الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Coronary artery disease is one of the leading causes of death in the world and atherosclerosis is the main underlying etiology.
The etiology and pathogenesis of atherosclerosis is not well established. However, it was hypothesized that endothelial dysfunction, inflammation, and oxidative stress are primary mediators in the development of atherosclerosis.
The aim of the present work was to find a relationship between plasma adiponectin level, myeloperoxidase activity, and serum nitric oxide and severity of coronary atherosclerosis.
In order to achieve this goal, 48 male subjects were evaluated and divided into 4 groups; group I consisted of 12 CAD patients with single vessel disease, group II consisted of 12 CAD patients with double vessel disease, group III consisted of 12 CAD patients with multivessel disease, and group IV(control group) consisted of 12 individuals of matched age and sex presented with chest pain and their coronary angiography was normal. All groups were subjected to coronary angiography to evaluate the severity of coronary atherosclerosis if present.
Following proper selection of patients and control subjects, the following laboratory tests were performed for all of them:
• Determination of plasma adiponectin concentration by ELISA.
• Determination of MPO activity using O-dianisidine as a substrate.
• Determination of serum NO metabolites concentration (nitrite / nitrate) by Griess reaction.
• Determination of serum lipids concentration (total cholesterol, TG, HDL-ch, LDL-ch) by colorimetric methods.
The result of the present study showed a significant association between the occurrence of CAD and each of low adiponectin level, high MPO activity, low nitrite level, low nitrate level, high total cholesterol level, high TG level, high LDL-ch level, low HDL-ch level, and high LDL/HDL-ch ratio. They may all be regarded as predictors or risk factors for CAD. Furthermore, adiponectin, MPO activity, nitrite, total cholesterol, LDL-ch and LDL/HDL-ch ratio were the factors that affect the severity of coronary atherosclerosis. A significant correlation was found between low adiponectin level and atherogenic lipid profile. Moreover, the present study showed a significant decrease in adiponectin level in hypertensive and cigarette smoking CAD patients compared to normotensive and non cigarette smoking patients suggesting that low adiponectin level might interact with these traditional risk factors to induce oxidative stress and endothelial dysfunction, thereby promoting atherosclerosis. Furthermore, a significant correlation was found between high MPO activity and atherogenic lipid profile. A significant increase in MPO activity in cigarette smoking CAD patients compared to non cigarette smoking patients was also found suggesting a possible interaction between MPO and the latter risk factors to induce and promote oxidative stress and vascular inflammatory process in coronary atherosclerosis.
Another point of interest in the results of the present study was the significant correlation of both low adiponectin level and high MPO activity with NO metabolites (nitrite / nitrate) level. Such correlation suggests that NO could be a link parameter and a common mediator for the action of adiponectin and MPO. The latter result highlights the importance of NO as both diagnostic tool and therapeutic target in atherosclerosis. Inspite of the latter result, the present study failed to prove any significant correlation between adiponectin and MPO which might be proved by further studies on large population samples.
The findings of the present study suggest that endothelial dysfunction, vascular inflammation, and oxidative stress are primary interacting mediators in the pathogenesis of coronary atherosclerosis.