The public discussion took place for the master’s student (Istabraq Ahmed Shahab) Department of Chemistry - University of Anbar on Tuesday 3/9/2024 in Jaber bin Hayyan Hall. for his tagged thesis

 " Study the Relationship between Adipokine, Sublating and Netrin-1 Among Patients with Type II Diabetes Mellitus and Acute Coronary Syndrome in Al-Anbar Governorate"

The discussion committee consisted of:

 Acute coronary syndrome (ACS) encompasses three diseases that are associated with atherosclerosis in the coronary arteries: unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI), and ST-elevation myocardial infarction (STEMI). Type 2 diabetes (T2DM) exacerbates the progression of atherosclerosis and is associated with increased risk of developing ACS. Approximately 25–30% of patients admitted for ACS have T2DM. Human resisting is an adipokine, which has been suggested to be an inflammatory marker, with possible links to atherosclerosis and coronary heart disease. Subfatin, also known as Meteorin-like protein (Metrnl), is a recently discovered adipokine that benefits glucose homeostasis with anti-inflammatory properties. Netrin-1 is a recently discovered diagnostic biomarker that indicates atherosclerosis, angiogenesis, and ischemia-reperfusion damage. The main goal of this study is to determine serum levels of resisting, subfatin, netrin-1, and some biochemical variables in ACS Patients with and without T2DM. Then, study the correlation of resisting, subfatin, and netrin-1 with each other and with several other vital variables.

This study included 60 ACS patients admitted to Al-Ramadi Teaching Hospital (Al-Anbar, Iraq), from November 2023 to February 2024. The participants were categorized into two groups: 30 patients with both ACS and T2DM and 30 patients with ACS but without T2DM. The control group comprised 30 healthy individuals who matched the patient groups regarding sex and age. Levels of resisting, subfatin, netrin-1, lipids, fasting blood glucose (FBG), Hemoglobin A1c (HbA1c), C-reactive protein (CRP), troponin I, Creatine kinase-MB (CK-MB), urea, creatinine, uric acid, and electrolytes were estimated for each participant.

The results showed a significant increase in the levels of resisting, netrin-1, Troponin I, CK-MB, CRP, Triglyceride (TG), Very low-density lipoprotein cholesterol (VLDL), urea, creatinine, and calcium in ACS with T2DM or ACS without T2DM patients compared to healthy control, while the results showed a significant decrease in the levels of subfatin in both groups of patients compared to the control. The ACS with T2DM group had significantly higher levels of FBG, HbA1c, TG, CK-MB, and VLDL than the ACS without T2DM group.

A significant positive correlation was found between resisting and subfatin in the ACS without T2DM. It also showed a significant positive correlation between resisting and CRP in both the ACS with T2DM and the ACS without T2DM. There was a significantly negative correlation between subfatin in ACS without T2DM, and each of T.C, LDL. Also, there was a significant positive correlation between Netrin-1 and BMI in the ACS with T2DM and a significant positive correlation between Netrin-1 and Troponin I in the ACS without T2DM.

In conclusion, serum levels of resisting, subfatin, and netrin-1 may be used as indicators for predicting and diagnosing ACS in patients with and without T2DM.