Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Republic of Korea.
J Cardiol. 2012 Sep;60(3):204-9. doi: 10.1016/j.jjcc.2012.03.006. Epub 2012 May 31.
Inflammation plays a significant role in acute coronary syndrome (ACS) and type 2 diabetes mellitus (DM). There may be similar inflammatory changes in non-DM patients with ST elevation myocardial infarction (STEMI) and DM patients with stable angina (SA), and DM patients with STEMI may have more severe changes than the former two groups. The objectives of this study were to investigate whether the level of inflammation was similar in patients with non-DM STEMI and DM SA, and to evaluate whether the changes in the level of inflammation were more severe in patients with DM STEMI compared to the other two groups.
A variety of inflammatory markers including: highly sensitive C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), IL-18, vascular cell adhesion molecule-1 (VCAM-1), and matrix metallopeptidase-9 (MMP-9) as well as insulin resistance were compared among the three groups: DM STEMI (90 patients), DM SA (91 patients), and non-DM STEMI (76 patients). Inflammatory marker levels were not significantly different between the DM SA and non-DM STEMI groups. However, hsCRP and IL-6 were increased in the DM STEMI compared to the DM SA patients (p=0.005 and p=0.004, respectively). In addition, hsCRP, ESR, and IL-18 were increased in the DM STEMI compared to the non-DM STEMI patients (p=0.017, p=0.020, and p=0.033, respectively). Furthermore, the fasting insulin and the homeostasis model assessment were significantly increased in the DM STEMI compared to the DM SA patients (p=0.04 and p=0.004, respectively).
DM SA and non-DM STEMI may have similar inflammatory changes. DM STEMI may be a more severe inflammatory condition compared to patients with DM SA or non-DM STEMI.
炎症在急性冠脉综合征（ACS）和 2 型糖尿病（DM）中起着重要作用。非 DM 型 ST 段抬高型心肌梗死（STEMI）患者和 DM 型稳定型心绞痛（SA）患者可能存在类似的炎症变化，而 DM 型 STEMI 患者的炎症变化可能比前两组更为严重。本研究旨在探讨非 DM STEMI 患者与 DM SA 患者的炎症水平是否相似，以及 DM STEMI 患者的炎症水平变化是否比前两组更为严重。
比较了三组患者（DM STEMI 患者 90 例，DM SA 患者 91 例，非 DM STEMI 患者 76 例）的多种炎症标志物，包括：高敏 C 反应蛋白（hsCRP）、红细胞沉降率（ESR）、白细胞介素-6（IL-6）、白细胞介素-18（IL-18）、血管细胞黏附分子-1（VCAM-1）和基质金属蛋白酶-9（MMP-9）以及胰岛素抵抗。DM SA 组和非 DM STEMI 组的炎症标志物水平无显著差异。然而，与 DM SA 患者相比，DM STEMI 患者的 hsCRP 和 IL-6 升高（p=0.005 和 p=0.004）。此外，与非 DM STEMI 患者相比，DM STEMI 患者的 hsCRP、ESR 和 IL-18 升高（p=0.017、p=0.020 和 p=0.033）。此外，与 DM SA 患者相比，DM STEMI 患者的空腹胰岛素和稳态模型评估显著升高（p=0.04 和 p=0.004）。
DM SA 和非 DM STEMI 可能具有相似的炎症变化。与 DM SA 患者或非 DM STEMI 患者相比，DM STEMI 可能是一种更为严重的炎症状态。
