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|Title||The Assessment of Lp-plA2 and Apolipoprotein(a) as Markers of Cardiovascular Risk among Type 2 Diabetes Mellitus Patients in The Gaza Strip|
|Title in Arabic||تقييم مستوى Lp-PLA2 و Lp(a) كمؤشر لحدوث أمراض القلب والأوعية الدموية لدى مرضى السكر من النوع الثاني في قطاع غزة|
Background: Diabetes is a chronic metabolic disease accompanied with high risk of heart disease and stroke. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is associated with circulating atherogenic lipoproteins such as low density lipoprotein (LDL) and highly specific for vascular inflammation and atherosclerosis. Lipoprotein (a) (Lp (a)) has been considered as a predictor of cardiovascular diseases and stroke among type 2 diabetes mellitus (T2DM) patients. Heart attack and stroke are the major causes of premature death in people with diabetes. Aim of Study: To assess Lp-PLA2 and Lp (a) as an early predictors of cardiovascular complications among T2DM patients. Materials and Methods: In a case control study Lp-PLA2, Lp (a) and high sensitive C-reactive protein (hsCRP) were assessed as predictors of cardiovascular diseases among 86 T2DM patients and 30 normal subjects. Questionnaire interviews and biochemical investigations were applied. (Lp-PLA2), hsCRP and Lp(a) were measured using immunoturbidimetric technique, cholesterol (TC), Triglycerides (TG) and high density lipoprotein (HDL-C) were measured using colorimetric and kinetic methods and Low density lipoprotein (LDL) was calculated by empirical relationship of Friedewald. Fasting blood sugar (FBS), hemoglobinA1c (HBA1c), creatine phosphokinase (CPK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), were measured using enzymatic methods. All ethical permission from local ethical committee was obtained before study conducting. Results: Our study showed that the main age of T2DM among the studied population is 56.93 ± 8.74 years and the levels of A2 (Lp-PLA2) , Lp(a), hs.CRP, FBS, HbA1c, TC, TG, LDL, LDH, CPK, were significantly increased among T2DM patients compared with the normal control (P≤0.05). This study identified 27.9% of the cases reported with heart diseases, 72.1% with neuropathy, and 19.8% retinopathy. It also showed that 27.9% have over weight and 51.2% of the cases were obese. Importantly, 45.4% of T2DM showed high level of A2 (Lp-PLA2), 40.7% of T2DM have high levels of Lp (a) and high level of hsCRP was observed among 48.8% of T2DM. The Pearson correlation test showed Positive correlation between Lp-PLA2 with BMI, FBS, HbA1c, Lp(a), hs-CRP, triglyceride, cholesterol, and LDL. On the other hand, there was a negative correlation between Lp-PLA2, Lp(a) and HDL. Strong positive correlation was found between A2 (Lp-PLA2) and Lp(a) (r=0,96,P<0,001, TC (r=0.8, P<0.001), TG (r=0.61, P<0.001), LDL (r =0.7,P<0.001) and BMI (r=.73, P<0.05). Strong positive correlation was found between Lp(a) and TC (r=0.76, P<0.001), TG (r=0.64, P<0.001), LDL (r =0.65, P<0.001) and A2 (Lp-PLA2) (r=0,96,P<0,001). Furthermore, strong positive correlation was found between FBS and HBA1c (r=0.75,P<0.001), AST, Urea, creatinine and uric acid P<0.008). Conclusions: A2 (Lp-PLA2) and Lp(a) may considered as a predictor and an early diagnostic markers of CVD mortality, Vascular inflammation, Atherosclerosis, Neuropathy, Nephropathy and Blindnessamong T2DM.
|Publisher||الجامعة الإسلامية - غزة|
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