Serum endostatin level as a marker for coronary artery calcification in type 2 diabetic patients.

OBJECTIVE: To assess the relationship between serum endostatin (ES) and coronary artery calcification (CAC) in type 2 diabetic (T2DM) patients. METHODS: The study included 110 participants with coronary artery disease (CAD); 55 with T2DM, for serum ES levels by enzyme-linked immunosorbent assay and CAC by contrast-enhanced spiral computed tomography (CT). RESULTS: Mean serum ES value was 66.54 ng/mL [95% confidence interval (CI), 61.77-71.32 ng/mL]. Serum ES levels positively correlated with Agatston score index [ASI; r = 0.701, p < 0.001; high sensitive C-reactive protein (hs-CRP) r = 0.783, p < 0.001]. On multiple regression analysis, the highest three ES quartiles (2, 3, and 4) were related to ASI in diabetic patients, adjusted ES level was an independent predictor of CAD [odds ratio (OR) = 1.065; 95% CI, 1.008-1.126; p = 0.026] and for the number of coronary vessels affected (OR = 1.089; 95% CI, 1.018-1.164; p = 0.013) in T2DM patients. Receiver operating characteristics (ROC) analysis showed serum ES at a cutoff value of 86.5 ng/mL can predict the risk of CAC in T2DM, with a sensitivity of 74.1%, specificity of 71.4%, p < 0.001 and area under curve (AUC) of 0.776. CONCLUSION: Measurement of serum ES levels can improve diagnosis of CAC and could be useful as a high sensitive marker for the presence and progression of atherosclerosis in T2DM patients.

RELATION BETWEEN SCHISTOSOME PAST INFECTION AND METABOLIC SYNDROME.

Schistosome antigens modulate host metabolic profiles in experimental animals. The effects of previous schistosome infection (PSI) and the development of metabolic syndrome remain unknown in humans. This study evaluated previous schistosome infection (PSI) related to metabolic syndrome (MS). A total of 547 participants aged >40 years from rural areas of Zagazig district were enrolled. Of them, 269 patients with. PSI and 305 normal served as controls. For all participants blood pressure, height, body weight and waist circumstance (WC) were measured. Blood samples were examined biochemically to determine triglyceride (TG), fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HIDL-C). Associations between PSI and MS were evaluated using logistic regression. Patients with PSI had significantly lower levels of body mass index (BMI), WC, TG, insignificantly low levels of fasting -blood glucose (FBG) and significantly higher levels of high-density lipoprotein cholesterol (HDL-C) compared with controls. Prevalence of MS in PSI was significantly low than controls (32.7% vs. 42.3% respectively). PSI significantly associated with low prevalence of metabolic syndrome and its components, including central obesity, hypertension, hyperglycemia, hypertriglyceridemia and low HDL-C. Potential long-term effects of PSI may reduce metabolic syndrome risk.

Value of the mitral valve resistance in evaluation of symptomatic patients with mild and moderate mitral stenosis--a dobutamine stress echocardiographic study.

BACKGROUND: Conventional stenosis indexes poorly reflect the major hemodynamic consequence of mitral stenosis (MS). Valve resistance (VR) is a physiologic expression of stenosis. OBJECTIVES: This study aimed to demonstrate whether the mitral valve resistance (MVR) and its changes, relate to restricted exercise capacity in patients with mild and moderate mitral stenosis. METHODS: Twenty-four patients with rheumatic mild-to-moderate MS underwent transthoracic echocardiographic study (resting and dobutamine stress echocardiography [DSE]), divided into two groups; group I: symptomatic (12 patients) and group II: asymptomatic (12 patients). Mitral valve area (MVA), mean transmitral diastolic pressure gradient (TMPG), cardiac output (CO), and MVR were measured in all patients at rest and at peak DSE. Changes (∆) in MVA, TMPG, CO, and MVR were calculated. Data underwent statistical analysis. RESULTS: From resting to peak dobutamine infusion, the MVR significantly decreased from 111.4 ± 28.2 to 83.6 ± 27.0 dynes sec/cm(5) in group II (P < 0.001). The increase in MVR in group I (13.8 ± 10.3 dynes sec/cm(5)) compared with its reduction (-27.8 ± 15.6 dynes sec/cm(5)) in group II were highly significant different (P < 0.001). A reduction in MVR by less than 21.5 dynes sec/cm(5) at peak dobutamine infusion reflect a cutoff value considered to detect the hemodynamic significance of mild-to-moderate MS with a sensitivity of 92% and a specificity of 73%. CONCLUSION: The changes in the MVR can be used as a DSE parameter for expression of stenosis severity and to describe discrepancy in symptom status in patients with mild-to-moderate mitral stenosis.