Relationship between Biomarkers of Carbohydrate, Energy and Adipokine Metabolism in Patients with Acute Myocardial Infarction and Type 2 Diabetes Mellitus

Abstract

The purpose of the study was to examine the indicators of carbohydrate, energy and adipokine metabolism in acute myocardial infarction patients with or without type 2 diabetes mellitus. Materials and methods. A total of 134 patients with ST-segment elevation acute myocardial infarction in the presence or absence of type 2 diabetes mellitus aged 58.97 ± 7.92 years were examined in the Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” and Kharkiv Railway Clinical Hospital No. 1 of the “Center of Healthcare” branch of Public Joint Stock Company “Ukrainian Railway”. The main group (group 1) included 74 patients with acute myocardial infarction and type 2 diabetes mellitus. The comparison group (group 2) was represented by 60 patients with acute myocardial infarction without type 2 diabetes mellitus. The control group was composed of 20 otherwise healthy individuals. Serum concentrations of insulin, adropin, irisin, fatty acid binding protein 4 and C1q/TNF-related protein were measured by enzyme-linked immunosorbent assays. Results and discussion. It was found that the levels of glucose, insulin, HOMA-IR index were increased in acute myocardial infarction patients with or without type 2 diabetes mellitus when compared with the control group (p˂0.05). In acute myocardial infarction patients with type 2 diabetes mellitus, the serum levels of adropin, irisin and C1q/TNF-related protein were significantly lower, while the fatty acid binding protein 4 levels were higher as compared to those in the control group (p<0.05). Acute myocardial infarction patients with type 2 diabetes mellitus demonstrated significantly lower serum concentrations of adropin and C1q/TNF-related protein in comparison with acute myocardial infarction patients without type 2 diabetes mellitus (p<0.05). Negative correlations between blood glucose and adropin (r = -0.499, p<0.001), irisin (r = -0.495, p<0.001), fatty acid binding protein 4 (r = -0.518, p<0.001), between HOMA-IR and adropin (r = -0.304, p<0.02), fatty acid binding protein 4 (r = -0.429, p = 0.001), as well as positive correlations between blood glucose levels and C1q/TNF-related protein (r = 0.435, p = 0.001) were revealed in acute myocardial infarction patients. In acute myocardial infarction patients with type 2 diabetes mellitus, negative correlations were found between blood glucose and adropin (r = -0.504, p<0.001), irisin (r = -0.520, p = 0.03), C1q/TNF-related protein (r = -0.546, p<0.001); between blood insulin and adropin (r = -0.361, p = 0.017), irisin (r = -0.396, p = 0.01), C1q/TNF-related protein (r = -0.361, p = 0.018); between adropin and HOMA-IR (r = -0.508, p = 0.001), C1q/TNF-related protein (r = -0.436, p = 0.003), as well as positive correlation between blood glucose and fatty acid binding protein 4 (r = 0.508, p = 0.007); between blood insulin and fatty acid binding protein 4 (r = 0.501, p = 0.001); between HOMA-IR and fatty acid binding protein 4 (r = 0.516, p<0.001). Conclusion. Characteristics of adropin, irisin, fatty acid binding protein 4 and C1q/TNF-related protein serum levels are evidence of violated energy and adipokine metabolism in both diabetic and non-diabetic patients with acute myocardial infarction. Relationships between adropin, irisin, fatty acid binding protein 4 and C1q/TNF-related protein could indicate involvement of these markers in carbohydrate metabolism