الفهرس 
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Abstract
CAC is a surrogate marker of atherosclerosis presence and its score correlates with plaque burden in subjects with normal renal functions.
Both preclinical and emerging clinical studies suggest an important role for apelin in human physiology and pathology. However, the contribution of apelin to the pathogenesis of cardiovascular diseases needs to be better defined.
The aim of the present study was to explore the correlation of serum apelin level with CCS and also to investigate the relationships between serum apelin level and different cardio-metabolic risk factors.
The present study included 100 subjects referred for cardiac MDCT for assessment of CAD regardless of their glucose homeostasis state.
The main findings of the present study were:
• Forty three percent of the studied subjects had positive CAC.
• Subjects with detectable CAC had significantly lower serum apelin level than subjects without detectable CAC.
• Subjects with detectable CAC had significantly higher FPG, HbA1c and WBCs count than subjects without detectable CAC.
• There was a statistically significant inverse correlation between serum apelin and CCS after controlling for traditional cardiovascular risk factors and hs-CRP.
• There was a statistically significant inverse correlation between serum apelin and the following parameters: age, FPG, HbA1c, ALT, AST and WBCs count.
• There was a statistically significant direct correlation between serum apelin and HDL-C.
• Serum apelin was significantly lower in the diabetic subjects in comparison to the non diabetic subjects.
• There was a statistically significant direct correlation between CCS and the following parameters: DBP, ALT, AST and WBCs count.
• There was a statistically significant inverse correlation between CCS and the following parameters: ABI and serum bilirubin.
Conclusion:
This preliminary observational study demonstrated that subjects with positive CAC had significantly reduced serum apelin. Moreover, serum apelin showed an independent inverse correlation with CCS; these findings indicate that apelin may be related to coronary calcification which is a reliable estimate of coronary atherosclerosis.
To the best of our knowledge, the present study is the first to report an association of apelin with CCS in patients with suspected CAD. Apelin emerges as a novel biomarker of ACAD, but this result remains to be proved prospectively.
Our results suggest that apelin may be a promising adipokine with a possible atheroprotective role; however, caution is advisable in extrapolating these findings to clinical settings. Despite of the limited sample size and the cross-sectional design of this work, we believe that our data may be a convincing base for conducting further studies to evaluate whether low apelin state could directly promote human ACAD.