Jiménez-López Rafael, Romero-Trevejo José Lorenzo, Fernández-Romero Lourdes, Martín-Chaves Laura, Romero-Cuevas Miguel, Molina-Ramos Ana Isabel, Sánchez-Quintero María José, Murri Mora, Costa Francesco, Bodí Vicente, Gutiérrez-Bedmar Mario, Rodríguez-Capitán Jorge, Pavón-Morón Francisco Javier, Jiménez-Navarro Manuel
Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), 29010 Málaga, Spain.
Emergency Department, Virgen de la Victoria University Hospital, Campus de Teatinos s/n, 29010 Málaga, Spain.
J Clin Med. 2024 Aug 20;13(16):4906. doi: 10.3390/jcm13164906.
: Coronary artery disease (CAD) and type-2 diabetes mellitus (T2DM) are characterized by chronic low-grade inflammation. However, measuring cytokines typically involves invasive blood sampling, which can be problematic for CAD patients. This study aimed to assess ophthalmological parameters and tear cytokines in patients with CAD, comparing those with comorbid T2DM to those without to understand their inflammatory profiles. : One hundred subjects with suspected chronic or acute CAD were initially included in this single-center cross-sectional study after clinical stabilization. Seventy-two patients with confirmed CAD were divided into two groups: 32 patients with T2DM and 40 patients without T2DM. A total of 144 eyes were examined, and tear fluid samples were collected to determine cytokine concentrations. Ophthalmological parameters and tear concentrations of cytokines were analyzed, controlling for age, sex, and other cardiovascular risk factors. : Patients with CAD and T2DM exhibited decreased ophthalmological parameters and increased cytokine concentrations in comparison to those without T2DM. Significant inverse correlations between ophthalmological parameters and cytokine concentrations were observed. Following adjustment, a full logistic regression model for distinguishing patients with CAD and comorbid T2DM included macular cube volume, mean macular thickness, interleukin (IL)-4, IL-5, IL-6, IL-8, IL-9, IL-13, granulocyte colony-stimulating factor (G-CSF), CCL3, CCL4, and CCL11/eotaxin-1, demonstrating excellent discriminatory power (Area Under the Curve = 0.95, 95% Confidence Interval = 0.91-0.99; < 0.001). Subsequently, IL-5 (Odds Ratio = 1.68, 95% CI = 1.26-2.24; < 0.001), G-CSF (OR = 1.06, 95% CI = 1.02-1.11; < 0.01), and CCL11/eotaxin-1 (OR = 1.56, 95% CI = 1.19-2.05; = 0.001) emerged as the most distinguishing variables in a reduced model (AUC = 0.89, 95% CI = 0.84-0.95; < 0.001). : Differences in ophthalmological variables, mainly in cytokine concentrations, suggest distinct pathophysiological mechanisms in patients with CAD based on the presence of T2DM. These findings demonstrate that the inflammatory profile can be readily detected through tear sample cytokines, proving valuable for establishing more accurate prognoses and monitoring in cardiometabolic disorders.
冠状动脉疾病（CAD）和2型糖尿病（T2DM）的特征是慢性低度炎症。然而，检测细胞因子通常需要进行侵入性血液采样，这对CAD患者可能存在问题。本研究旨在评估CAD患者的眼科参数和泪液细胞因子，比较合并T2DM的患者与未合并T2DM的患者，以了解他们的炎症特征。
在临床稳定后，100名疑似慢性或急性CAD的受试者最初被纳入这项单中心横断面研究。72名确诊CAD的患者被分为两组：32名合并T2DM的患者和40名未合并T2DM的患者。共检查了144只眼睛，并收集泪液样本以测定细胞因子浓度。分析眼科参数和泪液中细胞因子的浓度，并对年龄、性别和其他心血管危险因素进行控制。
与未合并T2DM的患者相比，合并CAD和T2DM的患者眼科参数降低，细胞因子浓度升高。观察到眼科参数与细胞因子浓度之间存在显著的负相关。调整后，用于区分合并CAD和T2DM患者的完整逻辑回归模型包括黄斑立方体积、平均黄斑厚度、白细胞介素（IL）-4、IL-5、IL-6、IL-8、IL-9、IL-13、粒细胞集落刺激因子（G-CSF）、CCL3、CCL4和CCL11/嗜酸性粒细胞趋化因子-1，显示出优异的辨别能力（曲线下面积=0.95，95%置信区间=0.91-0.99；P<0.001）。随后，在简化模型中，IL-5（优势比=1.68，95%CI=1.26-2.24；P<0.001）、G-CSF（OR=1.06，95%CI=1.02-1.11；P<0.01）和CCL11/嗜酸性粒细胞趋化因子-1（OR=1.56，95%CI=1.19-2.05；P=0.001）成为最具区分性的变量（AUC=0.89，95%CI=0.84-0.95；P<0.001）。
眼科变量的差异，主要是细胞因子浓度的差异，表明基于T2DM的存在，CAD患者存在不同的病理生理机制。这些发现表明，通过泪液样本细胞因子可以很容易地检测到炎症特征，这对于在心脏代谢紊乱中建立更准确的预后和监测具有重要价值。
