A Lipid Clinic Service in Kuwait: Preliminary Observations

Abstract

Despite a dramatic increase in the prevalence of coronary heart disease (CHD) within the Kuwaiti population, hyperlipidemia, which is an important risk factor for CHD, is inadequately characterised. Since over half of all patients seen at Kuwait’s Mubarak Teaching Hospital had elevated plasma cholesterol and/or triglyceride levels, the hospital opened a Lipid Clinic Service (LCS). The LCS provides a specialized diagnostic and therapeutic service to patients with primary hyperlipidemia. This report presents our preliminary observations on the first 150 patients seen at this clinic during the first 6 months of operation (March–September 1995). A nationality survey of the clinic attendees revealed that 46.7% were Kuwaitis, 4.0% other Gulf Arabs, 34.0% other Arabs (predominantly Egyptians) and 15.3% South Asians (predominantly Indians). Patient referrals came to the clinic from neighboring polyclinics (38.7%), hospital outpatient clinics (25.3%), clinical biochemistry laboratory (16.7%), hospital dietetic service (5.3%) as well as other sources (14.0%). Of the 117 patients with primary hyperlipidemia, 48.7% had predominant hypercholesterolemia, 23.9% were classified as mixed hyperlipidemia, and 27.4% had predominant hypertriglyceridemia. Over 75% of the men, and 22% of the women smoked regularly. About a third of the women were postmenopausal. The pattern of observations in the 28 patients with diabetes, incidentally seen in the clinic, was similar to that in the nondiabetic subjects with primary hyperlipidemia. The constellation of biochemical risk factors for CHD (higher triglyceride and uric acid and lower high density lipoprotein levels, coupled with a tendency towards central obesity and cigarette smoking) was more common in the men than in the women. This may account for a higher risk of CHD in men. Lipid and metabolic profiles did not differ between Kuwaitis and other nationals, suggesting that similar factors underlie the disorder in all patients. These features, similarly, did not differ between the pre- and postmenopausal women. This preliminary report on the first 150 patients seen in the LCS in Kuwait demonstrates a need for this type of specialized service in the country.

Beneficial changes in serum apo A-1 and its ratio to apo B and HDL in stable hyperlipidaemic subjects after Ramadan fasting in Kuwait

“…They had been diagnosed hyperlipidaemic on the basis of fasting plasma cholesterol (TC) b 7.0 mmolal andaor fasting plasma triglycerides (TG) b 3.0 mmolal andaor current supervised hypolipidaemic medication (Akanji et al, 1996. All had normal renal, liver and thyroid function and none had any features of CHD.…”

“…It is currently believed that close to 50% of the adult population in Kuwait and other Gulf Arab countries is hyperlipidaemic (Akanji et al, 1996;Abdella et al, 1998;Mitwalli et al, 1994). Many attend specialized Lipid Clinics, and we have previously reported on our experience in running such a clinic in Kuwait (Akanji et al, 1996.…”

“…Many attend specialized Lipid Clinics, and we have previously reported on our experience in running such a clinic in Kuwait (Akanji et al, 1996. Almost all the indigenous population in Kuwait as well as a highly signi®cant proportion of the expatriate population are muslims.…”

Diabetic Dyslipidaemia in Kuwait

“…About 15% of the adult Kuwaiti population has type 2 diabetes [1] and over 50% are hyperlipidaemic by current diagnostic criteria [1][2][3]. Type 2 diabetes and hyperlipidaemia are major risk factors for coronary heart disease (CHD) [4][5][6].…”

“…Approximately 30% of the patients attending the Lipid Clinic in Kuwait are diabetic [2,3]. Also, recent reports from Kuwait suggested that up to 46% of men and 72% of women presenting in coronary care units with acute myocardial infarction were diabetic while 53% of the men and 80% of the women were hyperlipidaemic [10][11][12].…”