رسائل دكتوراة
English
2023
Evaluation of Apelin, Leptin , Homocysteine and Selenium in Sera of Patients with Acute Myocardial Infarction in Babylon Governorate
احمد فيصل فالح مهدي, شكري فايز السعد, مفيد جليل عوض
كلية الطب-جامعة بابل · العراق
Acute myocardial infarction (AMI) is characterized by sudden myocardial tissue death resulting from an imbalance between coronary blood supply and myocardial demand. Typically caused by an occlusive thrombus formation in a ruptured or eroded coronary artery, it triggers an inflammatory response, eventually replaced by granulation tissue and a collagen-based scar.
This case-control study was done at the Laboratory of Chemistry and Biochemistry Department, College of Medicine, University of Babylon during the period from February 2022 until May 2023. The study aimed to determine the role and diagnostic value of apelin, leptin, homocysteine, and selenium among AMI patients. The entire samples were collected from patients attending Marjan Medical City in Al-Hillah city.
This study included 120 participants (48 females, 72 males), who were divided into three groups. The first group included 27 patients (7 females, 20 males) with mean age 63.3 ± 10.5, diagnosed as STEMI. The second group included 33 patients (11 females, 22 males) with mean age 59.5 ± 8.0, diagnosed as NSTEMI. The third group included 60 apparently healthy participants (30 females and 30 males) with mean age 62.4 ± 9.4 as a control group.
The study concludes that a number of risk factors are associated with AMI, where at the forefront of these factors was family history with an odds ratio of 27.8, followed by hypertension with an odds ratio of 27.3. Also, the results of the current study showed that the combination of multiple risk factors could double the risk of AMI, as well as may contribute to increase the size of the infarction, which leads to worse prognosis compared to AMI patients with a single risk factor.
The results of the present study showed a significant increase in the mean levels of apelin, leptin, and homocysteine in AMI patients in both groups (STEMI and NSTEMI) as compared to the control group, and there was also a clear discrepancy in levels when comparing the STEMI group with the NSTEMI group. The results of the present study also showed a significant decrease in the mean levels of selenium in AMI patients in both groups (STEMI and NSTEMI) in comparison to the control group, with no significant difference between the levels of selenium in the STEMI group and NSTEMI group.
In this study, there was a significant positive correlation between leptin, homocysteine, and apelin with cardiac troponin I in AMI patients in both groups. Also, there was a significant negative correlation between selenium and cardiac troponin I in acute myocardial infarction patients in both groups.
The study concludes that patients with AMI in Babylon Province have high levels of homocysteine, leptin, and apelin, with higher levels in the STEMI group than NSTEMI. This pattern of results could indicate a role for these markers in the formation of thrombosis, atherosclerosis, oxidative stress, and the occurrence and prognosis of AMI. Also, the study concludes that patients with AMI in Babylon Province have low levels of selenium compared to the control group, which may serve as a biomarker in monitoring the antioxidant status in AMI patients.
In summary, apelin, leptin, homocysteine, and selenium exhibit potential as standard panels for patients suspected of experiencing AMI, serving as confirmatory and monitoring biomarkers. Moreover, the utilization of apelin within medical facilities may serve as a diagnostic biomarker, aiding in categorizing the type of AMI when an electrocardiogram cannot be readily performed.