Anti-apolipoprotein A-1 autoantibodies as risk biomarker for cardiovascular diseases in type 2 diabetes mellitus

OBJECTIVE

Anti-Apolipoprotein A-1 autoantibodies (anti-ApoA-1 IgG) represent an emerging prognostic cardiovascular marker in patients with myocardial infarction or autoimmune diseases associated with high thrombotic events. The aim of this work is to investigate the incidence of anti-apoA-1 autoantibodies in type 2 diabetes (T2DM) patients with and without CVD and to study potential association with disease risk and its effect on plasma lipid parameters.

METHODS

Qualitative determination of anti-apoA-1 IgG was assayed in sera from 302 subjects classified into T2DM patients (n=102), T2DM+CVD (n=112) and healthy controls (n=88).

RESULTS

The incidence of anti-apoA-1 IgG was significantly higher among CVD patients (35.7%) than T2DM patients (8.8%) or control subjects (6.1%), p<0.0001. A significant association with CVD was identified (p<0.0001) and subjects who were positive for anti-apoA-1 IgG were at 8.5 times increased risk to develop CVD when compared to controls. Diabetic patients who were positive for the antibodies showed 5.7 times increased CVD risk. ROC analysis indicated anti-apoA-1 IgG as a risk biomarker for CVD in T2DM patients with an AUC value of 0.76, sensitivity of 35.7% and specificity of 91.2%. Studying the effect on lipid parameters, anti-apoA-1 IgG associated with significantly higher serum concentrations of TC and non-HDL-C in all groups and with higher concentrations of LDL-C in diabetic patients and higher TC/HDL-C ratio in CVD patients.

CONCLUSION

Our results indicate that anti-apoA-1 IgG is a cardiovascular risk biomarker in T2DM patients.

Paraoxonase-1 gene Q192R and L55M polymorphisms and risk of cardiovascular disease in Egyptian patients with type 2 diabetes mellitus

Background

Increased oxidative stress or an impaired antioxidant defense mechanism may play a crucial role in the onset and progression of atherosclerosis. Recently, Paraoxonase −1 (PON1) which accounts for most of the antioxidant effect of high density lipoprotein (HDL) cholesterol has been presented as a potential therapeutic agent against atherosclerosis development. Allele frequencies for PON1 gene that influence enzyme concentration as well as activity differ greatly among ethnic groups and data from several studies showed ethnic variations in the interpretation of cardiovascular disease (CVD) associated with PON1 polymorphisms. In this work, we investigated PON1 Q192R and L55M polymorphisms in Egyptian patients with type 2 diabetes mellitus (T2DM) and its association with CVD.

Methods

The study included 184 subjects classified into 3 groups; T2DM, T2DM + CVD, and healthy controls. PON1 polymorphisms were genotyped by real-time PCR and PON1 concentration was assayed in serum by ELISA (enzyme linked immunesorbent assay).

Results

Genotype and allele frequencies of Q192R were significantly different between controls and diabetic patients. Frequency of QQ genotype was significantly higher in healthy controls, while QR and RR genotypes were significantly higher in diabetic patients (p = 0.02). Frequency of 55LL and LM genotypes were significantly higher in patients than in controls (p = 0.009). Q192R polymorphism associated with CVD in our diabetic patients (p = 0.01) and with low serum PON1 concentration (p = 0.04). Multiple logistic regression analysis revealed significant correlations between 192R and other independent CVD risk factors.

Conclusion

PON1 192R and 55 L alleles are associated with T2DM. Q192R polymorphism is associated with CVD and lower serum enzyme concentration and might represents a novel risk factor for CVD in Egyptian patients with T2DM.

A Study of the Interaction between Hepatitis C Virus Infection and Pulmonary Disorders: Assessment of Interferon Gamma and Alpha-1-Antitrypsin

Objectives: To study lung diseases in chronic HCV infection and vice versa and to find immunological and/or hereditary interrelating factors.Material and Methods: Study included 134 individuals, all were subjected to screening for anti-HCV antibodies by ELISA, HCV-RNA by real time PCR, pulmonary function tests, quantitative assay of interferon gamma and alpha-1- antitrypsin in serum by ELISA and genotyping of alpha-1- antitrypsin gene by Light Cycler PCR.Results: 76.5% of chronic HCV patients had abnormal PFT (P = 0.03), mainly reduced DLCO and reversible airway obstruction, and 41.6% of chest diseased patients were HCV-positive with a significant decrease in large and small airways functions. Interferon therapy improved PFT parameters. Only 33% of chronic HCV infection affected by chest abnormality responded to interferon therapy while 50% of chest free patients did. Serum IFN-γ was higher in HCV and chest patients than in control (P=0.02). All serum α1AT deficient patients had M/null genotype.Conclusions: A pathogenic role of chronic HCV infection in lung diseases is evident. Interferon treatment may reduce chest complications and improve pulmonary functions. However, chest affection may reduce the response to interferon treatment. M/null genotype of α1AT gene might play a role in chronic HCV infection and chest co-affection.