A comparative study of prevalence of Glucose-6-Phosphate Dehaydrogeanase Deficiency in essential Hypertensive and Normotensive Adults aged between 35 and 65 years at the University Teaching Hospital, Lusaka, Zambia
Kwangu, Mwenya C.
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BACKGROUND:Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is the most common enzymopathy in humans and affects over 400 million people worldwide, majority being in Africa. G6PD catalyses the first reaction of the pentose phosphate pathway where it plays a role in generation of NADPH, which is essential in reducing glutathione. In the reduced state, glutathione decreases oxidative stress. Oxidative stress has been shown to adversely affect vasodilation of small vessels which is essential for reducing blood pressure. There is however, limited scientific evidence that associates G6PD deficiency and aetiology of essential hypertension. This study aims at determining the prevalence of G6PD deficiency in both the essential hypertensive and normotensive adults, and also establishing its association to essential hypertension. It will also determine the levels of nitric oxide (NO) in both groups and its association to essential hypertension. METHODS: An analytical cross-sectional design was applied to 89 essential hypertensive participants and 89 healthy normotensive participants, making a total of 178. All the participants were aged between 35 and 65 years. Blood was collected for G6PD activity and serum levels of NO, glucose, creatinine; and, urea and electrolytes. In addition, routine urinalysis was done. A logistic regression was used to investigate the association of age, sex, nitric oxide levels, and G6PD deficiency with essential hypertension as the dependant variable. RESULTS: The G6PD deficiency was found in 14 (16%) participants with essential hypertension and 9 (10%) control participants. The difference however, in the G6PD deficiency prevalence rate was not statistically significant (p= 0.13). Logistic regression analysis, including G6PD deficiency, age, nitric oxide, and gender as covariates, revealed that G6PD deficiency was significantly associated with increased risk for essential hypertension (odds ratio [OR]=2.9, 95% confidence interval [CI]=1.07-7.94, p=0.036), while nitric oxide was significantly associated, but with reduced risk for essential hypertension (odds ratio [OR]=0.99, 95% confidence interval [CI]=0.98-0.99, p=0.001). The analysis further showed a significant association of age and essential hypertension, with participants in age groups 46-55 and 56-65 being at higher risk of developing essential hypertension than those in age group 35-45 (odds ratio for age groups [OR]=2.4, 95% confidence interval [CI]=1.05-5.54, p=0.037 and [OR]=7.3, [CI]=3.22-16.61, vi p=0.000 , respectively). The study also revealed no association between gender and essential hypertension ([OR]=0.79, [CI]=0.39-1.60, p=0.52). CONCLUSION: The study established that the difference in the G6PD deficiency prevalence rates was not statistically significant at 0.05 significance level (p=0.13). Therefore, the results support the hypothesis that states that there is no difference in G6PD deficiency prevalence between the essential hypertensive and normotensive adults, though the study showed a possible role of G6PD deficiency in the pathophysiology of essential hypertension. The findings also demonstrated an association between age, nitric oxide levels and essential hypertension
- Natural Sciences