Abstract

Background: Obesity is highly prevalent in Pakistan and contributes to cardiovascular risk by promoting dyslipidemia and low-grade inflammation.
Objectives: To compare fasting lipid profiles and advanced cardiac risk markers—high-sensitivity C-reactive protein (hs-CRP), apolipoprotein B/A-I ratio, and atherogenic index of plasma (AIP)—between obese and non-obese adults attending a cardiology clinic.
Methods: In this comparative cross-sectional study at Sharif Medical City Hospital, Lahore (1st, January 2024 – 31st, December 2025), 35 obese (BMI ≥ 30 kg/m²) and 35 non-obese (BMI < 25 kg/m²) outpatients (30–60 years) without diabetes, hypertension, thyroid dysfunction, recent acute coronary syndrome, chronic inflammation, pregnancy, or lipid-lowering therapy were consecutively enrolled. After a 10–12 h fast, serum total cholesterol, triglycerides, HDL-C, and LDL-C (enzymatic assays); apolipoproteins A-I and B (immunoturbidimetry); and hs-CRP (high-sensitivity immunoturbidimetry) were measured. VLDL-C was estimated as TG/5 and AIP as log₁₀(TG/HDL-C). Independent-samples t-tests and Pearson’s correlations were performed (SPSS v.26; p < 0.05).
Results: Compared with non-obese subjects, the obese group had significantly higher triglycerides (192 ± 48 vs. 144 ± 35 mg/dL), LDL-C (138 ± 30 vs. 119 ± 26 mg/dL), VLDL-C (38 ± 10 vs. 29 ± 7 mg/dL), and total cholesterol (214 ± 36 vs. 196 ± 32 mg/dL; all p ≤ 0.02), and lower HDL-C (37 ± 9 vs. 52 ± 11 mg/dL; p < 0.001). Hs-CRP (4.0 ± 1.4 vs. 1.9 ± 0.8 mg/L), ApoB/A-I ratio (0.96 ± 0.22 vs. 0.64 ± 0.17), and AIP (0.69 ± 0.20 vs. 0.46 ± 0.15) were markedly elevated in the obese cohort (all p < 0.001).
Conclusion: In this Pakistani cardiology population, obesity is associated with an atherogenic lipid profile, heightened systemic inflammation, and unfavourable lipoprotein ratios. Incorporation of these advanced markers into routine risk assessment may improve early identification of high-risk patients.