Evaluation of serum Apoliporotein A-1 and Apoliporotein B as markers for early prognosis of cardiovascular disease in Saudi diabetic paitents with type 2 diabetes of Riyadh City Kingdom of Saudi Arabi

Abstract

The Saudi didactic patients participated in this study presented with high concentration of fasting blood glucose (FBG) and elevated level of glycosylated hemoglobin (HbA 1c), a condition which reflects poor glycemic control. Nevertheless, hypercholesterolemia and hypertriglyceridemia were also detected as a significant increase in total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-c) were evident over control and over reference normal values. Apolipoproteins were also altered in the blood of Saudi diabetic participants in which Apo B drastically increased, while Apo A-1 was reduced, this decrease of Apo A-I was correlated with a decrease in HDL level, a condition known to increase the risk of cardiovascular disease. When assessing the changes in Apolipoproteins in relation to the glycemic control, it has been found that under poor glycemic control (e.g. elevation of FBC, and HbA 1c) Apo B were drastically elevated in the blood of diabetic patients with CHD, (85% increase over control value, and up to 75% control in diabetic patients without CHD). ApoA-1 showed apposite situation during increased blood glucose level, a decrease from control value was seen but the levels sill within the normal values (normal reference value = 94 mg/dl – 178 mg/dl). LDL cholesterol almost behaved as Apo B, in which about 85% and 75% increase over control values were attained in diabetic patients with CHD and diabetic patients without CHD respectively. Similarly, the reduced levels of Apo A-1 in both diabetic patients were correlated with significant reduction in HDL level, 30.9 mg/dl. Are reduction of Apo A-1 and HDL in diabetic patients is a bad marker and bad clinical condition which may increase the risk of developing cardiovascular disease. Since these marker showed 75% and 25% decrease in patients with CHD and patients without CHD respectively. The results of this study came to the assurance that Apo B and Apo A-1 are of high efficacy and as good markers in detection of cardiovascular disease in diabetic patients of this study since Apo B increase could be detected in individual of about 90% of the patients with CHD and up to 66% in the diabetic patients without CHD respectively. The comparable rise in LDL levels was 80% and ‫.‪50% in CHD patients, and patients without CHD respectively‬‬ ‫‪(table6), HDL decrease occurred in 66% and 85% in both diabetic‬‬ ‫.‪patients‬‬ ‫‪The conclusion of this study that Apo B and ApoA-1 can be‬‬ ‫‪used as biological markers for with high efficacy early prognosis‬‬ ‫.‪of cardiovascular disease in diabetic patients‬‬