الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Over the past few decades obesity has become a major burden for health world-wide. Its prevalence in developing countries that have adopted a Western lifestyle has tripled in 20 years. Today more than 1.1 billion adults world-wide are overweight (BMI > 25 kg/m2) and 312 million of them are obese (BMI > 30 kg/m2).
Obesity is a major cause for development of the metabolic syndrome (MetS), a state characterized by overweight, insulin resistance, hypertension and impaired lipid metabolism and body fat distribution. Individials with MetS have marked risks for the development of type 2 diabetes and they possess high cardiovascular mortality.
Adipose tissue is infiltrated with macrophages and the macrophage quantity has been correlated with measures of insulin resistance. In addition to stimulation of low-grade inflammation, the secretion of adipokines regulating food intake, insulin sensitivity, blood pressure is altered in obesity.
The increasing prevalence of hypertension occurred in conjunction with a dramatic increase in the prevalence of overweight and obesity. Data from the NHANES show a strong linear relationship between BMI and systolic and diastolic blood pressures. The Framingham Heart Study showed that a 5% weight gain increases hypertension risk by 30% in a 4-year period.
Recent studies indicate an important role of adipose tissue hormones called adipokines in obesity-associated complications. A number of adipokines like leptin, adiponectin, and resistin have been identified, and apelin has recently been added to the family of adipokines , expression of both apelin and apelin receptor (APJ) has been described in adipocytes.
One of the physiologic functions of the apelin/APJ system is regulation of cardiovascular function. In humans, they found significantly higher plasma apelin levels in obese when compared to leaner subjects.(11) In patients with essentiasl hypertension, circulating Apelin levels are reduced, and lower plasma Apelin is independently associated with more profound left ventricular systolic and diastolic function impairment.
The aim of this study is to determine the relation of serum apelin to obesity associated hypertension as well as to myocardial performance.
The study was carried out on 60 obese subjects (BMI equal to or more than 30 kg/m2) of both male and female gender with age between 20 -50 years attending the Internal Medicine and the Endocrinology Outpatient Clinics in Alexandria Main University Hospital, who were categorized into two groups: Group I: included 30 obese hypertensive subjects (B.P>140/90). Group II: included 30 obese non hypertensive subjects (B.P<140/90). In addition to 25 healthy subjects of matched age and sex as a control group.