Зміни показників енергетичного та ліпідного обміну в пацієнтів на гострий інфаркт міокарда та цукровий діабет 2 типу

Abstract

The purpose of the study was to examine the indicators of lipid and energy metabolism in patients with acute myocardial infarction in the presence or absence of type 2 diabetes mellitus. Materials and methods. A total of 134 patients with acute ST-segment elevation myocardial infarction in the presence or absence of type 2 diabetes mellitus aged 58.97 ± 7.92 years were examined on the basis of the Intensive Care Department at the Government Institution “L. T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine” and the Kharkiv Railway Clinical Hospital No. 1 of the branch “Center of Healthcare” of Public Joint Stock Company “Ukrainian Railway”. Group 1 consisted of 74 patients with acute myocardial infarction and type 2 diabetes mellitus aged 59.42 ± 7.66 years. Group 2 (comparison group) included 60 patients with acute myocardial infarction without type 2 diabetes mellitus aged 58.42 ± 8.25 years. The control group comprised of 20 healthy individuals. All the patients of groups 1 and 2 underwent percutaneous coronary intervention. The study was conducted from September 1, 2018 to December 31, 2020. Serum concentration of adropin and irisin in patients was determined by enzyme-linked immunosorbent assay. Total cholesterol and high-density lipoprotein cholesterol in serum were measured by peroxidase enzymatic method. Triglyceride levels were analyzed by enzymatic colorimetric method. The atherogenic index was calculated by A. M. Klimov formula. Very low-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels were estimated by the Friedewald formula. Results and discussion. Group 1 patients were found to have higher serum triglyceride levels compared with group 2 patients (p<0.05). In groups 1 and 2, total cholesterol and low-density lipoprotein cholesterol levels presented an upward tendency (p˃0.05), and very low-density lipoprotein cholesterol levels were significantly by 4.04 and 2.92 times increased, respectively, as compared to the control group (p<0.05). The serum adropin levels were significantly lower in patients with acute myocardial infarction and type 2 diabetes mellitus in comparison to those in patients with acute myocardial infarction without type 2 diabetes mellitus (p<0.05). There was a significant decrease in the concentrations of adropin and irisin in both groups compared with the control group (p<0.05). Conclusion. Characteristics of changes in adropin and irisin levels suggest an energy homeostasis imbalance in acute myocardial infarction in the presence or absence of type 2 diabetes mellitus that may significantly increase the risk of cardiovascular complications of acute myocardial infarction in this category of patients. The relationship between adropin, irisin and lipid profile may indicate the influence of these markers on lipid metabolism