Evaluating The Activity Of Paraoxonase 1 In Myocardial Infarction

Section: Original Articles
Issue
Vol. 9 No. 1 (2021): Volume 9 Issue 1
Published
Jan 1, 2021
Pages
46-57

Abstract

Background and objective: Little is known about paraoxonase1 (PON1) activity and its relation to Coronary Artery Disease (CAD). This study aimed to assess the association of serum PON1 activity with myocardial infarction and to found out its possible relationship with serum High density lipoprotein (HDL-C) in patients with MI. This study had also examined age, gender, lipid profile and evaluate of PON1 activity by changing the parameters as a risk factor. Methods: This case-control study was carried out at the College of Medicine-Hawler Medical University, from 18th February 2019 to 18th September 2020. Blood specimens were obtained from MI patients in Hawler Cardiac center. A total number of 176 participants were enrolled in this study grouped into 120 patients with MI (36 females and 84 males) diagnosed by consultants and 56 subjects healthy controls (30 females and 26 males). Measurements of serum (PON1, Troponin and lipid profile) were determined in both MI patients and control group. Statistically SPSS version package 20 is used. Results: The results revealed significant decrease in serum PON1 activity in patients with MI (3.070.18 ng/ml) comparing with controls serum PON1 activity (4.790.27 ng/ml) (P<0.01). The levels of serum Total cholesterol, Triglycerides, LDL-C and Troponin in patients with MI were significantly higher (P<0.01) when compared to controls. According to gender it was 36(30%) in females, in males 84(70%). Conclusion: The study concluded that patients with MI had low serum PON1 activity.

References

  1. .
  2. According to a meta-analysis, PON1 polymorphisms which are highly active in lipid peroxide hydrolysis are associated with decreased CHD risk. This likely underestimates the real contribution of PON1 in CHD, since these polymorphisms accounts for a small portion of the PON1 activity variations. However, they are important due to the fact that genetic influences are not confounded by other factors connected to both the CHD and diminished PON1 activity
  3. .
  4. Atherosclerotic CAD contains a wide range of clinical entities including asymptomatic subclinical atherosclerosis along with its clinical complications, such as myocardial infarction (MI), angina pectoris, and sudden cardiac death. CAD is the major cause of mortality among industrialized societies. The heterogeneity of clinical CAD in one hand, and the underlying multi-decade complex pathophysiological processes with genetic and environmental interactions, in the other hand, makes it difficult and costly to understand the genetic architecture of CAD and MI
  5. .
  6. Coronary Artery Disease (CAD) is the main cause of morbidity and mortality all over the world. Serum paraoxonase which has antiatherogenic features is a lipoprotein (HDL)-bound enzyme with high density. Oxidative stress contributes a major role in atherosclerotic process
  7. .
  8. Free radicals of oxygen have been increasingly used to describe injuries in ischemic heart. The relation of high serum uric acid concentration with raised cardiovascular risk have been identified, nevertheless its effect on acute myocardial infarction (MI) remains unclear. Some recent study attempted to find the role of zinc in oxidative stress and tissue injuries. Increased oxidative stress is associated with glutathione peroxidase, superoxide dismutase levels, raised MDA and decreased zinc. Thus, MI changes according to oxidative stress, irrespective of gender
  9. .
  10. In addition, the female participants had higher mean age and BMI than the men. Similar results were reported by Yang et al who showed that the females were older than the males, which indicates healthy life pattern and the rather normal coronary artery in females than in males of the same age
  11. .
  12. The findings of the present study showed that serum cholesterol level in MI groups was higher in comparison with the control group, which indicates that the occurrence of myocardial infarction is highly associated with the mean concentration of cholesterol. This result was in agreement with those of the study conducted by Guerin et al who referred to serum cholesterol as an independent risk factor for acute myocardial infarction. They stated that this association is linear, with no threshold level
  13. .
  14. The mean value for TG in MI patients was higher than the control group. Similarly, the results of the study by Soeiro Ade et al revealed that the risk of major cardiovascular events significantly increased in patients with a TG level 170 mg/dl
  15. .
  16. The paraoxonase (PON) 1 located on the high-density lipoprotein (HDL) is the main cause of its antioxidant activity. Moreover, trial studies have shown the protecting potential of PON1 against atherogenesis. The HDL has longer effects on reduction of low-density lipoprotein (LDL) lipid peroxidation compared to antioxidant vitamins, thus, could be more protective. Recently, a number of important progresses have occurred in the context of PON research
  17. .
  18. The present study indicated that the serum PON1 level in MI group was lower in comparison with the control group. In this regard, the results by Skmen et al showed that PON1 concentration and activity are lower in subjects with significant coronary artery disease. They also indicated that PON1 concentration and activity are significantly associated with coronary artery disease assessed by quantitative coronary angiography
  19. .
  20. When there is no insulin, regular physical activity facilitates the glucose entrance into the cell through influencing several signaling pathways. Also, regular exercise results in improvement of lipid profile and increased PON-1 activity. The interaction of PON-1 with High-density lipoprotein (HDL) in the presence of calcium results in prohibition of low-density lipoprotein (LDL) oxidation, hydrolyzation of free radicals, inhibition of hemoglobin glycation and maintenance of homocysteine structure in the blood. Additionally, decreased PON-1 activity is positively related to the risk of cardiovascular diseases, dyslipidemia, gastric cancer, renal failure, insulin resistance, and Alzheimers disease
  21. . Based on its key function in lipoprotein catabolism pathways, human paraoxonase 1 (PON1), which is a calcium-dependent lipoprotein with high-density associated with ester hydrolase, has been increasingly regarded as an effective factor in coronary heart disease (CHD)
  22. . Decreased hospitalization due to MI and patient ages shows improvement in treating coronary artery disease during this period. On the contrary, Yeh et al indicated that the age of MI was similar within the 10-year period
  23. . For example, our understanding of basic biochemical function of PON1 and the possible modulators of its activity has considerably improved. Low activity of serum PON1 is clearly associated with coronary heart disease (CHD). However, the evaluation of the relationships between low serum PON1 and CHD has shown that the activity of low serum PON1 activity could be an autonomous predictor of new CHD cases
  24. . However, an increased cardiac Troponin I alone will never cause a clinical diagnosis, although this fact cannot be ignored that cardiac Troponin I measurements have been a precious step forward in identifying high-risk patients with acute coronary syndromes
  25. . In addition, there is a multiplicative relation between cholesterol and other major risk factors on the relative risk of myocardial infarction. Furthermore, inflammation, insulin resistance, and high serum cholesterol levels are associated with decreased serum paraoxonase 1 activity
  26. . It is essential to diagnose acute MI quickly because improved long-term outcomes of heart function can be obtained if the time between symptom onset and reperfusion therapy is appropriately short
  27. . Moreover, in their study, Ibanez et al showed that PON1 polymorphisms are independent risk factors for MI patients
  28. . This supports the idea that PON1 associated with HDL-C.
  29. In the present study, the analysis of serum Troponin I in myocardial infarction patients was found to be significantly higher in comparison with the control group. In line with the results of the present study, Park et al indicated that elevated serum concentrations of cardiac Troponin I causes myocardial damage; however, this is not necessarily equals to myocardial infarction. As they reported, it remains for the clinician to distinguish whether an increased cardiac Troponin I concentration is the result of coronary plaque rupture/occlusion or whether it has another cause
  30. B. Sc. CHEMISTRY/SALAHADDIN UNIVERSITY
  31. B.Sc. M.Sc., PH.D. CLINICAL BIOCHEMISTRY
  32. Evaluating The Activity Of Paraoxonase 1 In Myocardial Infarction
  33. DOI:10.33899/mjn.2021.168081 2020, College of Nursing, University of Mosul.
  34. Creative Commons Attribution 4.0 International License https://mjn.mosuljournals.com/article_168081.html
  35. SHELAN ISMAEL SABER
  36. LEWEZA B. ABBAS

Authors

SHELAN ISMAEL SABER

B. Sc. CHEMISTRY/SALAHADDIN UNIVERSITY

leweza belal abbas

B.Sc. M.Sc., PH.D. CLINICAL BIOCHEMISTRY

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