THE CARDIO-PROTECTIVE "PARAOXONASE-1" AS A VALUABLE PROMISING TOOL IN DIAGNOSIS AND/OR ASSESSMENT OF CARDIOVASCULAR RISK IN TYPE 2 DIABETES

Background: Type 2 Diabetes Mellitus \"T2D\"remains frequently undiagnosed for many years; as the hyperglycemia is often not severe enough to provoke noticeable symptoms. Thus, such patients are at increased risk of developing macrovascular and microvascular events. Diabetic cardiovascular \"CVD\" complications are one of the most leading causes of death worldwide. Prevention of long-term chronic complications has become one of the main goals of modern treatment in T2D. However, new tools are still needed for early detection or even prediction of CVD risk to facilitate decreasing morbidity and mortality rates associated with T2D. Objectives:In this study, authors aimed to afford access to information that may allow early detection &/or prediction of macrovascular complications in Egyptian patients with T2D. Subjects and Methods:The study included200 clinically diagnosed T2D patients (subdivided according to presence of CVD complication). In addition, 60 healthy controls were selected with comparable socioeconomic, age, body mass index, and sex distribution. Inclusion and exclusion criteria were applied. Glycemic control indices, lipid profile, Paraoxonase-1, MCP-1, ICAM-1, VCAM 1, and Lp (a) were measured. Results were statistically analyzed. Results: Serum levels of Paraoxonase-1 (↓),MCP-1 (↑), ICAM-1 (↑), VCAM 1 (↑), and Lp (a) (↑) were altered significantly in both diabetic cohorts compared to healthy controls. Also, Paraoxonase-1 (↓↓), MCP-1 (↑↑), ICAM-1 (↑↑), VCAM 1 (↑↑) levels showed significant alteration in T2D patients with CVD compared to those without complication. Additionally, with respect to prediction of CVD risk, results predict that Paraoxonase-1 has higher and better diagnostic accuracy index as indicated by ROC analysis. Conclusion: Paraoxonase-1 is a sensitive biomarker in T2D with anti-atherogenic cardio-protective properties; its circulating levels may be a valuable future tool for early diagnosis and/or assessment of CVD risk associated with T2D.