption, primary biliary cirrhosis, cholestatic liver diseases, rheumatic diseases, nephrotic syndrome, HIV
infection and some medications.

It is one of the major risk factor in the development of CAD. Various studies 16,17 have shown the elevated plasma
levels of lipid as risk factors in emergence of CAD.

The present study found significantly raised levels of both TG and VLDL cholesterol levels in the anemic subjects,
as compared to healthy controls. Similar results were observed by Tanzer et al. in Turkish children.

Shirvani et al., in their study conducted on elderly patients, showed that serum triglyceride, cholesterol and LDL
levels were lower in the iron deficiency group than in the control group18.

Yang et al. showed that women with iron deficiency anemia had higher serum triglyceride levels than healthy
controls, while theyhad lower HDL cholesterol levels than healthy controls 19.

A study on Korean girls (14-19 years) showed reduced levels of TG in severe anemia13 while another study20 on
Turkish children with anemia reported no effect on either TG or VLDL levels.

Various studies have been performed to define the related mechanisms underlying dyslipidemias in anemia. High
TG levels have been explained on the basis of impaired carnitine biosynthesis together with increased TG synthesis
and decreased TG degradation6,21,22 in anemia. Lower serum cholesterol can be due to decreased hepatic synthesis23
or dilutional effects of serum22,23,24.

Long-term follow-up studies are required to know whether the hypocholesterolemia caused by anemia has a
beneficial effect on atherosclerosis and its complications. The effect of treatment of anemia on lipid profile also
needs to be further evaluated.

Conclusion:-
These findings indicate that there is abnormal serum lipid profile in anemia in Indian adults, which is consistent with
the findings of several other studies. Nonetheless, to identify the possible mechanisms, further studies are
recommended to be carried out.

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Conflict of Interest:
None.

Source of Funding:
Self.

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