Publication Date
6-1-2018
Journal
The Texas Heart Journal
DOI
10.14503/THIJ-16-6052
PMID
30072850
Publication Date(s)
June 2018
Language
English
PMCID
PMC6059509
PubMedCentral® Posted Date
6-1-2018
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Cardiovascular diseases/ethnology/enzymology/physiopathology, delivery of health care, genetic predisposition to disease, glucose phosphate dehydrogenase deficiency/analysis/complications/diagnosis/epidemiology, mass screening, military medicine, retrospective studies, risk assessment, risk factors, United States/epidemiology
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) protects erythrocytes from oxidative stress and hemolysis; G6PD deficiency is the most prevalent enzymopathy. The United States military routinely performs tests to prevent exposing G6PD-deficient personnel to antimalarial drugs that might cause life-threatening hemolytic reactions. In addition, G6PD is a key determinant of vascular function, and its deficiency can lead to impaired nitric oxide production and greater vascular oxidant stress—precursors to atherosclerosis and cardiovascular disease. Using military medical records, we performed a retrospective, cross-sectional study to investigate whether deficient G6PD levels are associated with a higher prevalence of cardiovascular disease than are normal levels, and, if so, whether the relationship is independent of accepted cardiovascular risk factors.
We analyzed the medical records of 737 individuals who had deficient G6PD levels and 16,601 who had normal levels. Everyone had been screened at U.S. military medical centers from August 2004 through December 2007. We evaluated our dependent variable (composite cardiovascular disease) at the individual level, and performed binary logistic regression of our independent variable (G6PD status) and control variables (modifiable cardiovascular risk factors). The adjusted odds ratio of 1.396 (95% CI, 1.044–1.867; P <0.05) indicated that G6PD-deficient individuals have 39.6% greater odds of developing cardiovascular disease than do those with normal levels.
Early intervention may reduce the incidence of cardiovascular disease in military personnel and civilians who have deficient G6DP levels.