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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Glycaemic Control and Inflammatory Mediators in Diabetic Patients with Coronary Artery Disease
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Glycaemic Control and Inflammatory Mediators in Diabetic Patients with Coronary Artery Disease

机译：糖尿病冠状动脉疾病患者的血糖控制和炎症介质

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Glycaemic control in diabetic patients is directly related to the severity of Coronary Artery Disease (CAD) and increased morbidity and mortality rates. Inflammation plays an important role in the pathogenesis of disease and inflammatory markers such as High sensitive C-Reactive Protein (hsCRP), and inflammatory cytokines such as Interleukin-6 (IL-6), and Tumour Necrosis Factor-alpha (TNF-α) have been found to be implicated in the initiation and progression of CAD. Literature suggests that inflammation is a key feature for atherogenesis in Type 2 Diabetes Mellitus (T2DM). Aim: To compare the severity of CAD and assess the level of glycaemic control and inflammatory mediators in CAD patients with and without T2DM. Materials and Methods: The present prospective study was conducted on 80 angiographically diagnosed CAD patients (aged >30 years) with (40) and without (40) T2DM. The metabolic risk factors including levels of blood sugar fasting and post prandial were assessed by Glucose Oxidase Peroxidase (GOD-POD) method, and glycated haemoglobin (HbA1c) level by ??Nycocard?? reader. Serum Total Cholesterol (TC) was estimated by CHOD-POD method, Triglyceride (TG) by GPO-PAP method, and High density lipoprotein-cholesterol (HDL-C) by Immuno-inhibition method. Low-density lipoprotein cholesterol (LDL-C) and Very low-density lipoprotein (VLDL-C) was calculated by Friedewald formula. Serum insulin, hsCRP, IL-6, TNF-α levels was assessed by sandwich Enzyme linked Immunosorbent Assay (ELISA), and Homeostasis Model was used for assessment of insulin Resistance (HOMA-IR). Chi-square test, Independent t-test and ANOVA were used for statistical analysis, and p-value <0.05 considered as significant. Results: The level of hsCRP, IL-6, TNF-α, and HbA1c was significantly increased due to cytokines released by monocytes/macrophages mediated β-cell damaging process. Diabetic patients with poor glycaemic control, i.e., HbA1c >8.5%, had higher incidence of triple/multivessel disease suggesting involvement of higher number of coronary vessels with higher severity of the stenosis. Among lipid profile, significantly raised TG and LDL-C levels (p<0.005) and significantly decreased HDL-C in CAD patients with T2DM and its severity (p<0.005) was observed. Significantly elevated inflammatory markers, hsCRP, IL-6 and TNF-α were found to be association with severity of CAD. Conclusion: Combinatorial analysis of glycaemic control (HbA1c) and serum cytokines (IL-6, TNF-α, and hsCRP) with clinical risk factors (Triglyceride and LDL-C) may contribute to the assessment of the severity of CAD, and thereby help in the risk stratification of T2DM and CAD.
机译：糖尿病患者的血糖控制与冠状动脉疾病（CAD）的严重程度以及发病率和死亡率的增加直接相关。炎症在疾病和炎症标志物（例如高敏C反应蛋白（hsCRP））和炎症细胞因子（例如白介素6（IL-6）和肿瘤坏死因子-α（TNF-α））的发病机理中起重要作用。已发现与CAD的发生和发展有关。文献表明炎症是2型糖尿病（T2DM）动脉粥样硬化形成的关键特征。 目的：比较有和没有T2DM的CAD患者的CAD严重程度并评估其血糖控制和炎症介质的水平。 材料与方法：本前瞻性研究是对80例经血管造影诊断的CAD患者（年龄> 30岁）患有（40）和不患有（40）T2DM进行的。用葡萄糖氧化酶过氧化物酶（GOD-POD）方法评估血糖空腹和餐后的代谢危险因素，用“ Nycocard”方法评估糖化血红蛋白（HbA1c）水平。读者。血清总胆固醇（TC）通过CHOD-POD方法估算，甘油三酸酯（TG）通过GPO-PAP方法估算，高密度脂蛋白胆固醇（HDL-C）通过免疫抑制方法估算。通过弗里德瓦尔德公式计算低密度脂蛋白胆固醇（LDL-C）和极低密度脂蛋白（VLDL-C）。通过夹心酶联免疫吸附测定（ELISA）评估血清胰岛素，hsCRP，IL-6，TNF-α水平，并使用稳态模型评估胰岛素抵抗（HOMA-IR）。卡方检验，独立t检验和方差分析用于统计学分析，p值<0.05被认为是显着的。 结果：由于单核细胞/巨噬细胞介导的β细胞破坏过程释放的细胞因子，hsCRP，IL-6，TNF-α和HbA1c的水平显着增加。血糖控制不佳的糖尿病患者，即HbA1c> 8.5％，三重/多支血管疾病的发生率更高，提示参与的冠状血管数量更多，狭窄程度更高。在脂质谱中，在患有T2DM的CAD患者中，TG和LDL-C水平显着升高（p <0.005），HDL-C显着降低，并且其严重程度也显着（p <0.005）。发现炎症标志物，hsCRP，IL-6和TNF-α明显升高与CAD的严重程度有关。 结论：血糖控制（HbA1c）和血清细胞因子（IL-6，TNF-α和hsCRP）与临床危险因素（甘油三酸酯和LDL-C）的组合分析可能有助于评估CAD的严重程度，从而有助于T2DM和CAD的风险分层。

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