Center for Clinical Heart Research, Oslo University Hospital, Ullevål, Oslo, Norway.
Cardiovasc Diabetol. 2010 Sep 2;9:47. doi: 10.1186/1475-2840-9-47.
Inflammation plays an important role in the pathophysiology of both atherosclerosis and type 2 diabetes and some inflammatory markers may also predict the risk of developing type 2 diabetes. The aims of the present study were to assess a potential association between circulating levels of inflammatory markers and hyperglycaemia measured during an acute ST-elevation myocardial infarction (STEMI) in patients without known diabetes, and to determine whether circulating levels of inflammatory markers measured early after an acute STEMI, were associated with the presence of abnormal glucose regulation classified by an oral glucose tolerance test (OGTT) at three-month follow-up in the same cohort.
Inflammatory markers were measured in fasting blood samples from 201 stable patients at a median time of 16.5 hours after a primary percutaneous coronary intervention (PCI). Three months later the patients performed a standardised OGTT. The term abnormal glucose regulation was defined as the sum of the three pathological glucose categories classified according to the WHO criteria (patients with abnormal glucose regulation, n = 50).
No association was found between inflammatory markers and hyperglycaemia measured during the acute STEMI. However, the levels of C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) measured in-hospital were higher in patients classified three months later as having abnormal compared to normal glucose regulation (p = 0.031 and p = 0.016, respectively). High levels of CRP (≥ 75 percentiles (33.13 mg/L)) and MCP-1 (≥ 25 percentiles (190 ug/mL)) were associated with abnormal glucose regulation with an adjusted OR of 3.2 (95% CI 1.5, 6.8) and 7.6 (95% CI 1.7, 34.2), respectively.
Elevated levels of CRP and MCP-1 measured in patients early after an acute STEMI were associated with abnormal glucose regulation classified by an OGTT at three-month follow-up. No significant associations were observed between inflammatory markers and hyperglycaemia measured during the acute STEMI.
炎症在动脉粥样硬化和 2 型糖尿病的病理生理学中起着重要作用，一些炎症标志物也可能预测 2 型糖尿病的发病风险。本研究的目的是评估炎症标志物的循环水平与无已知糖尿病的急性 ST 段抬高型心肌梗死（STEMI）患者在急性期的高血糖之间的潜在相关性，并确定在急性 STEMI 后早期测量的炎症标志物的循环水平是否与在同一队列中 3 个月随访时的口服葡萄糖耐量试验（OGTT）异常葡萄糖调节有关。
在初次经皮冠状动脉介入治疗（PCI）后中位数为 16.5 小时，从 201 例稳定患者的空腹血样中测量炎症标志物。三个月后，患者进行了标准的 OGTT。异常葡萄糖调节的定义为根据世界卫生组织（WHO）标准分类的三种病理血糖类别之和（异常葡萄糖调节患者，n = 50）。
在急性 STEMI 期间测量的炎症标志物与高血糖之间没有关联。然而，在住院期间测量的 C 反应蛋白（CRP）和单核细胞趋化蛋白-1（MCP-1）水平在三个月后分类为异常葡萄糖调节的患者中较高（p = 0.031 和 p = 0.016，分别）。高水平的 CRP（≥75%分位数（33.13mg/L））和 MCP-1（≥25%分位数（190ug/mL））与异常葡萄糖调节相关，调整后的 OR 分别为 3.2（95%CI 1.5，6.8）和 7.6（95%CI 1.7，34.2）。
在急性 STEMI 后早期测量的 CRP 和 MCP-1 水平升高与 3 个月随访时 OGTT 分类的异常葡萄糖调节有关。在急性 STEMI 期间测量的炎症标志物与高血糖之间未观察到显著相关性。
