الفهرس 
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Abstract
Coronary artery disease (CAD) is a narrowing of the small blood
vessels that supply blood and oxygen to the heart. Coronary artery
disease (CAD) is the leading cause of death worldwide. It is noted that
the symptoms and signs of coronary artery disease appear in the
advanced state of disease, most individuals with coronary artery disease
show no evidence of disease for decades as the disease progresses
before the first onset of symptoms, in form of sudden heart attack.
Omentin-1 (Intelectin-1) is a newly identified protein that is highly
and selectively expressed in visceral adipose tissue. Omentin-1 may act
as an endocrine factor affecting muscles, liver and omental adipose
depot to enhance insulin-mediated glucose-uptake in adipocytes,
activate protein kinase Akt/PKB, and improve the insulin sensitivity of
fat cells. Interestingly, circulating omentin-1 levels have been
negatively correlated with obesity and insulin resistance.
Omentin plays an anti-inflammatory role by preventing the TNFα-induced COX-2 expression in vascular endothelial cells. The plasma
levels of omentin were decreased in patients with coronary artery
disease (CAD), which indicated that omentin-1 may also be involved in
the occurrence of coronary artery disease.
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Omentin inhibits TNF-α-induced inflammation of intravascular
Smooth Muscle Cells (SMCs), and its anti-inflammatory role is
attributed, at least in part, to the inhibition of superoxide production.
Omentin has two isoforms: omentin-1 and omentin-2; omentin-1 was
shown to be the major circulating isoform in human plasma. In
addition, omentin-1 was also regarded as a protective cytokine in the
metabolic imbalance condition of the body. Therefore, decreased levels
of omentin-1 may be involved in the occurrence and development of
coronary artery disease (CAD).
This study aimed to assess the role of plasma levels of omentin-1
in elderly patients with coronary artery disease. This study included 90
participants; divided into three groups: group I 30 stable angina
pectoris cases, group II 30 acute coronary syndrome cases and group
III (control group) 30 volunteers from the general population matched
for age and sex without evidence of any coronary artery disease neither
by history nor by investigations.
There were no statistically significant differences between the
studied groups as regarding age and sex distribution. However, there
was significant difference between groups as regarding body mass
index (BMI) with significant difference between control group and both
the stable angina, acute coronary syndrome groups & non-significant
difference between stable angina and acute coronary syndrome group.
Among ACS groups there were no statistically significant differences
between the 3 groups as regarding age, BMI and sex distribution.
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Also in our study, there was highly statistically significant
difference between studied groups as regarding occurrence of diabetes
mellitus and hypertension. It showed that 73.3 % of acute coronary
syndrome patients were diabetic compared to 66.7% among stable
angina group and both groups showed equal frequency in occurrence of
hypertension. Among ACS groups there were no significant difference
between the 3 groups as regarding occurrence of diabetes mellitus and
hypertension.
There was highly statistical significant difference between studied
groups as regarding total cholesterol and LDL-C while there was
significant difference between them as regarding triglycerides and
HDL-C. There was significant difference between control & acute
coronary syndrome groups, also between stable angina & acute
coronary syndrome groups in total cholesterol and HDL -C, but there
was no significant difference in both of them among control & stable
angina groups (P>0.05). Also, there was significant difference between
control and the other 2 groups as regarding triglycerides. Among ACS
groups there were no significant differences among the 3 groups as
regarding levels of total cholesterol, triglycerides , HDL-C and LDL-C.
In our study, there was highly statistical significant difference
between the studied groups as regarding AST, but the difference was
non-significant among groups in ALT. There was significant difference
between stable angina & acute coronary syndrome groups in ALT.
Also, there was significant difference between control & acute coronary
syndrome groups, & stable angina in AST. Among ACS groups there
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were no significant differences among the 3 groups as regarding levels
of ALT and AST.
Also, there was significant difference between the studied groups
as regarding hsCRP, but the difference was non-significant among
groups in creatinine level and urea level. There was highly statistical
significant difference between ACS groups as regarding hsCRP. It was
noticed that there was significant difference between unstable angina
group, STEMI & non STEMI groups but there was no difference
between STEMI and non STEMI groups. There were no significant
differences between the ACS groups as regarding Urea and Creatinine
levels.
Our study showed that there was statistically significant difference
between studied groups as regarding Omentin-1 level. Also, there were
significant decrease in its level in stable angina group and acute
coronary syndrome groups compared to control group , yet there was no
difference between stable angina versus acute coronary syndrome
groups. Among ACS groups there were no significant differences as
regarding Omentin-1 levels.
In our study, there was non-significant negative correlation
between Omentin-1 level and body mass index, total cholesterol , LDLC, urea, creatinine and AST, and non-significant positive correlation
between omentin-1 and HDL-C and ALT. There was significant
positive correlation between Omentin-1 level and triglycerides. But,
there was highly statistical significant negative correlation between
Omentin-1 level and hsCRP. Among acute coronary syndrome‟s
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groups, there was non-significant negative correlation between
Omentin-1 level and body mass index, total cholesterol, LDL-C, urea,
creatinine, AST. There was non-significant positive correlation between
Omentin-1 level and triglycerides, HDL-C, hsCRP & ALT.
Our study found that at cut off ≤ 9 .5 ng / L omentin-1 has 83.3%
sensitivity and 71.7% specificity with 59.5% PPV and 89.6% NPV with
75.6% accuracy. So, we can consider that omentin-1 may be involved
in CAD and can be used as abiomarker for its occurance