الفهرس 
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Abstract
A atherosclerosis is influenced by an inflammatory process, IL-18 is one of the inflammatory biomarkers that lately has been in focus among researchers in cardiovascular disease (CVD). Being a member of the IL-1cytokine family and a pro-inflammatory cytokine, the molecule plays an important role in the inflammatory cascade (1).
The purpose of this study was to evaluate serum levels of IL-18 and gene polymorphism at 137 G/C and 607 C/A sites of IL 18 gene in patients as regards presence and /or absence of coronary artery disease and type 2 DM and their influence on IL-18 levels, and gene expression in circulating leukocytes as well as their distribution in subgroups of patients were assessed.
180 individuals were enrolled, divided into four groups; group I (n = 41 patients): non diabetic subjects without CAD, group II (n = 51 patients): non diabetic patients with CAD, group III (n = 40 patients): diabetic patients without CAD, group IV (n = 48 patients): diabetic patients with CAD.
Participants in the study were subjected to full history taking, thorough clinical examination, 12 leads ECG.
2D echocardiography, M-mode were performed; LV dimensions were measured including LVEDD, LVESD, IVSD, LVPWD, LVMI and left ventricular ejection fraction.
Serum IL-18 levels were measured and genotyping at 137 G/C and 607 C/A SNPs were performed in addition serum glucose (fasting and post prandial, HBA1C) and lipid profile were measured to all patients.
Coronary scoring was done to all patients using vessel, severity, syntax and euro scores.
Results of the current study showed that:
Demographic and clinical data:
Age
The mean age for group I (control group) was 55.7 ± 6.27years,the mean age for group II was 56.47 ± 6.75years and the mean age for group III was 53.97± 7.918years, the mean age for groupIV was 56.12±6.73.There was no statistical significant difference between the 4 groups as regard age (p-value > 0.05).
Clinical data:
There was highly significant difference between all studied groups as regard DM, HTN, and smoking index (p- value < 0.001).
LV Echocardiography:
There was a significant difference between all studied groups as regards echocardiographic parameters LVEDD, EF, IVS (P-value < 0.05).
There was a significant difference between all studied groups as regards LV mass (P-value < 0.05) but no significant difference as regards LV mass index (P-value > 0.05).
Serum IL-18 levels:
As regard serum IL 18 level there was highly significant difference between all studied groups and also high significant difference between coronary groups (II&IV) and non-coronary groups(I&III) , (P-value < 0.001).
Coronary angiographic data and coronary scoring:
As regarding coronary angiography scores there was high significant difference between all studied groups as regards severity and syntax scores also there was high significant difference between the coronary groups(group II&IV),(P-value < 0.001). While there was no significant difference between studied groups as regard euro score (P- value > 0.05).
As regard vessel score there was high significant difference between all studied groups and there was high significant difference between the two coronary groups (group II&IV), group II (non-diabetic coronary group) contains 22 patients have one vessel disease and 15 patients have two vessel disease and 14 patients have three vessel disease, while group IV (diabetic coronary group) contains 7 patients have one vessel disease and 17 patients have two vessel disease and 24 patients have three vessel disease (P-value < 0.001).
Genetic data:
There was high significant difference between all studied groups regarding 137 G/C genotype distribution with predominance of CC genotype in non-coronary groups (groups I&III) accounting 25patients (60.98%) in group I and 21 patients (52.5%) in group III and predominance of GG genotype in coronary groups (groups II&IV) accounting 32patients (62.75%) in group II and 29 patients (60.42%) in group IV (P-value < 0.001).
There was no significant difference between all studied groups regarding 607 C/A genotype distributions without predominance of any CC, CA, or AA genotype in any of the studied groups (P-value > 0.05).
High significant difference between three genotypes of 137 G/C SNP (CC, GC, and GG) as regarding coronary angiographic severity and syntax scores (P-value < 0.001).
No significant difference between three genotypes of 137 G/C SNP (CC, GC, and GG) as regarding coronary angiographic euro score, (P- value > 0.05).
High significant difference between three genotypes of 137 G/C SNP (CC, GC, and GG) as regard serum IL 18 levels, (P-value < 0.001).
No significant difference between three genotypes of 607 C/A SNP (CC, CA, and AA) and any of another laboratory, echocardiographic, coronary angiographic or demographic parameters, (P-value > 0.05).
There was high significant difference between three genotypes of 137 G/C SNP and vessel score (P-value < 0.001) as following:
- CC genotype patients includes 46 patients (56.79%) have no vessel disease and 10 patients(34.48%) have one vessel disease, and 2 patients (6.25%) have two vessels disease, and only one patient (2.63%) has three vessel disease.
- GC genotype patients includes 22 patients (27.16%) have no vessel disease and 4 patients(13.79%) have one vessel disease, and 13 patients (40.63%) have two vessels disease, and 8 patient (21.05%) have three vessel disease. (table 30)
- GG genotype patients includes 13 patients (16.05%) have no vessel disease and 15 patients(51.72%) have one vessel disease, and 17 patients (53.13%) have two vessels disease, and 29 patients (76.32%) have three vessel disease.
There was no significant difference between three genotypes of 607 C/A SNP and vessel score (P-value> 0.05).
Correlation between serum IL 18 levels and other variables.
Positive high significant correlation between serum IL 18 level and serum fasting blood sugar, post prandial blood sugar and serum HBA1C,(P-value < 0.001).
Positive significant correlation between serum IL 18 level and serum total cholesterol, triglycerides, and serum LDL levels, (P-value < 0.05).
No significant correlation between serum IL 18 level and serum HDL levels, (P-value > 0.05).
Negative significant correlation between serum IL 18 level and EF. (R value = - 0.221 and P-value < 0.05).
Positive high significant correlation between serum IL 18 level coronary angiographic severity, syntax, and vessel scores, (P-value < 0.001).
No significant correlation between serum IL 18 level coronary angiographic euro score, (P value > 0.05).