الفهرس 
Contents.Only 14 pages are availabe for public view
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Abstract
Coronary artery disease (CAD) is the leading cause of cardiovascular mortality worldwide, with more than 4.5 million deaths occurring in the developing world. Despite a recent in developed countries, both CAD mortality and the prevalence of CAD risk factors continue to rise rapidly in developing countries (303).
IGF-1 plays a specific role in the intricate cascade of events of cardiovascular function, in addition to its well established growth-promoting and metabolic effects. IGF-1 is believed to mediate many effects of GH. IGF-1 promotes cardiac growth, improves cardiac contractility, cardiac output, stroke volume, and ejection fraction. In humans, IGF-1 improves cardiac function after myocardial infarction by stimulating contractility and promoting tissue remodeling. Furthermore, IGF-1 facilitates glucose metabolism, lowers insulin levels, increases insulin sensitivity, and improves the lipid profile. These data suggest an attractive therapeutic potential of IGF-1. Both clinically observed and experimentally induced impairments of cardiac function are also found to be associated with abnormal IGF-1 levels. IGF-1 and its binding proteins have been considered as markers for the presence of certain cardiac abnormalities, indicating that IGF-1 may be a risk factor for certain cardiac disorders (304).
Among the various growth factors involved in atherosclerotic plaque development. The majority of IGFs in the circulation are bound to IGF binding proteins, of which IGF binding protein 3 (IGFBP-3) is the carrier of more than 80% of circulating IGF-1. But, although IGFBP-3 is an important regulator of the bioactivity of IGF-1, there is evidence to suggest that IGFBP-3 possesses functions independent of its role as an IGF-I carrier protein (305).
GH-deficient adults, who have low circulating IGF-1 levels, are at high risk of CVD mortality and have increased carotid artery wall thickness and endothelial dysfunction, (306). Several population-based prospective studies have suggested that low circulating levels of IGF-1 within the normal range may predict increased risk of ischemic heart disease (307, 308) and ischemic stroke (18). IGFBP-3 levels have been both directly and inversely associated with prevalent and incident CVD (18,309). Low IGF-I levels may adversely affect the risk of developing insulin resistance and related macrovascular complications (310).
This case control study was undertaken to determine the relationship between the levels IGF-1 and IGFBP-3 with coronary atherosclerosis in patients attending Suez Canal University Hospital. The study included 62 patients who are attending Suez Canal University Hospital in Ismailia from October2011 till February 2012 and 30 apparently healthy individuals controls.
In the present study, coronary artery disease was more frequent among males compared to females (67.7%, 32.3%) with no statistically significant difference in sex between patients & controls.
By comparing patients to control group regarding risk factors there was no statistically significant difference between both groups regarding to smoking, diabetes mellitus and hypertension.
All lipid profile parameters (HDL, Total Cholesterol, Triglycerides and LDL) were significantly different between both groups.