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Abstract : Peripheral arterial disease (PAD) is a progressive disorder characterized by stenosis and/or occlusion of large and medium-sized arteries. Systemic atherosclerosis remains the number one cause of morbidity and mortality in the western world and is the major cause of peripheral arterial disease (PAD), causing obstructions in blood flow in one or more of the major limb arteries. A case-control study was performed on 30 Intermittent and 30 Critical patients and 60 healthy controls during the period from February to May 2022.Focus on the estimation of ankle brachial index and lipid profile. detecting serum concentration of NGAL by using sandwich ELISA. The results of the statistical analysis showed a significant difference (P ≤ 0.01) between Intermittent & Critical patients groups and control group. The data showed an increase in NGAL levels in patients groups (intermittent& critical) compared with a control group where a significant difference (p<0.001), Observed the highest level in the intermittent PAD group (4.27±1.06 ng /ml), and the lowest value of NGAL was recorded in the control group (0.63±0.08 ng/mL). This study found that the highest value of the ankle-brachial index (ABI) was recorded control group (1.08±0.23) in the was highly significant with different groups. On the other hand, results showed that the highest level of TC, and TG in the critical group (276.65±78.13 mg/dL,225.34±62.96mg/dL, respectively), while the lowest level in the control group (207.39±74.97 mg/dL, 144.07±57.64mg/dL). The present data suggest a role for NGAL in the diagnosis as a biomarker for early detection of and prognostic factor in patients with peripheral arterial disease.