الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Obesity is closely associated with the development of metabolic syndrome,
hypertension, atherosclerosis and heart disease. However, despite the prevalence of
obesity, the links between it and the development of CVD are poorly understood at the
molecular level. It is now recognized that adipose tissue functions as an endocrine organ
by secreting adipocytokines, such as leptin, tumor necrosis factor- α, plasminogen activator
inhibitor type 1, interleukin-1β, interleukin -10, retinol binding protein-4, and adiponectin,
that are directly involved in obesity-linked disorders.
Many adipocytokines are positively regulated by adiposity, but adiponectin levels in
plasma are negatively regulated by accumulation of body fat, visceral fat in particular.
Clinical studies implicate hypo-adiponectinemia in the pathogenesis of type 2
diabetes, coronary artery disease, and hypertension. Increasing evidence from
experimental studies indicates that adiponectin plays a protective role in the development
of insulin resistance, hypertension and cardiovascular disease. Thus, adiponectin could be a
key molecule for clarifying the pathogenesis of obesity-linked disorders.
The general aim of the present study was to assess the serum adiponectin levels and
the nutritional status among coronary artery disease patients; while the specific objectives
were to estimate serum adiponectin level in patients with coronary artery disease, to assess
the nutritional status of these patients, and to study the relationship between the serum
adiponectin level and the nutritional status in coronary artery disease patients.
During a period of four months, a cross- sectional study was conducted in Alexandria
University Students Hospital. Eighty two male and female patients with confirmed
diagnosis of coronary artery disease were selected for the study.
All participants were interviewed to answer a pre-designed questionnaire which
included personal characteristics, medical and family histories and lifestyle habits. Weight,
height and waist circumference were measured, and body mass index was calculated.
Arterial blood pressure was also measured.
Fasting blood samples were collected from the patients to estimate serum
adiponectin level, fasting blood sugar level, and parameters of lipid profile. Adiponectin
was measured by ELISA technique using AviBion Human Adiponectin (Acrp30) ELISA
Kit from Orgenium Laboratories. The determination of fasting blood glucose, total
cholesterol, TG, HDL-C, and LDL-C concentrations was carried out on a cobas c 311
analyzer (Roche Diagnostics).
All patients were interviewed to answer a predesigned food frequency questionnaire
to collect dietary information concerning the amount and frequency of consumption of
different food items.
Every patient was also asked about the kinds and quantities of foods and beverages
that he or she has consumed on the previous day or on a typical day. The data about how
food was prepared was also collected.
Summary
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Characteristics of the study sample:
The highest proportion of male patients were 60 to 70 years, while the highest
proportion of the female patients were 50 to 60 years.
Secondary and university education were dominant among both male and female
patients. The highest percent of all patients were employed.
A positive family history of coronary artery disease, hypertension, diabetes mellitus,
and obesity was quite common among first degree relatives of patients.
Smoking was quite common among CAD male patients.
Hypertension, dyslipidemia, and diabetes mellitus were very common among both
male and female CAD patients.
Morbid obesity was very common among female patients and much more prevalent
than among male patients.
All of the female CAD patients and about two thirds of male patients were suffering
from abdominal obesity.
The main findings of the present study were:
Serum adiponectin levels were significantly lower in smokers than in non-smokers.
Among smokers, serum adiponectin levels were significantly higher in ex-smokers
than in current smokers.
Serum adiponectin levels were significantly higher in females than in males.
Serum adiponectin levels were significantly negatively correlated with serum TG
levels and positively correlated with HDL-C levels among male patients.
Serum adiponectin levels were not correlated with any of the anthropometric
measurements in the present study.
The daily intake of plant fats and the percentage of energy provided from them
showed an inverse association with adiponectin levels among female patients.
Serum adiponectin levels were significantly higher among patients taking statins and
among patients taking calcium channel blockers.
Summary
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The main recommendations of the present study were:
• Promoting and improving health through health education programs that focus on the
following:
1- Abstinence from smoking to eliminate its negative impact on health in general, and
specifically on cardiovascular health.
2- Avoiding obesity and achieving a healthy body weight.
3- Promoting healthy eating patterns to reduce cardiovascular disease risk.
• Conducting further studies concerning adiponectin and CAD among newly diagnosed
patients who did not receive any treatment and did not implement dietary or other
lifestyle changes using the prospective design to study the cause-effect relationship
between adiponectin level and CAD.