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

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM World Journal of Diabetes Pub Date : 2023-12-15 DOI:10.4239/wjd.v14.i12.1754

D. Shrivastav, Desh Deepak Singh, Rashid Mir, Pratishtha Mehra, Vimal Mehta, P. Dabla

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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 (r = 0.596, P = 0.001) and TNF-α (r = 0.337, P = 0.001) and a negative correlation with nitric oxide (r =-4.16, P = 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.

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糖尿病和非糖尿病冠心病患者体内 Nε-羧甲基赖氨酸和炎症指标的比较分析

背景冠状动脉疾病（CAD）是全球死亡的主要原因之一，印度约占冠状动脉疾病死亡总人数的五分之一。冠状动脉粥样硬化症（CAD）的发生与心肌中 Nε-羧甲基赖氨酸（CML）的积累有关，CML 与心肌纤维化相关。目的评估 CML 和炎症标记物对伴有或不伴有糖尿病的 CAD 患者的生化和心血管特征的影响。方法我们连续招募了 200 名接受冠状动脉造影术的 CAD 患者，并根据他们的血清糖化血红蛋白（HbA1c）水平将其分为两组（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。结果第一组（81 名男性和 19 名女性）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。第二组（89 名男性和 11 名女性）患者的平均年龄为（53.2 ± 10.3）岁。与第二组相比，第一组患者的冠状动脉粥样硬化更严重，单支血管病变的患者比例更高，左前降支冠状动脉的狭窄程度也更严重。I 组患者的左心房直径也更大。与 II 组患者相比，I 组患者的 CML、TNF-α 和 IL-6 水平明显较高，一氧化氮水平较低。此外，CML 与 IL-6 呈显著正相关（r = 0.596，P = 0.001），与 TNF-α 呈显著正相关（r = 0.337，P = 0.001），与一氧化氮呈显著负相关（r =-4.16，P = 0.001）。比值比分析表明，CML 在第三四分位数（264.43-364.31 ng/mL）的患者与糖尿病性 CAD 显著相关，这是未调整和调整后的协变量水平。结论 CML 和炎症标志物可能在 CAD 的发展过程中发挥重要作用，尤其是在糖尿病患者中，并可作为预测糖尿病和非糖尿病患者 CAD 的潜在生物标志物。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.