School of Biomedical and Allied Health Sciences

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Arterial Stiffness in Type 2 Diabetes Patients in Ghana
(University of Ghana, 2013-07) Yeboah, K.; Antwi, D.A.; Amoah, A.G.B.; Gyan, B.
Diabetes mellitus is associated with increased risk of cardiovascular diseases (CVDs) and mortality. Type 2 diabetes (T2DM) exerts it deleterious effects through the blood vessel which may lead to hypoperfusion and end organ damage. The ability to characterize the arterial system and derive related biomarkers that can predict the occurrence of CVDs and discriminate high risk subject for management would be of immense importance. Assessment of arterial stiffness and central hemodynamic indices had been shown to predict CVD events in healthy and diseased Caucasian and Asian population; few studies had been reported of the utility of arterial stiffness assessment in sub-Saharan Africa. This study measured the levels of arterial stiffness and central hemodynamic indices in Ghanaian T2DM subjects with and without hypertension, and compared to the levels in age and gender matched nondiabetes subjects with and without hypertension; in order to assess the impact of arterial stiffness in diabetes and hypertension conditions. Also, the associations of vibration perception threshold (VPT) and vascular growth factors, angiopoietin (ang)-1, ang-2 and vascular endothelial growth factors (VEGF), to the levels of arterial stiffness were investigated. In this study, 197 individual, composed of 68 hypertensive T2DM subjects, 46 nonhypertensive T2DM, 48 nondiabetes hypertensive subjects and 35 nondiabetes normotensive subjects volunteered to participate. Anthropometric characteristic and blood pressure measurement were performed. VPT was measured with Horwell Neurothesiometer and arterial stiffness was assessed using Tensiomed Arteriograph and Vasera. Fasting blood samples were collected from all the participants and nondiabetes subjects were screened for diabetes using the oral glucose tolerance test. Plasma glucose and lipid profile were assayed whereas vascular growth factors were assayed with ELISA. The study showed that aortic pulse wave velocity (PWV), heart-ankle (ha) PWV and aortic pressure indices were highest in hypertensive T2DM subjects, followed by nondiabetes hypertensive subjects, then the nonhypertensive T2DM subjects, and the control subjects with the lowest levels. However, cardio-ankle vascular indices (CAVI) was highest in hypertensive T2DM subjects, followed by nonhypertensive T2DM subjects, and then the nondiabetes hypertensive subject, with the control subjects having the least levels. The study also showed that female subjects had higher levels of aortic stiffness than the male counterpart, though no difference in CAVI and ha-PWV was observed. Arterial stiffness indices were found to generally increase with increasing age, duration of diabetes and body composition indices. Subjects with peripheral sensory neuropathy (PSN) were found to have higher levels of arterial stiffness indices than those without PSN. Of vascular growth factors, ang-2 was found to be associated with central aortic pressure and indices ang-1 was found to be associated with VPT. The findings of this study showed that diabetes and hypertension are associated with arterial stiffness in Ghanaians. Arterial stiffness is associated with impaired angiogenesis in Ghanaians. Arterial stiffness might also contribute to the development of PSN in Ghanaians.
Effect of Different Vegetable Fats on Lipid Profile and Risk of Atherosclerosis in Rats
(University of Ghana, 2013-07) Ainuson, J.K.; Amoah, A.G.B.; Wiredu, E.E.K.; Asare, G.A.; Addo, P.
Atherosclerotic vascular diseases (AVDs) are presently increasing rapidly in incidence and have become key contributors to the burden of disease in most developing countries like Ghana. The condition has been projected to more than double by 2025. The type and amount of dietary fat has been associated with several disorders including AVDs and it complications. Diet, as one of the most important modifiable risk factors of Coronary Heart Disease (CHD) modulates the other known risk factors. Excessive intake of dietary saturated fat and cholesterol has been found to increase serum cholesterol, thus leading to a high risk of cardiovascular diseases. Saturated fats, both of animal and vegetable or plant origin, have been discredited. This study was carried out to investigate the effect of vegetable fats including olive oil (OO), red palm oil (RdPO) and refined palm oil or palm olein (RfPO) on lipid profile and risk of Atherosclerosis in rat model. Three months old male Sprague-Dawley (S-D) rats (n=56) were divided into four groups: control, olive, red palm and refined palm oil groups (n=14 per group) received water and feed ad libitum. The controls were fed the standard rat chow whilst the treatment (oil) groups received diet enriched with extra 6% by weight of the corresponding oil. During the 16 weeks of dietary intervention, 7 rats were randomly selected from each group and sacrificed at two months intervals, and blood samples collected for biochemical analysis. Plasma lipid profile comprising of Total Cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), Apolipoprotein-A1 (Apo-A1), and Apolipoprotein-B100 (Apo-B100) were determined at baseline and at the end of every two months by the enzymatic technique using the Enzyme-Linked Immuno Sorbant Assay (ELISA). Pro- inflammatory markers including Interleukin-2 (IL-2), Interleukin-6 (IL-6), Tumor Necrosis Factor Alpha (TNF-α) and Total Antioxidant Status (TAS) were also determined by the ELISA method at baseline and at 2 and 4 months. There was no significant difference in the lipid profile of the treatment rats compared to the controls. However, there was a significant effect of the intake of the different oils on the inflammatory markers TNF-α and IL-6. There were also significant differences in the TAS of the rats from the different groups at month 2. Olive oil diet caused a significant decrease in the TNF-α and IL-6 mean concentrations (p=0.008) and (0.0041) respectively and an increase in the TAS mean concentrations (p=0.005). The two palm oil diets (RdPO and RfPO) caused an increase in both TNF-α and IL-6 concentrations. The red palm oil diet resulted in an increase in the TAS, whilst the refined palm oil diet caused a decrease in the TAS. However these effects were not statistically significant. The results suggest that the 3 different oils had different effects on the parameters investigated in this study. The increase in levels of the inflammatory indicators and reduction in total antioxidants levels recorded among rats fed RfPO enriched diet shows a likelihood of the oil enhancing inflammation and leading to oxidative stress and subsequent oxidative damage respectively, hence may have a potential of increasing the risk of development of atherosclerosis in rats. The intake of the red palm oil diet, although to some extent improved TAS of the rats, yet was associated with increased inflammation (TNF-α and IL-6). Therefore prolonged use may probably be associated with increased risk of developing atherosclerosis and other inflammatory diseases. On the contrary, intake of olive oil as a major source of fat may reduce the risk of atherosclerotic development due to its association with significant increase in TAS and a decrease in both IL-6 and TNF- α production in rats. The above findings therefore suggest that, olive oil may be most protective against atherosclerosis compared to the other oils. Also the red palm oil though unrefined, turned out to have a better antioxidant capacity than the refined form.