الفهرس 
Physiology oftheEndotheliumOnly 14 pages are availabe for public view
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Abstract
Atherosclerosis is a common macrovascular complication among patients with type 2 diabetes mellitus and is a major cause of multiorgan damage. It is often present at the time of diabetes diagnosis after the vessels has been exposed to chronic hyperglycemia during the prediabetic phase. Detection of diabetic ASCVD during its initial stages provides the opportunity for early therapeutic interventions to prevent or delay the onset of complications and improve outcomes (Wei et al.,1998)
PTX3 levels have been reported to be significantly elevated in acute myocardial infarction, and accordingly, statin treatment significantly decreases PTX3 levels. Due to the fact that PTX3 is able to reflect ACS condition better than CRP, it is highly possible that PTX3 is a superior biomarker to predict future cardiovascular events(Norata et al.,2008)
PTX3 has emerged as a key acute-phase protein associatedwith inflammation in cardiovascular disorders, including heart failure,atherosclerosis, acute coronary syndromes, and peripheral vasculardiseases. More importantly the predictive value of PTX3 appears to beindependent of other risk factors including other markers of the samesuperfamily such as CRP. The rapid increase of PTX3 plasma levelsduring cardiovascular events as a consequence of rapid synthesisby various cell types supports the idea that PTX3 could bean early indicator of the activation of both immune andinflammatory responses (Garlanda et al.,2002).
The aim of this study was to assess PTX3 plasma levels in metabolic syndrome patients compared to control subjects and their potential associations with anthropometric and clinical components of the syndrome as well as with carotid artery intima-media thickness (cIMT), a marker of subclinical atherosclerosis.
Aiming at tracing the early inflammatory markers of diabetic ASCVD, our study involved estimation of the levels of long PTX3as a novel marker of the endothelial dysfunction and preclinical atherosclerosis in four groups of participants. There was two groups of diabetic patients, with group I comprising diabetic patients with no ASCVD and group II comprising diabetic patients with ASCVD.
All participants were subjected to history taking,clinical evaluation involving estimation of their BMI, waist circumference, and blood pressure. The FBS level, HbA1c level, lipid profile, creatinine clearance, UACR, long PTX3 level, Echocardiography and cIMT by carotid ultrasound were determined.
We didn’t find a significant difference between mean plasma PTX3 levels as regard gender
Our study found that PTX-3 expression was higher in diabetic vs. non-diabetic patients, indicating that diabetes plays a role in the progression of atherosclerosis via PTX-3.
In our study,mean plasma PTX3 was significantly lower among patients with BMI ≥30 kg/m² compared to those with normal weight and overweighthis is in accordance with this data since
In study group I (Diabetic patients without cardiovascular disease), plasma PTX3 concentration was associated with elevated UACR.
In our study,we found that mean plasma PTX3 was significantly higher among patients with atherosclerosis in the carotid arteries compared to the ones without carotid atherosclerosis.In diabeticpatients with subclinical atherosclerosis, T2DM-related risk factors (Atherogenic lipid profile,hypertension, disease duration,diabetic kidney disease and c IMT) were significantly higher when compared to those without plaques.
Furthermore, it was observed that there were positive significant correlations between cIMT and sPTX3 in patients with atherosclerotic plaques in study group I.
We found in study group I,plasma PTX3 levels were correlated inversely with waist circumference and BMI.
There was a significant association in our studybetween mean plasma PTX3 concentration and UACR in group I (patients with type 2 diabetes without ASCVD). In this group mean plasma PTX3 concentration was significantly higher in A2 when compared to A1,in A3 compared to A1 and in A2 compared to A3 with p value <0.05
There was a significant difference between mean plasma PTX3 concentration and different stages of CKD in group I (patients with type 2 diabetes without ASCVD).
In our study, in patients with diabetes (group I+II), there was a significant positive correlation between PTX3 levels and duration of diabetes, fasting plasma glucose level, HbA1c level, LDL-cholesterol level, triglyceride level and elevated UACR and a significant negative correlation between PTX3 levels and Waist circumference,BMI &HDL :all of these factors may result in endothelial dysfunction in T2 diabetes.
In terms of clinical events,higher plasma PTX3 concentration turned out to be almost significantly related to the history of myocardial infarction,PCI and CABG in group II
The study concluded that serum pentraxin-3 (PTX3) was significantly elevated in patients with type 2 diabetes and these elevations were more significant in patients with ASCVD and there was significant positive correlation between pentraxin-3 and cIMT as well as HbA1c, fasting blood and urinary albumin excretion in all patients with type 2 diabetes. The association between PTX3,urinary albumin excretion and c IMT suggests that PTX3 had a role as inflammatory marker for early detection of diabetic ASCVD.