Features of changes in insulin-like growth factor-1 in patients with coronary heart disease in combination with type 2 diabetes mellitus

Abstract

The purpose of the study was to study the level of insulin-like growth factor-1 in the blood of patients with coronary heart disease with type 2 diabetes mellitus, in patients with coronary heart disease without type 2 diabetes mellitus and in almost healthy individuals. Materials and methods. We examined 73 patients (30 men, 43 women) with coronary heart disease aged 49 to 75 years (mean age –58.3 ± 1.8). All patients were treated in the therapeutic department of the prof. А. А. Shalimov Kharkiv Municipal Clinical Hospital No. 2. Examination of patients was performed using clinical, laboratory and instrumental methods. All patients had ischemic heart disease in the form of stable angina pectoris of I – II functional classes, I functional class was diagnosed in 27 patients, II – in 46 patients. From the group of examined patients in 36 patients the disease was accompanied by concomitant type 2 diabetes mellitus (group 1). Mild diabetes was detected in 15 people, moderate – in 21 patients. 37 patients did not have diabetes mellitus (group 2). Diagnosis of diabetes was based on the criteria of the World Diabetes Federation. The control group consisted of 20 people of the same age, who according to the results of clinical and additional studies were found to be practically healthy. Determination of insulin-like growth factor-1 and insulin levels in the blood was performed by enzyme-linked immunosorbent assay on a «Humareader photometer-analyzer». DRG kits (USA) were used to study the level of insulin-like growth factor-1. Results and discussion. It was found that patients with coronary heart disease with concomitant type 2 diabetes had higher levels in serum triglycerides (p <0.05) and very low density lipoprotein cholesterol (p <0.05) compared with patients with coronary heart disease without diabetes. Patients with coronary heart disease and concomitant type 2 diabetes showed a statistically significant increase in blood insulin levels compared with patients with coronary heart disease without diabetes. The results of the analysis of insulin-like growth factor-1 showed that the content of insulin-like growth factor-1 in the blood of patients with coronary heart disease and type 2 diabetes was probably lower compared with patients with coronary heart disease without diabetes and with practically healthy individuals (p <0.01). At the same time, the levels of insulin-like growth factor-1 in almost healthy individuals and patients with coronary heart disease without type 2 diabetes did not differ significantly. Conclusion. In patients with coronary heart disease with type 2 diabetes the level of insulin-like growth factor-1 is probably lower than in patients with coronary heart disease without diabetes and almost healthy individuals. Given the antiapoptotic, antiatherosclerotic, anabolic properties of this growth factor, it can be argued that the development of relative insulin-like growth factor-1 deficiency in the combination of coronary heart disease with type 2 diabetes causes a significant increase in the risk of cardiovascular complications in this category of patients