Abstract
Coronary heart disease (CHD) is a common multi-factorial disease. It is influenced by dietary factors, and inflammatory markers appear to predict outcomes. The dietary intake of patients at coronary risk and controls was assessed by food frequency questionnaire. Dietary macro- and micronutrient intake was related to plasma antibody titres to heat shock proteins. Dyslipidaemic patients (n=238) were recruited from the Lipid Clinics of a local NHS hospital, Guildford. Demographic features, including the prevalence of CHD risk factors such as hypertension and obesity, were typical of a Lipid Clinic population. Controls (n=189) were recruited from hospital and university employees. The dyslipidaemic patients were found to have a significantly higher dietary intake of protein (p<0.05), starch (p<0.05), fibre (p<0.05), total fat (p<0.05), selenium (p<0.05), zinc (p<0.01) and a higher dietary zinc/ copper ratio, compared to controls. These patients also had significantly higher serum copper (p<0.001), copper/caeruloplasmin ratio (p<0.01) and selenium (p<0.05) concentrations and lower GPx (p<0.001) and zinc/ copper ratio (p<0.05) than controls. Serum selenium concentrations decreased with accumulating features of the metabolic syndrome within the dyslipidaemic subjects (p<0.05). Among dyslipidaemia; obesity and the presence of the metabolic syndrome contributed significantly to serum C-reactive protein (CRP) concentrations. CRP concentrations increased with accumulating features of the metabolic syndrome (p<0.01). Although antibody titres to Hsp-60, -65 and -70 were higher in the dyslipidaemic patients (p<0.02), little of the variation in antibody titres could be explained by classical CHD risk factors. Dietary total fat (p<0.01), vitamin E (p<0.05) and C (p<0.01) were major determinants of titres to Hsp-60, dietary vitamin C (p<0.01), and vitamin E (p<0.05) were major determinants of titres to Hsp-65 (p<0.01), and dietary total fat was a determinant of titres to Hsp-70 (p<0.05). Treatment of dyslipidaemic patients with statins reduced titres to Hsp-60 (p<0.05), -65 (p<0.01) and -70 (p<0.01), and was also associated with a reduction in serum zinc (p<0.05), copper (p<0.01), caeruloplasmin (p<0.05) and CRP (P<0.05).