糖尿病和非糖尿病冠状动脉疾病患者中Nε-羧甲基赖氨酸与炎症标志物的比较分析

Comparative analysis of Nε-carboxymethyl-lysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients.

作者信息

Shrivastav Dharmsheel, Singh Desh Deepak, Mir Rashid, Mehra Pratishtha, Mehta Vimal, Dabla Pradeep Kumar

机构信息

Amity Institute of Biotechnology, Amity University, Jaipur 303002, Rajasthan, India.

Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Delhi 110002, India.

出版信息

World J Diabetes. 2023 Dec 15;14(12):1754-1765. doi: 10.4239/wjd.v14.i12.1754.

DOI:10.4239/wjd.v14.i12.1754

PMID:38222780

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10784802/

Abstract

BACKGROUND

Coronary artery disease (CAD) is a major cause of death worldwide, and India contributes to about one-fifth of total CAD deaths. The development of CAD has been linked to the accumulation of Nε-carboxymethyl-lysine (CML) in heart muscle, which correlates with fibrosis.

AIM

To assess the impact of CML and inflammatory markers on the biochemical and cardiovascular characteristics of CAD patients with and without diabetes.

METHODS

We enrolled 200 consecutive CAD patients who were undergoing coronary angiography and categorized them into two groups based on their serum glycosylated hemoglobin (HbA1c) levels (group I: HbA1c ≥ 6.5; group II: HbA1c < 6.5). We analyzed the levels of lipoproteins, plasma HbA1c levels, CML, interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), and nitric oxide.

RESULTS

Group I (81 males and 19 females) patients had a mean age of 54.2 ± 10.2 years, with a mean diabetes duration of 4.9 ± 2.2 years. Group II (89 males and 11 females) patients had a mean age of 53.2 ± 10.3 years. Group I had more severe CAD, with a higher percentage of patients with single vessel disease and greater stenosis severity in the left anterior descending coronary artery compared to group II. Group I also exhibited a larger left atrium diameter. Group I patients exhibited significantly higher levels of CML, TNF-α, and IL-6 and lower levels of nitric oxide as compared with group II patients. Additionally, CML showed a significant positive correlation with IL-6 ( = 0.596, = 0.001) and TNF-α ( = 0.337, = 0.001) and a negative correlation with nitric oxide (=-4.16, = 0.001). Odds ratio analysis revealed that patients with CML in the third quartile (264.43-364.31 ng/mL) were significantly associated with diabetic CAD at unadjusted and adjusted levels with covariates.

CONCLUSION

CML and inflammatory markers may play a significant role in the development of CAD, particularly in diabetic individuals, and may serve as potential biomarkers for the prediction of CAD in both diabetic and non-diabetic patients.

摘要

背景

冠状动脉疾病（CAD）是全球主要的死亡原因，印度约占CAD总死亡人数的五分之一。CAD的发展与心肌中Nε-羧甲基赖氨酸（CML）的积累有关，而CML与纤维化相关。

目的

评估CML和炎症标志物对有糖尿病和无糖尿病的CAD患者生化及心血管特征的影响。

方法

我们纳入了200例连续接受冠状动脉造影的CAD患者，并根据其血清糖化血红蛋白（HbA1c）水平将他们分为两组（I组：HbA1c≥6.5；II组：HbA1c<6.5）。我们分析了脂蛋白水平、血浆HbA1c水平、CML、白细胞介素-6（IL-6）、肿瘤坏死因子α（TNF-α）和一氧化氮水平。

结果

I组（81例男性和19例女性）患者的平均年龄为54.2±10.2岁，平均糖尿病病程为4.9±2.2年。II组（89例男性和11例女性）患者的平均年龄为53.2±10.3岁。与II组相比，I组的CAD更严重，单支血管疾病患者的比例更高，左前降支冠状动脉狭窄程度更严重。I组还表现出更大的左心房直径。与II组患者相比，I组患者的CML、TNF-α和IL-6水平显著更高，一氧化氮水平更低。此外，CML与IL-6（r = 0.596，P = 0.001）和TNF-α（r = 0.337，P = 0.001）呈显著正相关，与一氧化氮呈负相关（r=-4.16，P = 0.001）。比值比分析显示，处于第三四分位数（264.43 - 364.31 ng/mL）的CML患者在未调整和调整协变量水平下均与糖尿病性CAD显著相关。