European Journal of Cardiovascular Medicine

Dyslipidemia is now regarded as a substantial risk factor that might be modified by lifestyle modifications, based on 2020 report from the World Health Organisation,  and is a main cause of cardiovascular disease , globally, the main cause of both mortality and morbidity is cardiovascular disease.[1]  While cardiovascular diseases (CVD) account for 31.7% of all fatalities in India, the World Health Organisation notes that they only account for 17% of deaths in less developed countries. [1,2] From 2.26 million in 1990 to 4.77 million in 2020, the World Health Organisation's 2023 World Heart Report notes a notable rise in the mortality toll resulting from coronary heart disease (CHD). [3,4]

The current study "A study of the association of serum lipid profile with body mass index (BMI) in young Indian adults," was carried out at G.S.V.M. Medical College in Kanpur , ( U.P. ) , India , on 120 healthy first-year professional M.B.B.S. students, ages 18 to 25 years. After being informed about the study, the subjects gave their informed consent. Random selection was used to select the subjects. BMI was calculated and the measurement of waist circumference was taken at the umbilicus level. The waist-hip ratio was computed, and hip circumference was measured at the level of the greater trochanter. After an overnight fast of 12 to 14 hours, 5 ml of venous blood was drawn for the lipid profile (TC, TG, and HDL-C), which was performed using an auto analyzer in the pathology department of G.S.V.M. MedicalCollege,Kanpur ( U.P.) , India. .  

Each subject was asked to fill out a working proforma.

Each subject's anthropometric measurements, including height, weight, waist circumference (WC), hip circumference (HC), and body mass index (BMI), were noted.Weight (kg)/height (m2) was used to calculate the body mass index. Weight was measured without shoes and in light clothing. With no shoes on, heels together, and the head, shoulders, and buttocks touching the vertical wall surface, height was measured against the wall. The measurement of waist circumference was taken at the umbilicus level. The waist-hip ratio was computed, and hip circumference was measured at the level of the greater trochanter. After an overnight fast of 12 to 14 hours, 5 ml of venous blood was drawn for the lipid profile (TC, TG, and HDL-C), which was performed using an auto analyzer in the pathology department of G.S.V.M. Medical College,Kanpur .

The subjects were divided into following groups:

1. LIPID PROFILE ACCORDING TO BMI: “The male and female subjects were divided according to BMI with normal weight and overweight subjects shows the division of males and females respectively as in table 1 & 2 .. There were 55 males with BMI < 25 kg/m² and 5 males with BMI ≥ 25 kg/m²” . Mean BMI with normal weight was 20.76 ± 1.87 in males as compared to 27.39 ± 1.07 among BMI with overweight males.

Among Females, there were 45 females with “BMI < 25 kg/m²” and 15 females with “BMI ≥ 25 kg/m²”. Mean BMI with normal weight was 21.18 ± 1.87    in females as compared to 29.07 ± 1.07 among BMI with overweight females.

Table-1 Male subjects according to BMI

TABLE-2 Female Subjects According To BMI

2. LIPID PROFILE ACCORDING TO ACCORDING TO WC: “The male and female subjects were further divided according to reference (WC) as shown in Table 3 and 4respectively. There were 52 males with WC < 94 cm and 8 males with WC ≥ 94 cm. Among Females, there were 36 females with WC < 80 cm and 24 females with WC ≥ 80 cm”.

Table 3. Male Subjects According To Waist Circumference (WC)

Table 4 Female Subjects According To Waist Circumference (WC)

• LIPID PROFILE ACCORDING TO WHR: “The male and female subjects were waist-HHHHHHip Ratio (WHR) as shown in Table 5 and 6 respectively. There were 47 males with WHR < 0.90 and 13 males with WHR ≥ 90. Among Females, there were 16 females with WHR <0.85 and 44 females with WHR ≥ 0.85”

Table 5. Male Subjects According To Waist- Hip Ratio (WHR)

Table 6. Female Subjects According To Waist- Hip Ratio (WHR)

SD: Standard deviation

Table 6. Lipid Profile (mg/dl) According To Body Mass Index (BMI)

Normal total cholesterol <200 mg/dl, Normal triglyceride 30-200 mg/dl,Normal HDL 40 - 60mg / dl Normal LDL <100 mg/dl

Lipid profile on the basis of waist circumference (WC)

 :- “In below risk level (WC < 94 cm)  males, mean Cholesterol was 143.67± 21.87 mg/dl and in at risk level (WC ≥ 94 cm) males it was 184.62± 31.71 mg/dl. Total cholesterol was increased in at risk level males as compared to below risk level. Whereas in below risk level (< 80 cm) females, mean Cholesterol was 172.13 ± 16.71 mg/dl and in at-risk level (WC ≥ 80 cm) females it was 193.16 ± 18.73 mg/dl. Total cholesterol was increased in at risk level females as compared to below risk level females. (5,6,7,8,9).

The mean triglyceride was 137.74 ± 18.37 mg/dl in below risk level (WC < 94 cm) males and in at-risk level (WC ≥ 94 cm) males it was 184.8 ± 36.21 mg/dl. Mean triglyceride was increased in at risk level males as compared to below risk level males. Whereas in below risk level females, mean triglyceride was 140.3 ± 18.91 mg/dl in below risk level females and in at-risk level females it was 180.29 ± 27.32 mg/dl. Total cholesterol was increased in at risk level females as compared to below risk level females.

Mean HDL was reduced in both the sexes among at risk level individuals. The mean HDL was 45.67 ± 10.67 mg/dl in below risk level males and in at-risk level males it was 29.62 ± 6.71 mg/dl. Mean HDL was 47.75 ± 4.91 mg/dl in below risk level females and in at-risk level females it was 43.5 ± 8.92 mg/dl.

The mean LDL was 62.01 ± 18.71 mg/dl in below risk level males and in at risk level males it was 80.75 ± 20.61 mg/dl. Mean LDL was increased in at risk level as compared to below risk level males. Whereas in below risk level females, LDL was 64.52 ± 11.92 mg/dl in below risk level females and in at risk level females it was 78.54 ± 18.72 mg/dl. LDL was increased in at risk level females as compared to in below risk level females.

The mean VLDL was 25.23 ± 6.71 mg/dl in in below risk level males and in at-risk level males it was 26.37 ± 4.12 mg/dl. Mean VLDL was increased in at risk level males as compared to in below risk level males. Whereas in below risk level females, VLDL was 25.27 ± 5.94 mg/dl in below risk level females and in at-risk level females it was 26.27 ± 6.72 mg/dl. VLDL was increased in at risk level females as compared to in below risk level females.

According to our study, we found the conclusions as in males and females both, the lipid profile levels according to Body Mass Index (BMI) were within normal range. In normal weight males, mean Cholesterol was 144.88± 16.21 mg/dl and in over weight males it was 196.8 ± 23.12 mg/dl. Total cholesterol was increased in overweight males as compared to normal weight males. Whereas, in normal weight females, mean Cholesterol was 172.13 ± 21.32 mg/dl and in over weight females, it was 207.66 ± 17.26 mg/dl. Total cholesterol was increased in overweight females as compared to normal weight females. (Normal total cholesterol <200 mg/dl).(6,7,8,9,10)

The mean triglyceride was 137.74 ± 18.37 mg/dl in normal weight males and in over weight males it was 184.8 ± 36.21 mg/dl. Mean triglyceride was increased in overweight males as compared to normal weight males. Whereas, in normal weight females, mean triglyceride was 144.53 ± 21.32 mg/dl in normal weight females and in over weight females it was 191.6 ± 16.27 mg/dl. Total mean Triglyceride levels was increased in overweight females as compared to normal weight females. (Normal triglyceride 30-200 mg/dl ).

The mean LDL was 61.98 ± 24.74 mg/dl in normal weight males and in over weight males it was 92.4 ± 24.23 mg/dl. Mean LDL was increased in overweight males as compared to normal weight males. Whereas, in normal weight females, LDL was 64.13 ± 18.67 mg/dl in normal weight females and in over weight females it was 88.13 ± 7.42 mg/dl. LDL was increased in overweight females as compared to normal weight females. (Normal LDL <100 mg/dl).

In below risk level (WC < 94 cm) males, mean Cholesterol was 143.67± 21.87 mg/dl and in at-risk level (WC ≥ 94 cm) males it was 184.62± 31.71 mg/dl. Total cholesterol was increased in at risk level males as compared to below risk level. Whereas in below risk level (< 80 cm) females, mean Cholesterol was 172.13 ± 16.71 mg/dl and in at-risk level (WC ≥ 80 cm) females it was 193.16 ± 18.73 mg/dl. Total cholesterol was increased in at risk level females as compared to below risk level females.

The mean triglyceride was 137.74 ± 18.37 mg/dl in below risk level (WC < 94 cm) males and in at-risk level (WC ≥ 94 cm) males it was 184.8 ± 36.21 mg/dl. Mean triglyceride was increased in at risk level males as compared to below risk level males. Whereas in below risk level females, mean triglyceride was 140.3 ± 18.91 mg/dl in below risk level females and in at-risk level females it was 180.29 ± 27.32 mg/dl. Total cholesterol was increased in at risk level females as compared to below risk level females.

The mean LDL was 62.01 ± 18.71 mg/dl in below risk level males and in at-risk level males it was 80.75 ± 20.61 mg/dl. Mean LDL was increased in at risk level as compared to below risk level males. Whereas in below risk level females, LDL was 64.52 ± 11.92 mg/dl in below risk level females and in at-risk level females it was 78.54 ± 18.72 mg/dl. LDL was increased in at risk level females as compared to in below risk level females.

In below risk level (WHR <0.90) males, mean Cholesterol was 148.71 ± 21.87 mg/dl and in at risk level (WHR <0.90) males it was 184.62± 31.71 mg/dl. Total cholesterol was increased in at risk level males as compared to below risk level. Whereas in below risk level (WHR <0.85) females, mean Cholesterol was 181.5 ± 16.71 mg/dl and in at-risk level (WHR ≥ 0.85) females it was 193.16 ± 18.73 mg/dl. Total cholesterol was increased in at risk level females as compared to below risk level females.

The mean triglyceride was 138.48 ± 26.71 mg/dl in below risk level (WC < 94 cm) males and in at-risk level (WC ≥ 94 cm) males it was 155.23 ± 18.72 mg/dl. Mean triglyceride was increased in at risk level males as compared to below risk level males. Whereas in below risk level females, mean triglyceride was 142.43 ± 18.91 mg/dl in below risk level females and in at-risk level females it was 161.34 ± 27.32 mg/dl. Total cholesterol was increased in at risk level females as compared to below risk level females.

The mean LDL was 64.42 ± 18.71 mg/dl in below risk level males and in at-risk level males it was 65.78 ± 20.61 mg/dl. Mean LDL was increased in at risk level as compared to below risk level males. Whereas in below risk level females, LDL was 64.43 ± 11.92 mg/dl in below risk level females and in at-risk level females it was 72.2 ± 18.72 mg/dl. LDL was increased in at risk level females as compared to in below risk level females.

In our study, we compared the lipid profile levels in normal weight and overweight subjects according to their BMI, waist circumference (WC), and waist hip ratio (WHR). It found that overweight individuals had higher levels of cholesterol, triglyceride, and high-density lipoprotein (HDL) compared to normal weight individuals. (8,9,11,12,15) The mean cholesterol was higher in overweight males and higher in overweight females, while triglyceride levels were also higher in overweight males and higher in overweight females. The mean HDL levels were lower in both genders in the overweight category. LDL levels were higher in overweight males and higher in overweight females.The study also found a positive correlation between Body Mass Index (BMI) and Total Cholesterol and Triglycerides, but not with LDL and VLDL parameters in males.               (10,11,14,18) Male BMI was negatively correlated with HDL Cholesterol. Waist circumference was positively correlated with all lipid profile constituents except HDL cholesterol, with a negative correlation with total cholesterol and Triglycerides. Among females, a significant positive correlation was found between Body Mass Index (BMI) and Total Cholesterol and Triglycerides using Chi-square with Yates correction. Females had a negative correlation with HDL cholesterol.

The prevalence of obesity is on the rise in developing countries like India due to changes in lifestyle, diet, and increasing urbanization. Previous studies have reported similar findings of an increase in Total cholesterol (TC) levels in lean and obese men, as well as an increase in Triglycerides (TG) levels in overweight adults. However, no significant difference in Triglyceride levels was found between obese and non-obese individuals.

In conclusion, the study suggests that overweight individuals may have higher levels of cholesterol, triglyceride, HDL, LDL, and VLDL compared to normal weight individuals. A positive correlation was found between BMI and Total Cholesterol and Triglycerides, but not with LDL and VLDL parameters in males.

In males, waist circumference was positively correlated with all lipid profile constituents except HDL cholesterol, with a negative correlation with total cholesterol and Triglycerides. In females, waist circumference was positively correlated with all lipid profile constituents except HDL cholesterol, with a significant correlation with total cholesterol and Triglycerides. Females had a negative correlation with HDL cholesterol, while the correlation between waist circumference and LDL was statistically significant. The Waist-Hip Ratio was not statistically significant in relating to the rest of lipid profile parameters.The study found a positive correlation between Body Mass Index (BMI) , Total Cholesterol and Triglycerides using Chi-square with Yates correction.So , in conclusion, the study highlights the importance of lipid profile parameters in determining overall health. The study also found a positive correlation between BMI, waist circumference, and waist hip ratio with total cholesterol, triglycerides, and low-density lipoprotein cholesterol, which is consistent with previous researches. (5,9,11,13,18).

ETHICAL APPROVAL: -Ethical approval was given by Ethical committee of the Medical college.The written consent was taken from each subject of the study.

CONFLICT OF INTEREST: - We declare that there is no conflict of interest regarding the publication of this paper.

FUNDING: - This study was funded by self.

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